Jump to content
×
Are you looking for the BariatricPal Store? Go now!

What Kind of Weight Loss Surgery Is Best for Me? (Part 1)



Recommended Posts

Congratulations on deciding to get weight loss surgery or considering it. Now, what kind of WLS should you get? The ASMBS reports that the major surgery types in 2015 were the vertical gastric sleeve (VSG; 53.8% of surgeries), roux-en-Y gastric bypass (RNY; 23.1%), and adjustable gastric band (AGB; 5.7%).

Each has their pros and cons, and the one that is right for you depends on many factors. Here are some to consider in the first article of a two-part series on this important decision.



Speed and Amount of Weight Loss

The gastric bypass (RNY) and gastric sleeve (VSG) lead to faster weight loss. The expected weight loss with VSG is 50 to 70% of excess weight within two years; RNY leads to excess weight loss of about 80% within 18 months. Usually, heavier patients look towards the VSG and RNY, while the Adjustable Gastric Band (AGB) is sometimes used for lower BMI patients. Expected excess weight loss with AGB is 50% over two years.

The VSG can be the surgery of choice for heavier patients because the actual operation is a safer procedure than the RNY. However, the RNY could be better for you if you have diabetes since many patients have much better blood sugar control after the surgery.

Long Term Results

You may have a lower chance of keeping the weight off long-term with AGB compared to other surgeries, but that depends on several factors. You can keep the weight off if your band stays in place and if you make the commitment to continue to follow your WLS diet once you hit goal weight. The RNY has good long-term results for many patients who keep a good amount of weight off for 10 or more years. The VSG is a newer procedure and the jury is out on long-term results.

How It Works: Restriction, Malabsorption, and Hormones

All weight loss surgeries are “restrictive.” They restrict the amount of food you eat by making your stomach smaller so it fills up faster, with less food. The AGB does this by creating a small pouch that is separated from the larger portion of your stomach. The AGB is only restrictive, but it is the least invasive surgery type.

The RNY involves the surgeon separating the lower stomach, which is restrictive because it leaves you with only the upper stomach to hold food. The RNY is also malabsorptive because it leads to nutrient malabsorption. The surgeon connects the upper portion of your stomach to the lower part of your small intestine. After RNY, food “bypasses” the upper part of your small intestine which is where a good amount of digestion and absorption typically occur. That way, less of the food you eat is absorbed, so you get fewer calories. This is a benefit if you are looking for faster weight loss.

In the VSG, the surgeon removes about 75% of your stomach, leaving you with only a small tube-like “sleeve.” This is how it is restrictive. The VSG also helps you lose weight because it affects your hormones. Your stomach naturally produces a hormone called ghrelin that makes you hungry. When the surgeon takes out most of your stomach, you have less ghrelin and less hunger. The VSG may be for you if you always feel hungry.

Reversibility and Flexibility versus Implanted Devices

The AGB is an implanted device. That means you will have a foreign object in your body for good. Some patients do not mind this and prefer the AGB because it does not rearrange their insides.

Others prefer the RNY or VSG because there is no foreign object left inside your body. However, these options involve changes to your body. The RNY rearranges your digestive system, while the VSG removes most of your stomach.

Adjustability

The AGB is the only WLS option that is adjustable. You can tighten (or “fill”) the band to make it more restrictive and lose more weight, or loosen it to make it more comfortable. Loosening the band can also be helpful if you need to eat more food, such as if you become pregnant, or when you approach goal weight.

You are in the “green zone” when the band is tight enough for you to feel full between meals and lose weight, but not so tight that you feel side effects such as regurgitation, trouble eating solid foods, or coughing.

A drawback to the adjustability of the AGB is that you need to get it adjusted in a surgeon’s office. This can be inconvenient since you need to get it filled a few weeks after surgery, and may need to adjust it a few times before you get it right. It can also be difficult to find a surgeon who can do the adjustment for you.

You should always know the location of the nearest surgeon to fill or unfill your band if needed, whether pre-scheduled or in an emergency. This can be difficult if you get your band inserted far from home or even in another country.

There is a lot to consider when choosing a Weight Loss Surgery type, and we will look at even more factors in Part 2 of this series!

Share this post


Link to post
Share on other sites

Good to know. Always eager to learn more about what I'm planning to do. Thanks!


“There will be obstacles. There will be doubters. There will be mistakes. But with hard work, there are no limits.” —Michael Phelps

Share this post


Link to post
Share on other sites

Oh wow, to be honest, when I planned to have the surgery I didn't bother to research all options. I went in wanting the Sleeve and thankfully, my surgeon felt that was the best thing as well. When it came to the Sleeve, I was fully versed. Although, he did remove 80% of my stomach, not the standard 75%. I hope that's not a bad thing.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×