Sleeve vs gastric bypass

[neeciehoohoo 4]

I'm trying to decide which would work better for me, gastric bypass or the sleeve. I'm about 5'3 and 251 pounds. I found a weight loss calculator online that said that based on my height and weight I can expect to weigh 172 lbs after gastric sleeve which to me sounds great because it's a lot better than my current weight but it's not where I want to be. The same calculator says that I could expect to weight 152 with gastric bypass which sounds a lot better but the sleeve is safer so I'm kind of stuck between the two ????

[JosieAppleHead 74]

Its really up to you. You can lose more than the calculator indicated because its up to you and what you do in the honeymoon stage and after.

[lauraellen80 854]

I chose the sleeve over the bypass for several reasons:

• The estimated excess weight lost is about 10% more with the bypass. For me, that was about 10 lbs. In the grand scheme of things, not that much difference. And as @@JosieAppleHead said above, those are just averages and estimates.
• An extra 10 lb. loss didn't make up for the fact that I would have malabsorption for the rest of my life. And once I found out that the malabsorption of calories doesn't last forever, but the malabsorption of Vitamins and nutrients does, it definitely did not seem worth it.
• I have a family history of stomach and colon cancers. The idea of having a blind stomach hanging out in there made me nervous because of that.
• At first, I thought the bypass and its dumping syndrome might be a good deterrent for me from eating sweets and stuff. But only about 1/3 of bypass patients have it anyway. Plus, it seemed to be too unpredictable, and I didn't want to worry when I'm out that I was going to inadvertently eat something to trigger dumping, or end up becoming a recluse because I was afraid.
• Constipation can be more of an issue with the bypass--I had terrible problems with an anal fissure a couple years ago and had no intention of going back to that hell.
• Finally, from talking to people who've had surgery, reading, and talking to my surgeon, I came to the conclusion that the sleeve would allow me to live my life the most "normally."

But it's ultimately a very personal decision, and will depend on what you're the most comfortable with and any other health issues you might have. Good luck!

[jane13 2,256]

@@lauraellen80 - I totally agree with, its ultimately a very personal decision.

make the decision for you, its YOUR life.@@JosieAppleHead

[ShrinkingPeach 1,291]

@@lauraellen80, what a great post! It is truly your decision to make but involve your surgeon. They have done tons of these surgeries and can help you with expectations and what would be best for your overall health. I chose the sleeve for all the above listed reasons but I also had the conversation with my surgeon about my options and what he thought. He agreed the sleeve was the way to go.

Good luck and let us know how it goes!

[Djmohr 6,965]

There are so many many posts out there on this topic. Please make sure you do your research and spend time with your doctor discussing your personal health history.

I planned to go with the sleeve and had my heart set on it. When I met with my surgeon we discussed the fact that I suffered from reflux/Gerd. He recommended that I go with RNY instead. I was devastated and actually got a second opinion from my gastroenterologist who told me the same thing.

They both asked me why I was afraid of bypass since it is the gold standard in WLS. I shared my big concern which was malabsorption and of course all the old horrible stories that were out there.

I learned very quickly as I researched the heck out of this topic that if you follow the plan, get your labs drawn like you do regardless of which surgery you have, take your Vitamins which you also have to do regardless of which surgery you have, malabsorption will actually help you.

I also started reading about how many lap bands and sleeves have to be converted to bypass because of reflux. I wanted to go through this surgery only once. Even if you don't suffer from reflux now, both the band and sleeve can actually cause this issue where the bypass cures it.

Only you and your doctor can decide what is right for you, I am only suggesting that you continue to do research like you have clearly already begun. It will be worth it to you in the end.

Good luck on whatever choice you make. Please feel free to reach out.

P.S. Not everyone struggles with dumping syndrome either. If you do the bypass hoping that will control behaviors as some people do you may be disappointed. I would research that as well.

[borg/assimilated 576]

Most of us on this forum researched the various WLS options ad nauseam. When my surgeon realized I had done my homework he asked which surgery I was thinking about, he didn't disagree with my opinion. Do your research, discuss it with your surgeon and you will end up with the WLS that is best for you.

[CowgirlJane 14,259]

I think looking at statistics is very important, but in the end your personal contribution to the effort makes a big difference in results.

