I went into my nutritionist office through my dr, and she doesn't recommend the sleeve for me. How did you choose? I have an appointment with the bariatric team, and see what they say. She said for long term gastric is the way to go, but it's more invasive.

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What were the reasons she's suggesting bypass ??
I'm goin in that direction too ..
changing to bypass .. ?

What were the reasons she's suggesting bypass ??
I'm goin in that direction too ..
changing to bypass .. ?

She said with the bypass you can keep it off longer. With the sleeve it can last up to 5 years. She said if I lose weight before which I'm trying to I can be a little more successful with the sleeve. How much would you like to lose? I'm around 165.

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"She said with the bypass you can keep it off longer." I have never heard this. Gastric bypass is more invasive & you will lose more weight. However, you'll be on supplements for the rest of your life. You're also more susceptible to "dumping" where if you eat too much, you need to run to the bathroom.

I had the bypass and do not regret it. The RNY is better for long term weight loss if you are very heavy. I was not heavy but the RNY fixed GERD and diabetes (which I had). From what I have read on here (and other sites) is that those who get the sleeve are more apt to fall back into unhealthy eating habits and gain the weight back. It is harder (not impossible) for that to happen with a pouch. Just my $.02. Take it or leave it.

I think your nutritionist is misinterpreting the data. It's not that the bypass is NECESSARILY more effective long term, only that we have more EVIDENCE of it being effective long term. The sleeve as an individual operation is a relatively new procedure, so we just don't have as much long term data either way vs the RNY. But the info we do have is very promising.

I've done a lot of reading and from my (layman's) understanding, the bypass will help you lose weight faster (6mo to a year) vs the sleeve where you typically lose slowly over a period of 18 months. The typical difference between loss I think is often 10% of your weight ON AVERAGE, which may or may not be a big deal to you. (It wasn't to me, which is why I went with the sleeve.) Regain typically comes down to compliancy post-op more than what procedure you get. The average losses comes from the people who lose 150 lbs and completely overhaul their life and the people who eat around their surgery and lose less than ten or go on to gain past their original weight, so honestly I really didn't take it much into account when I was picking my procedure. I was much more concerned about the life I'd be living post op with both procedures and about my individual comfort level with the concept of the procedures themselves. Sleeve fit my vision for my future, so that's what I chose even though my surgeon was more in favour of the RNY as the "gold standard".

It is true the RNY is more invasive and also produces more restriction both in terms of volume of food AND type of foods you can eat. A lot of the things I can very easily eat post-op with my sleeve could make your average RNY patient very sick. some people see this as a pro to the RNY, others a con.

There are good reasons to pick either procedure, and sticking to the plan long term will bring success with EITHER procedure. After that it comes down to other factors: if you have GERD, if you have type 2 diabetes, how much weight you have to lose, how comfortable you are with malabsorption of nutrients, the speed you want the weight loss to be, whether you'd prefer the proven track record of the RNY, whether you want the ability to revise down the line, etc.

There's a lot to consider here, so definitely stick around and do some reading, but don't let the nutritionist tell you that you HAVE to get the RNY just because "after 5 years the sleeve stops working" and accept that as gospel or use it as the only deciding factor in your choice. Any surgery can result in weight regain, just as any surgery can result in stunning lifelong success. The specific surgery itself isn't nearly so important as the lifestyle changes you implement alongside your chosen procedure.

Edited May 23, 20179 yr by teacupnosaucer

My choice for Sleeve vs RNY was the amount of time under anesthesia. It was 3 times longer of a procedure for RNY. That was it. I think your NUT is way off base with the claim that you only lose weight for 5 years with a sleeve. Heck I don't think there is even a study that has been conducted on the sleeve lasting for more than 5 years yet. I think they are both good solutions, and both depend on whether the patient decides to work with or against the procedure.

For me the deciding factor was what effect any procedure may have on my future ability to have a healthy pregnancy. The traditional bypass is both restrictive and malabsorptive and requires a lot of supplements for the rest of your life. The sleeve is restrictive, but not really malabsorptive (data is out on just how much malabsorption is occurring long-term, but it's definitely less than RNY). Malabsorption of critical vitamins and minerals isn't great when you're creating a person and still need to supply those nutrients to yourself. Because being able to get pregnant is a big deal for me, I went with the procedure I thought would be healthiest for me and a future baby.

I decided on sleeve. It was my first choice mainly because it left the basic system intact. That means if I ever have problems a standard endoscopy will still be able to reach everywhere. The portion of my stomach is being removed and sent to pathology for testing. I was concerned about having a large portion of my stomach and intestines that would be inaccessible in the event of a cancer or other issue.
I also came out of my NUT consult feeling like the sleeve was the right one for me. I never could pinpoint the exact thing she said.
Because I'm at a high starting weight my surgeon double checked with me about the bypass.
I feel good about choosing the sleeve. People gain weight back on both surgeries. Keep doing your research and asking questions. That will get you to your answer.

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Rny has 30+years of research behind it, sleeve does not. My doctor said either would be fine for me. I went with rny. Outcomes long term are similar, with rny having a little more average weight loss ~10%, so I'm sure either is fine. I wanted the gold standard and the best shot at long term success. I'm sure sleeve would be fine too, but this isn't a surgery I want to do twice, and the benefits for me outweighed any additional risks or long term inconveniences like supplements.

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I should've had bariatric surgery ten years ago, but back then the options were only rny and lapband, pretty much. I never liked what they do to the stomach in both procedures. I think as time's gone on, the doctor's realized that the removal of the stomach is the only true way to get long term effects. With the Rny, they just staple off a small portion, which can lead to massive scarring, hernias, and stomach stretching down the road.

With the sleeve, like someone said before, it's a relatively new procedure so it's not responsible of a doctor, or anyone, to compare any surgery with it on a long term basis. I'm in a research study right now because doctors are noticing that when patients get the sleeve done, diabetes reverses itself almost immediately even before any major weight loss is performed. There's a positive hormonal change when they remove the stomach out of a person's body and they're just now starting to discover even more benefits to this procedure. With the RNY there's no reduced ghrelin hormone, which causes hunger. With the sleeve it is greatly reduced, causing patients to feel less hungry more often.

If I were you, and I was basically choosing between a malabsorption surgery and the sleeve, the RNY would be off the table. It's an archaic surgery. In five years it will probably be as obsolete as the lapband has become. It seems the doctors are moving towards the Duodenal Switch (DS) surgery for the malabsorption aspect. It has greater weight loss than any surgery available, and so far, patients keep a record 90% of their excess weight off for life. That's what the doctors wanted me to have since I had 225 pounds to lose. My doctor does it laparoscopically, but he likes to do the surgery in two parts. Sleeve first, then if I find myself needing more help, I can have the second part done that changes the digestive system ( I'm against malabsorption surgeries, so that's a no go for me).

As my sleeve goes, I've lost 34 pounds since the day of my surgery and I love, love, love it. No regrets. None.