Hi I am new to this. I have recently decided to have weight loss surgery. I have the option of gastric sleeve or lapband. I have alot to consider. I am I person that yo yo diets and even though I am fully dedicated to getting my health to its best. I'm afraid I'm going g to try to reward myself in the future. Which surgery is best for long term results? Also I have some concerns because I have Rheumatoid Arthritis for which I take immune suppressors and a daily steroid. Do any of you have an auto immune disease or take steroids? And if so which surgery did you try and how are your results?

The band causes all kinds of discomfort, less weight loss, and less permanent weight loss. People like it because it's "reversible," and sometimes even reverses itself by slipping, causing more trouble for the patient. It is also an extremely high maintenance instrument, requiring you to go into the hospital for filling every six weeks. I don't know what your schedule tends to be, but personally that sounds extremely irritating. Additionally, with your anatomy unchanged, your hunger hormone will respond to weight loss like it always does...increase your hunger and lower your metabolism when you lose weight.

The sleeve is in no way reversible, but has minimal complication rates, weight loss similar to bypass, and arrests your body's efforts to block your weight loss, and is better in this area than even the bypass. This was a no-brainer for me, and from what I hear the band may not even be offered in another decade. Weight regain is still possible, as is failure, but the sleeve is a lifelong opportunity to get it right, as hard as it may be to adjust at first. Good luck with your decision!

The band causes all kinds of discomfort, less weight loss, and less permanent weight loss. People like it because it's "reversible," and sometimes even reverses itself by slipping, causing more trouble for the patient. It is also an extremely high maintenance instrument, requiring you to go into the hospital for filling every six weeks. I don't know what your schedule tends to be, but personally that sounds extremely irritating. Additionally, with your anatomy unchanged, your hunger hormone will respond to weight loss like it always does...increase your hunger and lower your metabolism when you lose weight.

The sleeve is in no way reversible, but has minimal complication rates, weight loss similar to bypass, and arrests your body's efforts to block your weight loss, and is better in this area than even the bypass. This was a no-brainer for me, and from what I hear the band may not even be offered in another decade. Weight regain is still possible, as is failure, but the sleeve is a lifelong opportunity to get it right, as hard as it may be to adjust at first. Good luck with your decision!

. Thanks so much for the info. When did you have your sleeve? What's your stats now?

Edited September 2, 201510 yr by ktscott

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Hello there -

To answer your question - My docs felt the sleeve would be a much better option for me due to the fact that I already have some pretty significant malabsorption issues. Have been on B-12 injections due to my intrinsic factor not working. Also was the only person many of my docs had seen that actually developed scurvy even with eating fruits and veggies - they believed that making me more mal-absorptive would not be a good thing and I agreed. Sleeve has been an adjustment, but not a terrible one. Due to some of my other meds, it made sense to leave intestines alone for the most part. I hope that you come to a decision that works best for you. I know you can do this!

Kim

Hello there -

To answer your question - My docs felt the sleeve would be a much better option for me due to the fact that I already have some pretty significant malabsorption issues. Have been on B-12 injections due to my intrinsic factor not working. Also was the only person many of my docs had seen that actually developed scurvy even with eating fruits and veggies - they believed that making me more mal-absorptive would not be a good thing and I agreed. Sleeve has been an adjustment, but not a terrible one. Due to some of my other meds, it made sense to leave intestines alone for the most part. I hope that you come to a decision that works best for you. I know you can do this!

Kim

. Thanks Kim. Everyone has really been helpful in making this decision. I still have to talk to the Dr and see what he thinks but I am beginning to be Pro Sleeve.

Piggybacking on what others have said, I'd advise you to compare the success rates of the band and sleeve. Like people have mentioned, the success rates following the sleeve mimic those of the bypass (though longer term studies of sleeve patients aren't available because it hasn't been around a long time like the bypass) and the band is statistically less successful. Also, research shows both the sleeve and bypass change the levels of several hormones related to hunger in your body, helping you lose weight and possibly feel less hungry. The band does not induce these changes. The hormone changes are not yet fully understood, so it's a bit of an unknown how long these changes last after bypass and sleeve.

Edited September 2, 201510 yr by letitbeatles9

Piggybacking on what others have said, I'd advise you to compare the success rates of the band and sleeve. Like people have mentioned, the success rates following the sleeve mimic those of the bypass (though longer term studies of sleeve patients aren't available because it hasn't been around a long time like the bypass) and the band is statistically less successful. Also, research shows both the sleeve and bypass change the levels of several hormones related to hunger in your body, helping you lose weight and possibly feel less hungry. The band does not induce these changes. The hormone changes are not yet fully understood, so it's a bit of an unknown how long these changes last after bypass and sleeve.

