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What Kind of Weight Loss Surgery Is Best for Me? (Part 2)



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How do you know which type of weight loss surgery (WLS) is best for you? Part 1 of this series explored some of the factors to consider; here are a few more!



Reversibility

Each Weight Loss Surgery (WLS) type is designed to be permanent. However, the Adjustable Gastric Band (AGB) is fully reversible if necessary since the surgeon can remove the band from around your stomach. The Gastric Bypass (RNY) can be reversed, although the procedure is more complicated. The Gastric Sleeve (VSG) is absolutely irreversible since it involves removing most of your stomach from your body. Because of its reversibility, the AGB may be the choice for some younger patients or for those who do not want to take a dramatic step that affects their actual body parts.

Invasiveness and Recovery

The AGB is least invasive and has the shortest recovery time. It can even be an outpatient procedure, and you could get back to work in a week. This might be the only realistic option if you have very little sick leave available or you do not want to tell work colleagues about your surgery. The RNY and VSG are inpatient and require longer recovery times

Safety: Complications and Side Effects

Some risks of the AGB are band slippage or leakage, or erosion of the band. You could have vomiting or reflux if your band is displaced or filled too tight. Since the band can be removed, most of the complications can be stopped by emptying or removing the band.

The VSG has a higher rate of complications than the band. They can include leakage at the suture site. Nearly a quarter of RNY patients have complications of some sort, with more serious ones including staple line separation or leaks. You might opt for the AGB if you have a lower BMI without many health issues, or you might be more willing to take on RNY risks if your BMI is higher and you are more concerned about obesity-related issues such as diabetes.

The risk for nutritional deficiencies is higher with RNY and VSG. You can greatly lower your risk by taking the appropriate nutritional supplements, but you need to be prepared to take your bariatric Vitamins for life. The effects of Vitamin and mineral deficiencies can include osteoporosis, anemia, and nerve damage.

A Sweet Tooth and Dumping Syndrome

What are you looking to get out of your WLS? If all you need is help with Portion Control, AGB may be for you. It only helps with portion control, and it is up to you to make healthy food choices. On the other hand, the gastric bypass is best if you are looking for a tool to help you avoid sweets. That is because of the malabsorptive nature of RNY.

With RNY, your food passes through the lower part of your small intestine with less digestion than it would before surgery. Sugars that get to your small intestine can give you symptoms of dumping syndrome, including weakness, extreme fullness, diarrhea, nausea, and vomiting. Foods that cause dumping syndrome tend to be sugary and high-carb foods, such as candy, soft drinks, cakes, and pastries. Dairy and alcohol can also cause problems.

Most patients who get RNY have dumping syndrome at some point. Dumping syndrome can be beneficial because it gives you extra motivation to eat right – you know that if you grab that brownie, you may be headed for hours of misery! That can be a good reason to choose RNY. However, if the thought of dumping syndrome scares you, RNY is not for you!

There are many factors to consider as you choose your WLS type, but keep in mind that the decision is individual. You need to choose the WLS type that will work for you, even if it is not the one that worked for someone else. The decision is something to make after one or more serious conversations with your surgeon.

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3 hours ago, Alex Brecher said:

The AGB is least invasive and has the shortest recovery time. It can even be an outpatient procedure, and you could get back to work in a week.

Thanks for the article. :)

I wanted to add that my sleeve gastrectomy was an outpatient procedure, too. I was on the operating table in the morning and home that night.

It is also a relatively fast surgery. The bariatric surgeon said my surgery took 30 minutes.

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    • Prdgrdma

      So I guess after gastric bypass surgery, I cant eat flock chips because they are fried???  They sell them on here so I thought I could have them. So high in protein and no carbs.  They don't bother me at all.  Help. 
      · 1 reply
      1. NickelChip

        It's possible for a very high fat meal to cause dumping in some (30% or so) gastric bypass patients, although it's more likely to be triggered by high sugar, or by the high fat/high sugar combo (think ice cream, donuts). Dietitians will tell you to never do anything that isn't 100% healthy ever again. Realistically, you should aim for a good balance of protein, carbs, and fat each day. Should you eat fried foods every day? No. Is it possible they will make you sick? Maybe. Is it okay to eat some to see what happens and have them for a treat every now and again? Yes.

    • NovelTee

      I'm not at all hungry on this liquid pre-op diet, but I miss the sensation of chewing. It's been about two weeks––surgery is in two days––and I can't imagine how I'll feel a couple of weeks post-op. Tonight, I randomly stumbled upon a mukbang channel on YouTube, and it was strangely soothing... is it just me, or is this a thing? 
      · 1 reply
      1. NickelChip

        I actually watched cooking shows during my pre-op, like Great British Baking Show. It was a little bizarre, but didn't make me hungry. I think it was also soothing in a way.

    • Clueless_girl

      How do you figure out what your ideal weight should be? I've had a figure in my head for years, but after 3 mths of recovery I'm already almost there. So maybe my goal should be lower?
      · 3 replies
      1. NickelChip

        Well, there is actually a formula for "Ideal Body Weight" and you can use a calculator to figure it out for you. This one also does an adjusted weight for a person who starts out overweight or obese. https://www.mdcalc.com/calc/68/ideal-body-weight-adjusted-body-weight

        I would use that as a starting point, and then just see how you feel as you lose. How you look and feel is more important than a number.

      2. Clueless_girl

        I did find different calculators but I couldn't find any that accounted for body frame. But you're right, it is just a number. It was just disheartening to see that although I lost 60% of my excess weight, it's still not in the "normal/healthy" range..

      3. NickelChip

        I think it's important to remember that the weight charts and BMI ranges were developed a very long time ago and only intended to be applied to people who have never been overweight or obese. Those numbers aren't for us. When you are larger, especially for a long time, your body develops extra bone to support the weight. Your organs get a little bigger to handle the extra mass. Your entire infrastructure increases so you can support and function with the extra weight. That doesn't all go away just because you burn off the excess fat. If you still had a pair of jeans from your skinniest point in life and then lost weight to get to the exact number on the scale you were when those jeans fit you, chances are they would be a little baggy now because you would actually be thinner than you were, even though the scale and the BMI chart disagree. When in doubt, listen to the jeans, not the scale!

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      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Now that I'm in maintenance mode, I'm getting a into a routine for my meals. Every day, I start out with 8-16 ounces of water, and then a proffee, which I have come to look forward to even the night before. My proffees are simply a black coffee with a protein powder added. There are three products that I cycle through: Premier Vanilla, Orgain Vanilla, and Dymatize Vanilla.
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