Hi everyone. About a year ago I began looking into bariatric surgery, but officially made the call to a surgeon this year. I had my initial appointment with the surgeon at the end of February, where I went over my insurance requirements (weight loss, upper endoscopy, psychiatric eval and 3 consecutive months of meeting with my dietician and surgeon). When I initially met with the team, I was set on having RNY. My reasoning behind this, is because it's considered the "gold standard" of weight loss surgery. Now I'm considering VSG. Health-wise, obesity is my only issue. I don't have high blood pressure, sleep apnea or diabetes. I'm really just looking for advice from those of you who went back and forth between the two. I want to know which surgery you chose and why. I meet with my surgeon again in a few days, so I'm going to bring up VSG and see what he says. Thanks for all of your input

Really comes down to what you're looking to get out of your WLS. There are pros/cons with each one. If you have no other health issues that would help dictate which surgery would be better then go with what you want. You really have to think long term of what's better.

RNY pros can be that it leads toaster weight loss, greater weight loss over time, helps prevent one from overindulging in sweets due to possible dumping, is the "gold standard" like you said, better for those with acid reflux, could be reversed/revised in worst case scenarios. The cons are more reliance on vitamins every day, malabsorption, the bad side of dealing with dumping if you get it, to me it seemed more limitations on what you could eat

Sleeve pros are less alteration to the digestive tract, less likely to get dumping syndrome, mainly focuses on portion control (my main issue), more likely to have a normal diet after surgery, less reliance on vitamins. Main cons for me was that once that portion of your stomach is gone it's gone, may not lose as much weight overall compared to RNY or have a slower pace.

In the end I choose sleeve because I didn't want to deal with extra vitamins, I didn't have issues with sweets, and I wanted a slightly slower/steadier pace of weight loss. In my mind the sleeve was less invasive, meaning there was less alteration to my digestive tract.

If you do some searching you'll find a hundred threads on this topic as it's a frequent one.

I choose the sleeve because I was only aware of 3 options at the time in which my insurance covered.

1) Bypass - did not like the idea of vitamin dependence and the possibility that I did not weigh enough for the surgery.

2) Lapband - did not like the idea of going to the doctors for restriction fills and just the overall idea that it may erode or slip made me feel uneasy.

3) Sleeve - it was a mixture of both. Restriction that I needed and portion control and the less likelihood of being vitamin dependent.

Each has it's pros and cons. It really depends on which is the best for you and your needs.

I decided on the sleeve because I thought it was less invasive compared to RNY, I also wanted a slow and steady weight loss to prevent complications associated with rapid weight loss, and theirs little chance of vitamin deficiency! With the sleeve, it's a tool to help you reach your goals but if you are not committed it will not work

After wanting only the Sleeve, in the end I chose RNY per my surgeon's advice and after reading what seemed like thousands of experiences from both sides. I have a bunch of weight to lose and felt going with the "gold standard" would give me the best chance to do it. Plus I wanted to avoid having further surgery - a possibility if you end up with GERD after the sleeve.

At my Bariatric Practice of Excellence, all WLS patients have to take vitamins so if I was going to need to take them anyway, the extra iron and B12 needed for RNY wasn't a deal breaker.

I also went with the sleeve because it aligned with my needs to treat side effects of PCOS better than RNY, it was less invasive, and I wasn't keen on having my digestive system rerouted. I don't think there's anything wrong with RNY, I just felt that the sleeve would help me accomplish what I needed to with less "cutting".

I went back and forth between the two surgeries also. I had no health issues at all besides being overweight. In the end I decided on the RNY because it has been around longer and I felt the statistics of losing more weight and keeping it off was more of a positive than having to take vitamins. I don't mind the vitamins and got the good flavored chews that were recommended to me vs swallowing a pill. Other than that, the more foods I'm able to eat now I am getting the nutrients I need.

I'm very happy with my decision!!

Long term they are almost exactly the same. RNY people will lose more in the first year, but in the 2nd year they tend to really taper off, while Sleevers will still keep losing (this applies to high BMIers). So Long term at the 3 year mark, the WLS is almost exactly the same. or close enough that you can really make the choice of having your intestines rerouted is worth it.

Choosing RNY hoping that sweets will make you dump is a real roll of the dice. The majority of people with RNY don't dump long term.

If you are young and active, there is pretty much no reason to choose RNY over the sleeve unless GERD is a real concern.

I had my surgery as a youngish person and since the sleeve surgery has the most long term data (they have been cutting stomachs for ulcers for over 100 years), I decided long term it was the safest for a normal life.

Edited March 23, 20179 yr by OutsideMatchInside

Doesn't the rerouting of the intestines with the RNY affect your overall metabolism? What are the long term effects of absorption? I'm leaning toward RNY because portion control isn't a real struggle for me- but I just don't see real weight loss even on low calorie diets. So we're hoping the malabsorption will help in the long term.

Long term they are almost exactly the same. RNY people will lose more in the first year, but in the 2nd year they tend to really taper off, while Sleevers will still keep losing (this applies to high BMIers). So Long term at the 3 year mark, the WLS is almost exactly the same. or close enough that you can really make the choice of having your intestines rerouted is worth it.
Choosing RNY hoping that sweets will make you dump is a real roll of the dice. The majority of people with RNY don't dump long term.
If you are young and active, there is pretty much no reason to choose RNY over the sleeve unless GERD is a real concern.
I had my surgery as a youngish person and since the sleeve surgery has the most long term data (they have been cutting stomachs for ulcers for over 100 years), I decided long term it was the safest for a normal life.

Thank you...I was also torn between the 2 procedures. I was aiming towards the sleeve because I wanted my intestines intact because of the BM situation and also because I have a problem with malabsorping already. I liked RNY because I'm a sweet junkie, started to wean myself but I'm human I crave it. I know dumping isn't fun, but just the thought of it scares the crap out of me... But yes thanks for the advice and more would be loved if possible [emoji5]

Thank you...I was also torn between the 2 procedures. I was aiming towards the sleeve because I wanted my intestines intact because of the BM situation and also because I have a problem with malabsorping already. I liked RNY because I'm a sweet junkie, started to wean myself but I'm human I crave it. I know dumping isn't fun, but just the thought of it scares the crap out of me... But yes thanks for the advice and more would be loved if possible [emoji5]

I began considering the sleeve. I had my endoscopy Monday morning and I was showing signs of reflux, so I'm going to stick with RNY. Very happy with this decision. Best of luck to you !