I can't decide! Sleeve or Bypass....

I had an endoscopy hoping that would help me decide for me...but alas no luck. I have basically received all clearances besides two more months of supervised diet and insurance approval. I have researched and gone back and forth but I can not decide which one would be best for me. I do understand that everyone is different but was there a particular reason you chose one surgery over the other?

@@okiegirl1980 What surgery does your team recommend? I chose sleeve based on my surgeon's recommendation after reviewing my medical history and eating habits. I didn't want the malabsorption part of bypass - just want the restriction.

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@@okiegirl1980 I picked the Sleeve because I am young and active. My Dr said the Bypass was for older inactive people. Also I was completely opposed to having my intestines touched since they are perfectly healthy. You can live without a stomach if something goes wrong, but you really need a working intestinal tract.

I chose bypass because I need to lose approx 50% of my current, starting weight (my BMI is 49), and I know that I (personally) need every possible advantage to help me reach my goal. I am also 49 years old, my metabolism will be slowing down soon, and I don't feel like I have much more time to waste. I have been overweight since toddlerhood, and I am ready for this to be done.

I am quite healthy now considering my BMI, no co-morbidities except sleep apnea, so I am comfortable that I will be able to heal well. And I am having my surgery at Duke, so I have huge faith in the skills of my surgical team.

I have GERD now, don't want to take the chance that it will get worse if I had a sleeve, and hate the thought of a revision surgery if my GERD got dangerous.

So, it's RNY for me on Thursday, barely 3 days to go!

Going to support groups for a few months pre-op and talking with people who have had both surgeries really helped me with my decision.

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Edited August 16, 20169 yr by gina171

@@KristenLe they say either. If i was to start smoking again then bypass would be out b/c of ulcers. Nutritionist mentioned bypass gives you more consequences if you stumble... i.e. dumping.

@@OutsideMatchInside I'm 36 is that still young? I do not have major health problems yet.

I chose bypass because I need to lose approx 50% of my current, starting weight (my BMI is 49), and I know that I (personally) need every possible advantage to help me reach my goal. I am also 49 years old, my metabolism will be slowing down soon, and I don't feel like I have much more time to waste. I have been overweight since toddlerhood, and I am ready for this to be done.

I am quite healthy now considering my BMI, no co-morbidities except sleep apnea, so I am comfortable that I will be able to heal well. And I am having my surgery at Duke, so I have huge faith in the skills of my surgical team.

I have GERD now, don't want to take the chance that it will get worse if I had a sleeve, and hate the thought of a revision surgery if my GERD got dangerous.

So, it's RNY for me on Thursday, barely 3 days to go!

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Happy you are on your way! I'm sure you will be successful. I have very little acid reflux but really don't want it either. I have C-Pap and I cannot wait to have a bone fire for that thing!

@@okiegirl1980 Yeah 36 is still young, I was older than 36 when I had surgery but younger than 40.

@@KristenLe they say either. If i was to start smoking again then bypass would be out b/c of ulcers. Nutritionist mentioned bypass gives you more consequences if you stumble... i.e. dumping.

@@OutsideMatchInside I'm 36 is that still young? I do not have major health problems yet.

I don't eat sweets very often and don't really graze so they thought I only needed restriction. I want to be able to have cake if I want - without getting sick. If I had a sweet tooth - I'd probably go with bypass so I had that consequence. Some sleevers dump too though so I'm hoping not to be one.

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I chose the sleeve with my surgeon's guidance. I take a lot of meds, and I have a history of inflammatory bowel issues. It's not bothering me now, but could in the future. So, I didn't want malabsorption because of meds, and my surgeon said it would be better to leave my intestines alone. Sometimes there is no one deciding factor if you're young and have no co-morbidities, so it comes down to preference. Do lots of research from sources who have no vested interest in your decision. If you still can't decide, maybe your surgeon would have you lean more in one direction than the other based on your medical history and circumstances. Best wishes on your journey!!

I'm going to copy and paste something I wrote a couple weeks ago explaining my reasons for choosing the RNY over the sleeve. Hope my perspective helps in some way.

I did consider sleeve and would have happily gotten one if my surgeon had had some reason for me not to do the rny. But rny seemed like a better option for me based on a lot of different things.

- There is much more long-term data on it.

- It's considered the "gold standard" of wls.

- My bmi was very high at the beginning of the program... about 67. From everything I've observed/researched and learned in the surgeon's seminars, those with higher bmis tend to lose more during the honeymoon phase and continue to lose more/easier in the maintenance phase. I had a looong way to go to get to my goal.

- I wanted the accountability of the rny. Many sleevers I talked to simply didn't have dumping, or were able to tolerate slider foods even in the weight-loss phase. I wanted the most strict accountability either surgery could offer, and that meant the rny.

