Hey there,

Well I had my first surgeon appointment today. I was super nervous when I was in there, but it went better than expected. In the two weeks since starting the 1200 calorie diet I have lost 12 pounds. I didn't think I had done that and it was great to hear that with that weight loss, I am only 12 pounds away from meeting my goal weight for surgery. YAY ME

Since I have started this journey my mind has always been set on having the gastric sleeve. From my research it is the less evasive of the two. When I met with the dr today, he mentioned that gastric sleeve is good, but the bypass would be better. He also mentioned that if I am not able to lose the weight from the sleeve, we can always convert to the bypass later.

So my question to everyone is, and knowing that I don't want to go through 2 procedures, did anyone get the sleeve and regret not getting the bypass and visa versa?

Your input would be appreciated

Your doctor is recommending the bypass because you have so much extra weight to lose. The bypass is more effective because it limits your intake and the absorption of the food. The sleeve just limits what you can eat. The duodenal switch is a 2 part surgery where you do the sleeve first and then the bypass. This is very effective, but does come with more side effects like gas and diarrhea.

I recommend really researching all 3 and see what you will be most comfortable with. Good luck with your decision and your surgery.

Yes, it's really good to research all of your options. From what I've read the sleeve has the least complications. Two people I know had the sleeve and are very happy with it.

I felt just like you when I started. I also wanted a sleeve. My thought was that I wouldn't be rearranging my guts and I would have less issues with not getting enough nutrients. It seemed better in my mind.

My dr also suggested RNY. He said their data showed more weight loss with RNY (though the sleeve was close behind) and they had seen less weight gain with RNY 2-5 years post op.

After doing a lot of research of my own and still not coming to a clear decision I went ahead with the dr's recommendation. I'm only 10 days post op so I don't really have any advice but I hope you find what you need to make your decision.

I'm sure because of the weight that I need to lose, I would be told the bypass too but I am doing the sleeve. I think it's the one with the least amount of side effects. My pcp is supportive of the sleeve for me but he told my husband he was not supportive of the bypass because of complications.

I think RNY is the more "standard" option for people with such a high starting BMI. RNY patients usually lose weight much more quickly and more weight overall than sleeve patients. I completely understand your concerns about the long-term consequences of having your plumbing rerouted with RNY. That was one of the main reasons I wanted sleeve as well. I guess the question to ask yourself is, are you willing to put in the extra work it's going to take to lose all the weight with the sleeve. Not saying that RNY is "easier" necessarily, but you will have to compensate for the slower loss by doing more work to exercise and stick to the nutrition plan. Another question might be whether you are concerned about losing ALL of your excess weight or would be content just losing a significant portion of it.

Everyone's experience is different, but this calculator might give you a rough idea in the differences between RNY and sleeve in terms of what kind of weight loss you can expect and over what period of time:

https://www.realize.com/do-i-qualify/potential-results/comparison

Edit: I put in your current stats and it looks like with RNY you can expect to lose over 150 pounds in 18 months, whereas with the sleeve, you could expect just over 100 pounds. Again, though, these are just estimates.