I am having a hard time deciding on which surgery to do. I'm stuck betweengastric bypass and the sleeve. I'm 31 and have a BMI of 43. I do not have diabetes or any health issues other than being overweight. I want to lose a great amount of weight and keep it off, but I'm afraid with gastric bypass that I will lose too fast and have saggy skin. Another concern is if I go with the sleeve, I will not be able to control what I eat and eat sweets and carbs. With gastric bypass I feel that dumping could be a good thing to help control what goes in your body. My surgeon and I narrowed it down to these two, but ultimately it is my decision. Any help would be greatly appreciated. Thanks in advance.

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I too had a choice and wanted the RNY because of fear I would need all the help I could get. My surgeon really wanted me to do sleeve since I had no immediate issues such as diabetes. After research i felt sleeve was safer, and since they remove the stomach they get rid of hunger hormones. I am now 6 days out and I have no hunger. I also can't imagine having more things to worry about such as malnourishment ect. I mean this is major surgery. I ended up having extreme vertigo from reaction to anesthesia. For me there was so many things that could go wrong with RNY and I was very worried about looking older and having saggy skin. Some people have so many other health concerns the faster weightloss with RNY is better but i felt a slow steady weight loss was healthier for my body and skin. Everyone is different but for me there was so much that could go wrong, safer is always better.

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I too had a choice and wanted the RNY because of fear I would need all the help I could get. My surgeon really wanted me to do sleeve since I had no immediate issues such as diabetes. After research i felt sleeve was safer, and since they remove the stomach they get rid of hunger hormones. I am now 6 days out and I have no hunger. I also can't imagine having more things to worry about such as malnourishment ect. I mean this is major surgery. I ended up having extreme vertigo from reaction to anesthesia. For me there was so many things that could go wrong with RNY and I was very worried about looking older and having saggy skin. Some people have so many other health concerns the faster weightloss with RNY is better but i felt a slow steady weight loss was healthier for my body and skin. Everyone is different but for me there was so much that could go wrong, safer is always better.

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Thank you for sharing and congrats on your surgery

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I read you have to be careful with any medication including ibuprofen after bypass. That scares me. What if I have a migraine Or a fever? So I went from wanting a bypass to a sleeve. My surgeon at Barix clinics only does sleeve surgeries. He said he won't do bypasses anymore because of the increased chances of complications for patients.

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As far as I am aware, the chance of complications (or long term nutrition difficulties) is higher with a bypass. There are certain issues that make a sleeve more 'risky' (eg if you already have bad reflux, it may be worse after a sleeve).

I know that fast weight loss may give you saggy skin but I think a lot more about saggy skin is uncontrollable by us - if it's going to happen, it will happen. For me, it's frustrating but losing weight and feeling good is faaaar better.

However I think the most important thing is you. As far as I am aware, none of these surgeries will give long lasting effects if you don't make that happen. You have to continue to work at it for ever. Some of your 'food issues' (whatever they are) may well improve or even go away but some will definitely not (and you may even have some new ones).

I had a sleeve and feel in myself that I'm doing brilliantly and have no regrets whatsoever (starting BMI 6 yrs ago 42, start before surgery 32, now 26 - 5.5 months post sleeve) However I am fully aware of just how easily this could be reversed by me. I am very restricted with 'general food' but slider food far less so. If I eat little and often of the wrong things (which I generally don't) I can eat more than 2000 calories in a day.

So my advice would be to realise before you start that this will help you a lot, that you will definitely lose some weight but how much and for how long is really down to you. Go in with the attitude that you will continue to try to address your issues with food, work at it and enjoy your new life.

Good luck.

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Edited October 30, 20169 yr by gl12282

I read you have to be careful with any medication including ibuprofen after bypass. That scares me. What if I have a migraine Or a fever? So I went from wanting a bypass to a sleeve. My surgeon at Barix clinics only does sleeve surgeries. He said he won't do bypasses anymore because of the increased chances of complications for patients.

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I am a sleeve patient and was told not to take ibuprofen. Tylenol only.