- Many sleevers I talked to years out that had started very heavy as I did were not really happy with the larger amount they were able to eat, how easy it was to eat bad foods they should not eat, etc. The rny offers more restriction. True, I can stretch out my pouch just like a sleever can stretch out their sleeve but it seemed to me (and statistics back this up) that rny-ers had more restriction farther out than sleevers, and I wanted that.

- I also knew a lot of sleevers who, for whatever reason, wanted revisions years later and couldn't get them because of insurance, etc. I could mess up my rny too, of course, but I wanted the smallest chance possible, and the biggest bang for my buck.

- I saw many sleevers, particularly ones with high bmis, entering maintenance with 50, 60, 80 pounds left to lose to reach goal. Of course, this wonderful tool will help you reach goal after maintenance has started with enough work and dedication regardless of the type of wls, but since I had such a long way to go and I wanted to lose weight as quickly as possible to give me a good head start on my life-long road to health, the rny seemed a better option. As it is, I'm not yet in maintenance and I'm about 45 pounds away from my goal. Chipping away.

- The only arguments people had against the rny did not really matter to me at all. I have to take Vitamins for the rest of my life? Okay, no problem, most people probably should be anyway. There's a slightly higher risk with the rny? Okay, it's really a tiny extra risk, and with all the added benefits, entirely worth it. It didn't scare me at all. I may deal with malabsorption and other complications? Well yes... but so may the sleeve. The different percentages of risk were so close anyway, it didn't worry me at all to take that leap for what I perceived to be my best chance at getting the best head start I could, which would not only greatly improve my health (it has!) and greatly improve my self-esteem (it has!) but also greatly reduce the difficulties of everyday life (it has!!) as soon as I possibly could. I'm 24 and I left college two years ago because I was so sick. I've been sitting here fixing my body and essentially saving my life, and I really don't want to and can't wait another second to start my life. I'm enrolled and going back to school in about 3 weeks, and I look and feel pretty much normal now. I've had no complications, and I've lost 172 pounds since the day of surgery less than a year ago. This was my dream, and it felt like a silly and ridiculous fantasy before. But here I am, and everything I could have possibly wished for has come true for me. AND BONUS! It only gets better from here!

For all these reasons and many more that are more personal and harder to explain, I would choose the rny all over again, and again, and again...

I suck at taking vitaminz (sic).

I wanted to eat as normally as possible. (Sucks, I'm a slevever that dumps.)

I like my intestines.

I'm not diabetic.

I chose the sleeve. It worked.

I chose the sleeve, which was also what my surgeon felt was my best option. I'm peri-menopausal and I've had severe anemia in the past, so I didn't want to have the malabsorption that RnY creates, since I'm in dire need of Calcium because of my age and Iron because of my medical history. My BMI was 40.5 and my only co-morbidities were hypertension and sleep apnea. I've always been very active, so I wanted the surgery that would give me the best chance for weight loss with the least possibility of causing drastic changes in my ability to be active.

I'm only a couple of months out of surgery, so I don't know yet if I made the right choice, but I feel good, I'm down 38 lbs since surgery and I feel the best I have in 10 years.

Good luck in your decision, I struggled with it for months but finally made the decision and it was a relief to stop swinging between VSG and RnY.

I chose the sleeve because there is no dumping syndrome and I don't want my intestines to be messed with. Plus, it has safer statistics. Also, I heard the bypass is usually recommended for people who are over 300 pounds.

I suffered from severe acid reflux, I had diabetes and I was diagnosed with psoriatic and osteo arthritis in my late 20s.

I also had other medical issues but the main reason was I suffered from reflux and I only wanted to do this once so I went for bypass and am thrilled to death I did.

I have never had dumping syndrome and can eat anything I want just in smaller amounts. I will say just because I can eat anything doesn't mean I should or do.

Best of luck with your decisions

I'm like Djmohr, I never dump and I'm able to tolerate everything I could want, though that doesn't mean I actually eat whatever I want. It's entirely possible to have bypass without dumping, especially if you follow the plan to a t from the beginning. It gets a lot less restrictive further out. Just adding to the perspective!

I chose sleeve. My primary reasons were no rerouting of my intestines, I didn't have a history or acid reflux, and arthritis does run in my family, so keeping NSAIDs as an option was attractive. (Your doc may say differently about NSAIDs and the sleeve, but mine permits them when used judiciously). Plus being able to eat almost anything after healing seemed like a good idea to me.

Some mention dumping as a reason to get bypass. You won't know until you have surgery whether you will dump or not. Plus some sleevers, myself included, have dumping. Dumping can also go away after several months or years.

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