Hi all,

I'm a 30 year old female, around 41/42 BMI. I'm 1 NUT session away from submitting to insurance. I initially went to my surgeon asking for the bypass, to which he said I'm not overweight enough for and wouldn't be worth the complications. He said he wouldn't even consider it for me. And I left it at that.

As I'm reading more, I'm having some doubts about the long term success with the sleeve. I know that one can be equally successful with both, but when looking at averages across many people, bypass wins out. In my mind, I would want to take the option that affords me the best chances at success forever. But I'm not sure if there are other considerations I'm not aware of (besides malabsorption and complications).

At 40bmi and above, I would think I am definitely eligible for it. I like my surgeon, but I'm not sure if I should search out for a second opinion.

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It sucks you aren't given a choice. It should be your choice. I personally chose sleeve over bypass for a bunch of reasons, but it was MY choice. You should be given that same opportunity. Here are some of the reasons I chose sleeve:

• No rerouting of my intestines requiring multiple joins where there could be potential leaks.
• No malabsorption.. sure it's great for losing weight faster, but it can also lead to lifelong deficiencies. Also, I'm a runner and it is critical for me to be able to get in enough calories to fuel my body.
• Removal of the unused portion of my stomach. I hated the idea of my "old" stomach still being inside me and potentially developing ulcers or cancer or something and not being easily accessible with an endoscopy.
• Maintain the use of my pyloric valve. I was *really* weirded out by the idea that my pyloric valve would still be there, attached to my old stomach and opening and closing uselessly in response to signals from my new stomach. Ew.
• No dumping. Some people like the idea of dumping, because it's a deterrent to eating bad foods, but I wanted the option to eat small amounts of sweets and carbs down the road, once I was in maintenance. Also, not everyone who has RNY gets dumping, so it's risky to assume you will.
• Cheaper. I was self-pay and sleeve is just downright cheaper.

My BMI was also right around 40 when I started considering surgery. I managed to lose all of my excess weight and have been maintaining for 15+ months. So sleeve was definitely the best choice for me. But, again, everyone is different and should be allowed to make the best choice for themselves.

I chose sleeve for the same reasons. A few doc friends refer to the bypass as the gift that keeps giving, add in years Duan the road complications can still develop and need surgical correction.

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It sucks you aren't given a choice. It should be your choice. I personally chose sleeve over bypass for a bunch of reasons, but it was MY choice. You should be given that same opportunity. Here are some of the reasons I chose sleeve:

• No rerouting of my intestines requiring multiple joins where there could be potential leaks.
• No malabsorption.. sure it's great for losing weight faster, but it can also lead to lifelong deficiencies. Also, I'm a runner and it is critical for me to be able to get in enough calories to fuel my body.
• Removal of the unused portion of my stomach. I hated the idea of my "old" stomach still being inside me and potentially developing ulcers or cancer or something and not being easily accessible with an endoscopy.
• Maintain the use of my pyloric valve. I was *really* weirded out by the idea that my pyloric valve would still be there, attached to my old stomach and opening and closing uselessly in response to signals from my new stomach. Ew.
• No dumping. Some people like the idea of dumping, because it's a deterrent to eating bad foods, but I wanted the option to eat small amounts of sweets and carbs down the road, once I was in maintenance. Also, not everyone who has RNY gets dumping, so it's risky to assume you will.
• Cheaper. I was self-pay and sleeve is just downright cheaper.

My BMI was also right around 40 when I started considering surgery. I managed to lose all of my excess weight and have been maintaining for 15+ months. So sleeve was definitely the best choice for me. But, again, everyone is different and should be allowed to make the best choice for themselves.

@@JamieLogical thanks! I've heard sleeve also limits your hunger hormone, but with the stomach still there, I wonder if the same effect happens with bypass.

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My dr stated that with the bypass there is a loss of hunger for about 6 months.

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I was 310 at 5'6. BMI 50. I'm now 228 at four months post-operative. They chose sleeve for me because I'm 31 and childbearing age, meaning I might want to have a child in the next two or three years and they don't want malsorbtion to be an issue with Vitamins etc.

In retrospect I would have preferred bypass. It has better longer term results and I'm willing to get excessive blood work during a pregnancy should I chose to have one some day. Push for the surgery you think is right for you. If the surgeon won't do it -- find another. It's your life and you have to live in the body you create. I wish I'd pushed for bypass, but I'm making the most of the cards I've been dealt.