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I know people who had the band, bypass and then myself having the sleeve and everyone of us is happy with our results.....I choose the sleeve because I didnt want to lose to fast, have saggy skin nor did I want to lose my buttt!!!!!!.....I too didn't have any health issues which made me a better candidate for the sleeve.....You have valid points about both my best advice would be which one of the pros is most important to you....If having dumping is important to you then go with RNY my friend is a year out and still don't mess with sweets.....If in the end saggy skin would be a major problem then go with the sleeve.....Good luck!!!

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Oh and one more thing not saying you won't have saggy skin with the sleeve as well it just depends on a lot of factors...Good luck!!

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After watching quite a few youtube videos I have to say I've seen plenty of people with saggy skin with both surgeries. I myself am only 6 days post op from my vsg and Im already planning on preparing to really commit to a good exercise routine once I'm healed enough to try and combat that problem.

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You can have saggy skin with any weight loss - RNY or sleeve can result in the same loss and same saggy skin. Not everyone with RNY dumps with sweets. You need to change your eating habits with both surgeries. They are just Tools - you still need to do the work! I would not choose a surgery on these issues.

As far as I am aware, the chance of complications (or long term nutrition difficulties) is higher with a bypass. There are certain issues that make a sleeve more 'risky' (eg if you already have bad reflux, it may be worse after a sleeve).

I know that fast weight loss may give you saggy skin but I think a lot more about saggy skin is uncontrollable by us - if it's going to happen, it will happen. For me, it's frustrating but losing weight and feeling good is faaaar better.

However I think the most important thing is you. As far as I am aware, none of these surgeries will give long lasting effects if you don't make that happen. You have to continue to work at it for ever. Some of your 'food issues' (whatever they are) may well improve or even go away but some will definitely not (and you may even have some new ones).

I had a sleeve and feel in myself that I'm doing brilliantly and have no regrets whatsoever (starting BMI 6 yrs ago 42, start before surgery 32, now 26 - 5.5 months post sleeve) However I am fully aware of just how easily this could be reversed by me. I am very restricted with 'general food' but slider food far less so. If I eat little and often of the wrong things (which I generally don't) I can eat more than 2000 calories in a day.

So my advice would be to realise before you start that this will help you a lot, that you will definitely lose some weight but how much and for how long is really down to you. Go in with the attitude that you will continue to try to address your issues with food, work at it and enjoy your new life.

Good luck.

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Great advice, thank you so much

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I did not want my insides rearranged (so I never considered bypass), just cut the stomach out (also had my gallbladder removed at the same time). Recovery for me was a piece of cake (opps sorry for mentioning cake).

I'm 62 started with bmi of 40 with only mild sleep apnea. 2 1/2 months out BMI 30. No longer obese.

My stomach isn't as saggy as my boobs and butt. My arms are hopeless. But overall I look great. I will look into a breast lift in 2017.

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You can having dumping with both. You can have sagging skin with both. You lose rapidly with both, but statistically more with bypass. I had the sleeve because I didn't want my intestines rearranged. I still feel hunger, which is disappointing, but I deal with it.

One big question / thought is that if you are relying on dumping and the surgery to make you make good choices, are you sure you're ready?

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As lots of others said, you can get saggy skin no matter what.RNY a more dangerous detailed surgery with higher complications than sleeve and is better used for higher BMI. I was supposed to get it but due to multiple health issues physical and emotional, I take a lot if meds and often steroids too. Surgeon felt sleeve was safer for me and allows me to have steroids when needed unlike RNY and psychiatrist told me he has lots of trouble managing psych meds in RNY patients too.

I have a friend with chronic pain issues like me and she had RNY but now must take large doses of pain meds to get relief due to absorption pro lens

So tgey are great surgeries but your health history and future potential issues can really impact what u choose. You can loose lots of weight with sleeve too but you have to work harder then you would with RNY ...that's what tge surgeon told me however sleeve was a better choice due to my complex issues

Sagging can happen with either surgery, so that really shouldn't be a point of consideration. What does your surgeon think is the best surgery for you? You don't mention any co-morbidities, like reflux, diabetes, PCOS, etc...all of those should figure in when you make a decision.

Any of the surgeries can be successful or fail...it truly depends on you and your commitment to changing your lifestyle. If you don't feel that you can control your ability to eat or not eat certain foods, you may want to talk to a therapist to develop some techniques for when those cravings come crashing in. And they do...I had a VSG in June, and although I don't have any hunger, I still have cravings. Nice, huh?