Opinions on sleeve vs. bypass?

[jayleensmama 2]

I will be traveling to Mexico from Arizona to have surgery in February. I am still undecided on the sleeve vs bypass. My BMI is 40, and I am close to 100lbs overweight. I realize that this surgery isn't a fix, but a key to enter a new life. I am 37 years old, and was skinny most of my life. At 20 I had my daughter, and struggled with my weight since. In 2002, I lost close to 100lbs (around 80ish or so) and kept it all off until 2009. In 2009 I gained a good majority of it back (about 70lbs), and then I lost it again (around 50ish lbs). Both times were Atkins (and I did it the healthy way... not greasy everything). Again I gained it back, but this time I gained it all and then some around 2011. I have been back and forth since then. I need something that will basically have me suffer consequences if I don't stick to what I am supposed to. On a regular diet, if I ate something I wasn't supposed to, nothing would happen. If I do it this way, I am risking serious health issues, and I value my life. I am like a child that needs to burn their hand on the stove to stop doing something. I am not the one who is good with the threat of being burned.

After a lot of research, I am still undecided between the sleeve or the bypass. I would like to get your opinion on what you did, and what made you choose that route. What did you do? How long did it take you to lose the weight? How were you after surgery? How long until you were able to go back to work (I work from home, so I am assuming sooner than most people who have to get up and dressed and travel)?

I will thankfully have a friend join me in doing the surgery (she is undecided as well), so I am hoping that responses will help us both. Thank you for reading my super long post that I wasn't expecting to be so long!

Edited December 27, 2017 by jayleensmama

[catwoman7 10,846]

if you have problems with GERD, then most surgeons will recommend the bypass. There may be other health issues that would make one more appropriate than the other for you, but that is the major one. If you don't have such health issues, then it'll most likely be your choice (well, it'll be your choice regardless, since no one can FORCE you to have one or the other).

I chose bypass because I did have GERD. Also, it's an older surgery and has a lot more research behind it, and at the time I had it, it was considered the gold standard. The sleeve is more popular now, but I would still choose the bypass for myself because of the GERD issue. I did not want to risk it getting any worse. But both are good surgeries and there are a lot of people who have been successful with both.

[jayleensmama 2]

My BMI is 40, my friends is 35. I don't think she'd qualify for the bypass, but of course I could be wrong. I haven't been diagnosed with GERD, but being both overweight and not I have noticed I only have that when I am really overweight, and it's not daily. It's only periodically.

My main concern is the sleeve not working the way I think it would, and I have invested in a major surgery for nothing. I just have this feeling that the sleeve isn't as successful, but then again I associate bypass with morbid obesity (like 300+lbs) and while I am heavy, I am not THAT heavy, you know?

[catwoman7 10,846]

neither of those are concerns. There are a lot of people who have had bypass at a BMI of 35, and a lot of people who have had the sleeve who weigh over 300 lbs.

Edited December 27, 2017 by catwoman7

[MonkeyNurse 26]

My BMI was 44 when I had the sleeve 5 years ago. I lost 85 pounds but have regained almost all of it. A recent EGD showed my sleeve has a big outpouch at the top and it is really stretched. I found with the sleeve I could eat a lot of what they call "slider" foods... non-complex carbs like chips, popcorn, ice cream. That's how I started putting the weight back. My friend that had sleeve the same date as me has also put most of her weight back. She still has a lot of restriction but she drinks her calories. I am converting to bypass in 2 weeks. I'm hoping the fear of dumping syndrome and the new counselor I started seeing will help with my sugar addiction and help me keep the weight off this time.

[jayleensmama 2]

Sigh. Your reply is the exact reason why I am confused. I am worried with the sleeve I will gain the weight back because I, too, have a terrible sugar addiction.

20+ years ago my mom had a lap band, and lost 100lbs. She didn't really gain anything back, she really didn't lose a whole lot either because when she got it, she was 300+lbs. She said she was able to hold down junk food more than "real" food, so she would eat that instead.