I haven't heard that about the hormones. Great info. Thanks!

The hormone question is still open, and you can find a bunch of info here: http://www.bariatricpal.com/topic/349114-new-study-about-the-long-term-effectiveness-of-the-sleeve/

I went with the sleeve I was terrified of the dumping issues with the bypass, was leaning toward lap-band but saw the long term costs with adjustments. Some have done very well with the band, but wasn't for me.

Some things to consider: Are you taking maintenance drugs? Some don't do well. Ambien no longer works for me. Had to switch from ER meds to breaking up pills. Have you worked through food issues? What is your relationship with alcohol? Do you have a partner? It will change your relationship status. Big issues to discuss in advance.

But the long term - you have an 80% chance to change your life significantly by keeping 70% of your current weight off for the next five years with WLS. Less than 2% with the best behavioral modification programs. It's not a guarantee, it's a tool.

I am on maintenance meds. I take low dose predisone and Methotraxate due the those meds I can't not drink alcohol. I am happily married with a 1 year old boy. The food issues are my biggest concern. But I know I can do this. I have to do this is get where I need to be. I'd never considered having problems with swallowing the pills though.

I went with the lapband because I didn't want to permanently change my insides, and I am very glad I did.

In my opinion, which one you choose should depend on how successful you are with dieting on your own. The lapband really should be looked at as a tool which will help you stick to a lower calorie diet. Its adjustable to get more or less help. The issue is that the more you get the band filled, the more difficult your life becomes.

So if you just need a small to moderate amount of help to keep you on track and stick to a diet, I think that the lapband is a great choice. If you need a lot of help then the sleeve might be a better option.

I currently have a very low fill on my band, and after 4 months I am about 18 lbs from being in the normal bmi range. I had high blood pressure when I had the surgery, now my blood pressure is normal and I have cut the amount of medication I am taking in half. The lap band has helped me rapidly loose weight when I eat properly, and significantly reduced the damage during my moments of weakness. I tolerate all foods, and have had very few issues so far, unless I do something stupid like swallow food without chewing it.

While my experience has been great, I feel like that is because the band has such a low fill. If I had to keep my band significantly tighter to achieve weight loss, my experience would probably be totally different.

From the studies I have read, the complication rates of lap band were really high for the first few years that they were implanted. Though as technique and understanding have improved, the complication rates seem to have gone down quite a bit. I think a lot of doctors have soured on it because so many of the first wave of bandsters had issues with them.

My surgeon does not even do lap bands anymore, and said many of the surgeries he does today are revisions from band to sleeve or bypass.

I'll jump on the "band" wagon here. My insurance company pays for WLS, but specifically not the band because of all of the difficulties and eventual revisions that have been experienced. May be another thing to look into.

Additionally, with your anatomy unchanged, your hunger hormone will respond to weight loss like it always does...increase your hunger and lower your metabolism when you lose weight.

While I'm no longer pro-band, I would like it to be noted that this is untrue. With an optimally-tuned lapband (correct fill level, eating band-friendly food) hunger will not increase nor will metabolism slow down as bandsters lose weight. As long as the band is functioning properly and the patient remains compliant (and this is true of ALL WLS), hunger will remain dimmed and metabolism rolls along just fine.

Additionally, with your anatomy unchanged, your hunger hormone will respond to weight loss like it always does...increase your hunger and lower your metabolism when you lose weight.

While I'm no longer pro-band, I would like it to be noted that this is untrue. With an optimally-tuned lapband (correct fill level, eating band-friendly food) hunger will not increase nor will metabolism slow down as bandsters lose weight. As long as the band is functioning properly and the patient remains compliant (and this is true of ALL WLS), hunger will remain dimmed and metabolism rolls along just fine.

. Well thank you! Good to know. What surgeries have you had?

I went into my surgeon's consult knowing I wanted the Bypass and he agreed. It was an easy decision for me.

Lap Band: I didn't like the idea of a foreign object in my body. Research later showed many complications.

Sleeve: I'm not comfortable with the idea of losing a whole part of my stomach. Later on, research showed it wasn't right for me at my BMI. I felt I needed the malabsorption in addition to restriction.

Bypass: Gold Standard. Research backed up my decision. The rate of weight loss, the long term benefits. Oddly enough, I am strangely comfortable with the rerouting of my innards. I can't explain why but it just feels better to me. Possibly because it is reversible if complications arise and call for it.