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How to decide on best surgery



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How did you decide on which surgery to have? The VSG seems to be the most popular and pushed surgery through my research. I'm 49 BMI and can't seem to loose weight on any diet or exercise program since my hysterectomy 5 years ago. I am concerned that the sleeve will not be enough and know that I could convert to DS later but I don't want to waste anymore time trying something that may not work.

I know this is a conversation best with my doctor but I don't want to be pushed into a sleeve if it's not going to be effective.

I'll be self pay in Mexico.

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Do you currently have gerd or frequent heartburn?

Do you have access to bariatric care closer to home if there were a complication? If so, what procedures do they perform?

How keen are you in taking daily supplementation? (Vitamins)

How enthusiastic is your primary care physician to take care of you after surgery in Mexico?

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Its a (very!) personal choice. You have to take all the pros and cons of each surgery type and weigh those against what you feel comfortable with. There is absolutely no one on this board qualified to tell you which surgery is best for you. Heck, my surgeon pushed me for RnY and I cancelled 5 days before surgery because it took me all that time to decide I would really rather prefer to have a VSG.

I think all of the surgeries are effective depending on how much work you want to put into it, and all can fail you if you do not use them properly. As to your question regarding the sleeve in particular, there are several users on this board who have lost over 200 pounds with it.

I would say check out @blizair09 for success regarding the sleeve, and @Redmaxx for success regarding RnY, though there are plenty of others who have had great success with each.

Edited by Navigating the Wilderness

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Oh, and are you currently in counseling or therapy? food addiction won't be cured by surgery, it takes therapy.

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Oh, and are you currently in counseling or therapy? food addiction won't be cured by surgery, it takes therapy.

No therapy yet. It is something I need to look into. I'm the heaviest out of six kids taking after my mother. The rest of my siblings and father took to alcohol and smoking. I realize I'm just Eating myself to death and do need the mental help to save what's left of my life.


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Do you currently have gerd or frequent heartburn?
Do you have access to bariatric care closer to home if there were a complication? If so, what procedures do they perform?
How keen are you in taking daily supplementation? (Vitamins)
How enthusiastic is your primary care physician to take care of you after surgery in Mexico?

My insurance does not cover WLS at all but we do have several local hospitals that do offer all types procedures.
My primary care physician was excited about the Sleeve when I brought it up. He has several patients that have gone to Mexico and has agreed to my care before and after surgery.
I've had my bouts with heartburn but it's not as often as it once was.
I have no issues taking Vitamins and tried one of the special weight loss programs through my chiropractic office that had me taking handfuls of vitamins 3 times a day with Protein Shakes with very little success.



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Ok, in my "random stranger on the internet's" opinion, any of the procedures will do you well.

My BMI was almost 48, and I have the sleeve. Got it in Mexico, and couldn't be happier. With your history of ineffective diets, I can understand your concern. Your surgeon will know more about the procedure best for patients that couldn't lose on a traditional diet. (That wasn't me).

I said if I needed a bypass, I'd go locally... for a sleeve, Mexico was fine. Bypasses and DS's might need more after-care, and local surgeons dont like dealing with Mexico patients.

But that's just me ;)

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I didn't really have a choice. My surgeon talked to me for a bit, then asked me which procedure I was thinking about. I SAID VSG and he said, "It won't be enough. You have too much weight to lose. You need the DS." Since reading more about the procedures, I'm inclined to trust him.

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3 hours ago, fastfoodaddictnomore said:

How did you decide on which surgery to have? The VSG seems to be the most popular and pushed surgery through my research. I'm 49 BMI and can't seem to loose weight on any diet or exercise program since my hysterectomy 5 years ago. I am concerned that the sleeve will not be enough and know that I could convert to DS later but I don't want to waste anymore time trying something that may not work.

I know this is a conversation best with my doctor but I don't want to be pushed into a sleeve if it's not going to be effective.

I'll be self pay in Mexico.

At 6'0", I weighed 397 pounds when I started my journey in March 2016 with my six month pre-op diet program. I decided on the sleeve because the idea of re-routing my insides bothered me. I think that it is more about what you do with your tool than anything else. I embraced a Keto way of eating for the entirety of my six-month pre-op diet program, and lost 99 pounds by the day of surgery. I have continued that way of eating post-op (even through the food stages), and I have lost an additional 102 pounds (I got below 200 pounds for the first time in 19 years recently), and now I am only about 16 pounds away from my goal (180 pounds and a normal BMI). I am hoping to get there by the end of the summer.

Changing your relationship with food, staying on your plan, and getting up and exercising are keys to success with this journey. Too many people on this site get one of the surgeries and then seem to do nothing with it. They lose some weight during the "honeymoon phase" (when it is all but impossible to not lose weight), and then it all goes to hell when any more weight loss (or even maintenance) requires good decisions about food and drink.

Talk with your surgeon and together you can decide which procedure is right for you. But making sure that you are ready to deal with the mental battle of the journey is the best thing you can do for yourself.

Good luck!

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My BMI when I started was 52!! It is now 35 after losing 90lbs. My goal is to lose another 50lbs more. I was sleeve in Oct 2016. Being sleeved was the best thing


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I wanted DS however I wasn't comfortable having it done in Mexico and not having my surgeon local with such a major surgery (not that the sleeve isn't major but the routing of the intestines worried me) so I decided to do the sleeve. I was over 50 BMI and so far I'm so happy with the sleeve (I'm only 13 days out so I'm far from the poster child for success). Have you figured out who would provide care if there are complications that arise after surgery (I know your primary care doctor is going to provide after care but there could be things that arise that he/she can't handle). I would definitely discuss with both your bariatric surgeon and your primary care to help determine which surgery would be best for you.


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Are you self pay but have insurance in the US? You are going to need to monitor your blood work etc post-op.

I wouldn't have DS outside of the US only because the DS requires a lot of post-op care, you need your blood work etc monitored closely. It is a more complicated surgery so if you are thinking about DS, then find a Dr in the US.

The only way to make a decision is to think about what matter to you, what level of dedication you have, and how much maintenance you want to do long term.

You really just have to do your own research and decide based on your values.

As far as weight loss, the type of surgery you have doesn't matter, you pretty much choose how much weight you lose by how you eat. Surgery doesn't lose the weight for you.

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I had GERD so it was a no-brainer: RNY. If it weren't for that, I would have been comfortable with either one. They're both good surgeries, and there are many success stories with both. If you really want RNY, though, I wouldn't let someone push me into another choice unless there's some medical reason for doing so (which sometimes there is....). I think a lot of surgeons prefer doing VSG because it's an easier surgery - but YOU'RE the one who'll have to live with whatever you get...

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Surgeons like VSG because they can do 10 a day, with RNY they can only do 3-4.

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I have only lost and kept off a total of 17 pounds on the sleeve (out of 51). I work out and eat meticulously. I'm converting to the DS (sadi-s) next month. I figure I'm halfway there already. The sleeve is turning out to not have such great long-term success. I am reading about lots of failures, and I for that profile to the t. Wish I had just done the DS the first time.

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