I think it is risky to get the sleeve if you already suffer from reflux. That is the #1 serious long term complication from the sleeve. I spent a long time thinking about whether I could live with it since something like 20-30% of people have it long term - sometimes it doesn't even show up until years down the road.

If you don't have any "contradictions" to either surgery, i think really researching lifestyle impacts etc is important. They are both "good" alternatives but have pros and cons.

I am 3.5 years post band to sleeve revision and very happy with my choice.

[4MRB4PHOTO 3,899]

Q) "Sleeve vs gastric bypass".

A) Yes.

I am not being sarcastic. This is a personal choice that needs to be researched heavily (pun intended).

There are many factors involved, the amount of weight a person needs to lose, health conditions (such as GERD, diabetes, etc.), family history of diseases and weighing out the risks.

Continue to research the two surgeries. I had a large 3-ring notebook where I compare the Roux-en-y, VSG & lap band surgeries; I ruled out the lap band surgery early on.

I found studies and published papers from major research hospitals, JAMA, ASMBS and respected surgeons to help me make my decision. After reviewing all of the pros and cons of each surgery, I discussed it with my surgeon. He agreed that for ME with MY medical history, the VSG was the right choice.

I did find that the Roux-en-y procedure was more effective in long term weight loss (2+ years) and the effectiveness on lowering type-2 diabetes and other comorbidities were equal or better and there was a risk of developing GERD with the VSG and 80% of the stomach being removed, but the malabsorption, slightly higher risk of complications, etc., was not worth the additional risk. Also, I liked the body losing most of the Ghrelin hormone with the VSG.

The VSG is a newer procedure than the bypass for weight loss, but the longer term studies are starting to show the differences in excess weight loss may not be as much in the long term as originally thought (even though the percentage wasn't great to begin with).

The surgery type is a personal choice and it should be discussed with your surgeon. Just make sure you are well informed when you discuss this.

Congratulations on your decision to have WLS.

Remember, regardless of the surgery, it is only a tool. It is up to all of us to make sure we use it properly.

Either surgery will be ineffective if we go back to our old ways.

[Rogofulm 2,440]

Those who have already posted made excellent points! All those factors went into my choice as well. Your are a 5'3", 251 female. I started out as a 5'6", 265 male. One point that has not been mentioned... My doc showed research indicating that while the speed of weight loss from fastest to slowest is GB, then VSG, then LB, after time, statistics are showing long-term percentages of weight lost to be fairly equal. A friend of mine had a GB to relieve diabetes more quickly, but my diabetes was under control and I was off all meds within 2-3 weeks from surgery! I was also free of apnea in the same period. Blood pressure took 6 months or more, and cholesterol is getting there. Oh, and the asthma went away too. Like other sleevers, I was concerned about a lifetime of malabsorption from the GB, and liked the idea that the ghrellin factory was cut away in the VSG procedure. I also had some concern about the elasticity of the pouch from the bypass vs. the relative inelasticity of the sleeve.

Of course, as everyone has pointed out, which surgery you choose has to be a discussion between you and your doctor, but IMHO, at 251, you may not need need the more severe procedure unless there are other mitigating factors, like severe GERD, etc. If I had been 351, I might have come to a different conclusion. But I was in a similar boat as you. I followed all the rules for the sleeve and was able to exceed my goal in less than a year. Good luck with your decision, and enjoy your journey to better health!!!

[NikkiDoc 312]

When I first was looking to decide on which surgery my stats were similar to yours. 255 pounds and 5'3". I was looking at band versus sleeve. Bypass seemed too invasive. Dumping syndrome scared me, I trail ride my horse in the woods for hours at a time. Dumping syndrome would not be convenient at all.

I eventually decided on the sleeve. I did the 6 month supervised weight loss for my insurance and was down to 242. I had a 10 day liquid pre-op and was at 230 on the morning of surgery. This morning I was at 184 which is the lowest I have been in 6 years. I feel great. The sleeve was the right decision for me but it may not be for you.

In the end you need to make the decision for you. You know what you are comfortable with, you know what your eating pitfalls were that got you to the weight you are, your surgeon will know your medical history and your family medical history to help you make your choice.

On paper I was not a good candidate for the sleeve since I had GERD. But 3 months after surgery I was off Nexium, 1 week after surgery no longer needed my BP meds.

Take your time making the decision. It is a lifetime decision.