[TX_KB 29]

I will be traveling to Mexico from Arizona to have surgery in February. I am still undecided on the sleeve vs bypass. My BMI is 40, and I am close to 100lbs overweight. I realize that this surgery isn't a fix, but a key to enter a new life. I am 37 years old, and was skinny most of my life. At 20 I had my daughter, and struggled with my weight since. In 2002, I lost close to 100lbs (around 80ish or so) and kept it all off until 2009. In 2009 I gained a good majority of it back (about 70lbs), and then I lost it again (around 50ish lbs). Both times were Atkins (and I did it the healthy way... not greasy everything). Again I gained it back, but this time I gained it all and then some around 2011. I have been back and forth since then. I need something that will basically have me suffer consequences if I don't stick to what I am supposed to. On a regular diet, if I ate something I wasn't supposed to, nothing would happen. If I do it this way, I am risking serious health issues, and I value my life. I am like a child that needs to burn their hand on the stove to stop doing something. I am not the one who is good with the threat of being burned.
After a lot of research, I am still undecided between the sleeve or the bypass. I would like to get your opinion on what you did, and what made you choose that route. What did you do? How long did it take you to lose the weight? How were you after surgery? How long until you were able to go back to work (I work from home, so I am assuming sooner than most people who have to get up and dressed and travel)?
I will thankfully have a friend join me in doing the surgery (she is undecided as well), so I am hoping that responses will help us both. Thank you for reading my super long post that I wasn't expecting to be so long! [emoji4]

My surgeon said that the sleeve has a higher regain percentage than the bypass but a lot of it has to do with food choices. There are people who have been successful and unsuccessful with both operations. See what your surgeon recommends and reasons why. Good luck!


Lap band 10/2007 revised to RNY 12/22/2017
HW 270
SW 263
CW 256

[MonkeyNurse 26]

My surgeon said at a recent conference he went to the data showed a lot more regain with sleeve. He said he sees there being a lot of sleeve to bypass conversions in the future.

[NatureLover888 23]

Well, I have run the gamut on which surgery I wanted. First, I wanted the RNY, the "Gold Standard" which has a long history of success. Then I considered the Duodenal Switch (SUPER expensive) and then decided against that due to issues with Vitamin deficiency, baldness, and runny diarrhea! Then I was told by a surgeon that a gastric sleeve might be more effective. So now I am back to the ball park of getting an RNY after my surgeon told me that if you have a very high BMI, RNY IS STILL the Gold Standard. I want to lose 210 pounds! So, yes...the RNY is for me...going in TOMORROW for this life-changing opportunity!

[jayleensmama 2]

I think since I am self pay, and insurance isn't covering it I might be successful with the sleeve even though people have experienced weight gain. Maybe if you don't have to pay out of pocket you don't treat it as seriously? I don't know. I have a really bad sweet tooth, and when I get a craving for it, I can be really mean if I don't have it. I want the gastric bypass, but with less recovery time and not having to take Vitamins forever, it might be the one for me. I really hope after I do this, I don't have to go back in for something else, because that would have been such a waste of money. I am leaning towards sleeve, but am still not convinced.

For those of you having surgery or are going back, I wish you guys so much luck for a speedy recovery!!

[catwoman7 10,846]

24 minutes ago, jayleensmama said:

I think since I am self pay, and insurance isn't covering it I might be successful with the sleeve even though people have experienced weight gain. Maybe if you don't have to pay out of pocket you don't treat it as seriously? I don't know. I have a really bad sweet tooth, and when I get a craving for it, I can be really mean if I don't have it. I want the gastric bypass, but with less recovery time and not having to take Vitamins forever, it might be the one for me. I really hope after I do this, I don't have to go back in for something else, because that would have been such a waste of money. I am leaning towards sleeve, but am still not convinced.

