Help needed with decision RNY or Sleeve

[Terri70 37]

Looking at surgery in June (hopefully), Do you think it would be stupid to change my mind about getting RNY and instead get the sleeve? Do you think it's too late to change my mind? I keep going back and forth as to what I want to get done. Do you think if I did get the sleeve that I can lose 120lbs? What would be the benefit of switching?

[VSG2015 1]

HI, it's not stupid at all!, talk to your doctor and get more information. I had the sleeve surgery because it was way less invasive than the RNY and less could go wrong. You have to look at all the consequences, recovery time, what your expectations are after surgery. For me, there was no question, i was VSG all the way.

[Navigating the Wilderness 824]

I changed my mind 5 days before I was scheduled for RNY. The surgeon was very mad, but who cares? I did get set back like 3 months for surgery, but I am very happy with my VSG. There are a bunch of people on here who have lost over 200 pounds with the VSG, but the RNY works very good too. It is really a matter of preference.

[MarinaGirl 608]

Dr Matthew Weiner, a bariatric surgeon in Michigan, who has very informative videos on YouTube (check them out), says that Gastric Bypass has more durable weight loss long term than Sleeve Gastrectomy. He also talks about how you should have just 1 WLS in your life and not "plan" for a revision from VSG if necessary. But the biggie, imo, is the increased risk for GERD (aka acid reflux) with the VSG; to either develop it for the first time or for it to worsen for someone who already has it. GERD also puts you at increased risk for esophageal cancer, which doesn't have good survival rates. And taking PPIs long term increases your risk for dementia and/or osteoporosis.

I would talk to your surgeon about the actual risks of RNY vs VSG as statements that non-medical people may make that VSG is so much safer may not be accurate. Base your decision on sound data and guidance from professionals so you make the right choice for YOU. Good luck!

[Deactivatedfatgal 377]

Statistically, less complications with VSG vs RNY. Gerd is the biggest concern for VSG and can lead to needing a revision. RNY has the malabsorption aspect as well as other possible risks. I am not against either, I chose VSG because imo it was best for ME. If I need to revise in the future (a percentage of wls patients end up with a revision) than so be it! Even RNY patients get revised sometimes, so there really is no right or wrong, just pick best for you & health. My mother had RNY 10 almost 11 years ago & is doing well!

[TeahTeah 22]

I actually originally wanted RNY but changed my mind to have VSG. There are benefits and downsides to each procedure. So I'd say do what you think is best for you.

You typically lose more and quicker with RNY. With VSG it is less invasive and you don't have the Vitamin absorption problems. But with VSG you lose slower but don't have problems with the dumping syndrome.

[Dimples58 167]

I've been going back and forth with my decision as well. Do I want the Sleeve or Bypass?????? The choices we have to make. I decided to go with the Gastric Bypass due to my current medical conditions...diabetic, high blood pressure and knee arthiritis. According to research, GB has the highest rate in improving these type of conditions. Some people even stop taking meds as soon as 2 days after GB surgery. This is awesome. So do your research, don't be afraid to talk to those who had the surgeries and most importantly discuss your concerns with your Doctor. Just remember, the choice is yours, you want to be able to make a sound decision and have no regrets aftewards. I wish you the best in your new journey.

[Matt Z 4,138]

18 minutes ago, TeahTeah said:

I actually originally wanted RNY but changed my mind to have VSG. There are benefits and downsides to each procedure. So I'd say do what you think is best for you.

You typically lose more and quicker with RNY. With VSG it is less invasive and you don't have the Vitamin absorption problems. But with VSG you lose slower but don't have problems with the dumping syndrome.

You can absolutely have dumping with VSG. In fact you can have dumping without any WLS at all. Are RNY more prone, sure. But saying it isn't a potential problem is just incorrect.

Terri, you say you want to lose 120 lbs. VSG reports 50-60 (some 70)% loss of your total overage. RNY is upwards of 80%. Yes there are more potential complications with VSG over RNY. As someone that was banded 5 and a half years ago. I wish I would have went RNY off the bat. The band had all these amazing results reported. But the truth didn't follow the marketing. Sure, I lost 60ish lbs total already. But I'm stuck at around 300-315 lbs. Have been for 4 of the 5 years I've had the band. I'm currently in the progress of revising to RNY. Look at all your factors, how much you have to lose, etc. Understand that restriction alone will ONLY get you so far. That's why the RNY has a greater long term success rate, because of the malabsorption. I figure, I'm almost 40, over 300 lbs. If I don't do something to drop 100+ lbs now, I might not see 50.

[OutsideMatchInside 10,166]

I dumped in the first 6 months with the sleeve. I did it twice making dumb choices. I haven't dumped since. Also most RNY people only dump in the beginning also. Dumping isn't an always thing for most people. There is no reason to choose a surgery on dumping. A lot of people that are sweets lovers and choose RNY are disappointed to learn long term they have eat all the sweets they want. Nothing will stop you from eating cake but you.

