Ever since I decided to get WLS, I've been leaning toward the sleeve over bypass. Main reasons being I'm scared of the malabsorbtion and dumping. But... now that I'm closer to the end I'm wondering if the sleeve is the right choice,I'm not one that eats a crazy amount of food in a sitting. It seems like the sleeve is more aimed at smaller portions as a tool where the bypass really changes how you eat?

I know it's up to me how I eat, but the bypass seems more restrictive. Thoughts?

Stats: female 35, highest weight 253 current 242.

Also no comorbs

Well bypass isn't guaranteed to change how you eat. The person I know that had bypass, doesn't dump and eats everything under the sun, never got to goal.

Sleeve also changes how you eat. It is a lot more than just a smaller stomach. It removed most of the stretchy part of your stomach, so unlike bypass, you don't end up with a lot of increased capactiy down the road. It also removes the hunger hormone. So not only do you have less capacity, you have less desire (if you take your PPI and don't have GERD issues). Sleeve also changes how you eat by pushing you towards dense Protein. If you want any kind of fullness or satisfaction after a meal, then dense protein is going to give you that. Once you are healed everything else is easy to process or a slider.

Also are you really eating proper portions? Just because you aren't an over-eater by your or American standards (assuming you are American you have no info filled out..) does not mean you are eating proper portions. As a sleever I can eat a proper portion of meat 3-4 ounces and actually feel satisfied and full. That is the portion of meat everyone is supposed to be eating. Yet, most restaurants start steaks at 6 ounces with a lot of people eat 12 ounce steaks etc and considering that the norm. Most people are over eating even if they are not binge eating.

If you are active and healthy with no co-morbids, then the sleeve is going to offer you less long term issues and more bang for you buck. You can control your weight loss easier, no malabsoprtion long term, you can save money taking normal Vitamins and supplements etc. My Dr told my that RNY was for older sedentary people, and that younger people (I was a couple yeards older than you when I had surgery), do well with the sleeve.

I have lost more with my sleeve than most people lose with RNY, so it is kind of up to you which one you want. You can eat around any surgery. People choosing RY because they think they are going to dump, usually end up learning that isn't the case. Most people don't dump, even most RNY patients don't dump. Even if you do dump early on, long term once your body adjusts to surgery it is unlikely you will continue to dump.

It's pretty extreme to get either surgeries if you have no comorbidities aND not much weight to lose.

Have you considered reversible options like the band or ballon?

With the bypass and sleeve, you will need to think about life beyond weightloss. You will be always be very restricted, never can take NSAIDS(what happens if you need a hip replacement as you age?) and a commitment to Vitamins for life.

There's more to think about than weight loss.

I don't think anyone should consider the band. I think more are removed every day than placed. Too many complications.

I think the sleeve is becoming the main go-to procedure. For those that already have acid reflux, the RNY bypass would be better.

A good surgeon's opinion will be the most helpful for your particular situation.