For those of you having surgery or are going back, I wish you guys so much luck for a speedy recovery!!

actually, Vitamins forever are now recommended for sleeve patients, too...

here are the nutritional guidelines from the American Society for Metabolic & Bariatric Surgery. Pages 6-7 list the supplements required for each type of surgery ("SG" is the sleeve)

https://asmbs.org/wp/uploads/2008/09/ASMBS-Nutritional-Guidelines-2016-Update.pdf

Edited December 28, 2017 by catwoman7

[KimTriesRNY 1,853]

I think with any weight loss surgery, if you decide after that you are going to eat chips, Cookies, and pastries, you will gain. I have a bypass but if I chose to eat only milkshakes, would this mean I would lose weight?

You must be willing to stick to the post op diet or you will regain some, or worst case scenario all, of the weight that was lost.

Both the sleeve and bypass have Vitamins requirements for life. Both the sleeve and bypass have dietary restrictions for life. If you aren’t ready to make that commitment, you aren’t ready for this surgery in my opinion.

That being said with your past history and lower BMI a sleeve would certainly work for weight loss in your situation if you did not want the bypass. Keep in mind there is no guarantee if you have a bypass you will get dumping syndrome if that’s what you mean by “suffer the consequences if I don’t stick to it”, and dumping can also be something that lessens or disappears as a bypass matures so don’t choose a bypass based on that.

I hope you do some reading, researching, and thinking to come to a decision that is right for you.

[NatureLover888 23]

48 minutes ago, KimTriesRNY said:

I think with any weight loss surgery, if you decide after that you are going to eat chips, Cookies, and pastries, you will gain. I have a bypass but if I chose to eat only milkshakes, would this mean I would lose weight?

You must be willing to stick to the post op diet or you will regain some, or worst case scenario all, of the weight that was lost.

Both the sleeve and bypass have Vitamins requirements for life. Both the sleeve and bypass have dietary restrictions for life. If you aren’t ready to make that commitment, you aren’t ready for this surgery in my opinion.

That being said with your past history and lower BMI a sleeve would certainly work for weight loss in your situation if you did not want the bypass. Keep in mind there is no guarantee if you have a bypass you will get dumping syndrome if that’s what you mean by “suffer the consequences if I don’t stick to it”, and dumping can also be something that lessens or disappears as a bypass matures so don’t choose a bypass based on that.

I hope you do some reading, researching, and thinking to come to a decision that is right for you.

Kim, if you have the RNY (Bypass) and you drink milkshakes, you will get SICK. That's one of the reasons why people prefer RNY over sleeve. It has a TRIPLE prong attack on weight: reduced stomach size, reduce absorption of calories and fat, AND the 'gift' of Dumping. Meaning if you eat sweets you may get hot, sweaty, flushed, and nauseous, and possibly vomit it all up. Most sugar addicts find it isn't worth the feeling of being sick after indulging in sugary junk food.

[catwoman7 10,846]

20 minutes ago, NatureLover888 said:

Kim, if you have the RNY (Bypass) and you drink milkshakes, you will get SICK. That's one of the reasons why people prefer RNY over sleeve. It has a TRIPLE prong attack on weight: reduced stomach size, reduce absorption of calories and fat, AND the 'gift' of Dumping. Meaning if you eat sweets you may get hot, sweaty, flushed, and nauseous, and possibly vomit it all up. Most sugar addicts find it isn't worth the feeling of being sick after indulging in sugary junk food.

well, not *all* of us, but...yea. Some definitely get really sick on sugar (I wish I did...)

[KimTriesRNY 1,853]

1 hour ago, NatureLover888 said:

Kim, if you have the RNY (Bypass) and you drink milkshakes, you will get SICK. That's one of the reasons why people prefer RNY over sleeve. It has a TRIPLE prong attack on weight: reduced stomach size, reduce absorption of calories and fat, AND the 'gift' of Dumping. Meaning if you eat sweets you may get hot, sweaty, flushed, and nauseous, and possibly vomit it all up. Most sugar addicts find it isn't worth the feeling of being sick after indulging in sugary junk food

Don’t take what I said out of context.

My point was that choosing a bypass because you think you will have dumping is a mistake. Not everyone will have dumping syndrome according to my surgeon, and this was discussed in our preoperative class.

Yes, I have had a bypass but I do not know if I would have dumping as I have followed my surgeons diet plan.