What surgery you want is a personal choice. I picked the sleeve because it just seemed more logical to me. I'm single, live alone, not near family and I needed something with fast recovery, the least amount of long term maintenance and the lower complications rates.

@MarinaGirl seems to really hate the sleeve for reasons that don't even make sense. She had an experimental surgery that has little data to back up that isn't even widely performed. No one rags on her about that, but she makes a point to show up in every thread she can and bash the sleeve.

If you really listen to Dr Weiner he says every WLS should be considered a one time shot, and the reason is because you only get the metabolic reset once. Revisions don't give people the same metabolic reset as the first time. Plus with the exception of the band, because the band is just a terrible product, the reason people need revisions has nothing to do with the surgery and every thing to do with their food addiction, which he also explains. If someone is a food addict, surgery is not going to save them, no matter how many times they have it done.

GERD is at a 20% in the general population and 10% in sleevers. If you already have GERD prior to surgery then getting the sleeve (unless the cause of your GERD is a hiatal hernia) is not a smart option.

@Terri70

You just have to pick. The weight loss in the end will be about the same no matter what surgery you choose, because how much weight you lose and if you maintain depends solely on you and your choices. Weight loss surgery after about 6 months won't do the work for you, you have to. So the surgery you choose just depends on what you are most comfortable with.

[Sherrie Scharbrough 311]

I really don't understand why people need to run ANY of the choices each person makes, that it really is a personal choice. What works for me may not work for you. I had the RNY and my hubby had a SLEEVE. Just in our case, I defintly lost all my weight in 6 months with an 8# gain in 4 years. I have maintained my 1234# loss for almost 4 years. He had his Sleeve a year ago this June. He has lost 135#'s but mostly it is the food choices he makes. First off he weighed 460# now he weighs 330#'s. He still working on it. His choice defintly (he had the Lap Band for 13years) even back then was the RNY. He had complications after they removed the Band. That was in 2013. So in 2016 we went to Mexico for his surgery. When they got in there his band had caused so much scar tissue that he ended up with the Sleeve. My opinion on which surgery is the best would be WHATEVER YOU AND YOUR DR DECIDES ON. Educate yourself on all options. Then make a informed decision of which one works for you. Good Luck in whichever way you go.

[Apple1 2,572]

1 hour ago, Dimples58 said:

I've been going back and forth with my decision as well. Do I want the Sleeve or Bypass?????? The choices we have to make. I decided to go with the Gastric Bypass due to my current medical conditions...diabetic, high blood pressure and knee arthiritis. According to research, GB has the highest rate in improving these type of conditions. Some people even stop taking meds as soon as 2 days after GB surgery. This is awesome. So do your research, don't be afraid to talk to those who had the surgeries and most importantly discuss your concerns with your Doctor. Just remember, the choice is yours, you want to be able to make a sound decision and have no regrets aftewards. I wish you the best in your new journey.

I also considered bypass for the same reasons. Ultimately I decided to go with the VSG and I haven't taken any diabetes meds since day 2. I am hoping this will last as I am not eating solid foods yet.

[catwoman7 10,853]

they're both good surgeries. Most RNY'ers do not dump (the statistic that gets repeated on these boards is that 30% dump - not sure if there's any research behind that, but suffice it to say, a lot of us don't dump and never have). Dumping can be prevented by watching what you eat. You'll lose faster with RNY, but by two years out, the results are about the same. Certain medical issues may make one or the other surgery a better choice for you (e.g., if you have GERD, go with RNY).

I don't know why it would matter if you switched other than they might have to submit it to insurance again to have the other surgery approved - which may or may not delay you by a bit. But if that's what you want to do, then go for it.

[2ndSpring 350]

Both surgeries can lead to long term success and both surgeries have pros and cons. Go through your needs and medical risk factors with your doctor and match them to the surgery and post-surgery lifestyle that best suits you.

Ignore the weight loss statistics. They are misleading because they are averages and include people who are non-compliant. It is true that RNY loses faster up front, but over the years it equals out and an individual will lose weight in direct relation to how well they follow their program.

My decision factors that led me to choose the sleeve were that I didn't want malabsorption and I didn't have diabetes or gerd, so there was no benefit to choosing the more complicated surgery. If I had more to lose, or had diabetes or gerd, I may have chosen differently.

[Joann454 1,329]

Hi Terri! It's not too late. If you change your mind just tell your Dr why you changed your mind. This is your body and you have to do what is best for YOU. What made you choose RNY in the first place?

[noworries 1]

I too am in the deciding phase and just beginning this journey. Originally wanted the sleeve. May have to go with RNY due to reflux. I believe both give great results with hard work. But I am a little disappointed the sleeve may be taken off the table.


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