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Why pick gastric bypass over gastric sleeve?



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I have spoken to the doc and he recommends gastric bypass but I am not so sure I want that, I think I like the idea of the sleeve better. Does anyone know what the major differences are?

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5 minutes ago, Cara R said:

I have spoken to the doc and he recommends gastric bypass but I am not so sure I want that, I think I like the idea of the sleeve better. Does anyone know what the major differences are?

Well I would rather give you why I personally chose RnY as opposed to the sleeve. But here is a great site that breaks it down. https://www.obesitycoverage.com/the-complete-patients-guide-to-bariatric-surgery/

I chose RnY for several reasons. For one, I wanted the most restrictive procedure possible. RnY gives you a smaller pouch than the sleeve. This part will sound insane, but I also wanted the “dumping” reaction. I just believe that it will more than keep me on the right track if experiencing dumping is possible for eating the wrong thing. RnY has also been around for decades. For someone like me who has never had a major surgery, I wanted to go with the “golden seal”. And lastly, I had “fire” GERD when I was pregnant. I didn’t even want that as a remote possibility. Do your research and really see which is best for you. The website is organized well so you can figure it all out. Both procedures Are great options for weight loss. Best of luck!

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I figured since so many people have revisions from sleeve to RNY, I’d just have RNY to begin with. Higher weight loss and keep more weight off longer, per data.


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I am having a revision this summer. I feel like if you've been overweight your whole life, you've probably already tried eating less. If you have a sweet tooth or a binge issue, those would also be good reasons for bypass. Even sticking to the diet, I still couldn't get below 200, so I relaxed the diet. I've gained 50 pounds.

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For me it's because of my acid reflux. I know a lot of overweight people have reflux that goes away with weight loss but mine is just hereditary. I have had reflux since I was 16. I was 115 lbs. My surgeon agrees that because of my family history (mom and grandmother both have severe reflux) that bypass is the way to go.

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I chose gastric bypass because the rates of resolution of diabetes are higher and because I was starting with a very high BMI, and average weight loss tends to be a bit higher. There is also at this point more long-term data on gastric bypass as it has been practiced longer than the sleeve. There have been many people on here successful with both. Good luck!


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I chose RnY because I had horrible GERD and my surgeon said the sleeve would not be a good option. I also wanted the more restrictive procedure and was hoping for the negativing feedback from dumping syndrome because I tended to binge eat and had a big sweet tooth. I personally felt like the sleeve was still a bit too 'new' and there wasn't enough long term research especially with regards to regain. But, I also didn't dig too deep on that front since my GERD situation made me cross the sleeve off very quickly.

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Acid reflux ... and my high probability of HB and diabetes. Plus I wanted security instead of a future.... “let’s switch you to a bypass cuz sleeve didn’t work or made your acid reflux worse”


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This is what convinced me....

the risk associated with both surgery are equal, and the risk of complications after are equal.... BUT... if your sleeve leaks, it’s worse than a bypass leaking. Here’s why.... the sleeve leaves the esophagus and intestines attached... but your system is built for a certain sized stomach. When they make the stomach smaller, it creates a high-pressure environment. This is why food and bile pushes up. If you leak with this high pressure environment, the consequences are more severe. With the bypass, it is a low pressure system. Everything needs to be adjusted for slow system. (The speed in which you eat and drink also needs to slow down - or you get dumping).

The risk of leaving after a sleeve was my deciding factor and my surgeon said it was best for me.

Good of luck with everything!

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I tried the band in 2011. Lost 70 lbs. But the problems weren't worth it over all. I looked into revision to the sleeve as well, to me it was less invasive, less "messing around with my guts". By my surgeon advised against it. For me, putting a staple line directly through the scar tissue caused by the band would have posed too many risks.

I decided to revise to the bypass. Wish I had done so from the get go!

The bypass is the ONLY surgery that's going to give you both restriction AND reduced calorie absorption. You can "eat around" the band and sleeve with ease. The Bypass, with the changes in how your body processes fat and sugar, it's not so easy. With a sleeve you could totally just drink milkshakes all day and gain weight hand over fist, can't do that so easy with the bypass.

Can you succeed with the sleeve, absolutely. But you'll have to work at it a bit harder than the bypass, since you don't have the built in punishment system that is Dumping.

No matter what you decide, stick to it, use the tools, and accept set backs. Good luck!

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I wish I had the bypass from the beginning but I am a revision from sleeve to bypass.

i had no restriction with my sleeve about a year after my sleeve, developed extreme GERD & weight gain.

what people seem to forget is that the sleeve was the first step in getting the bypass. Docs figured people were doing just fine in the interim if healing between the two surgeries so the sleeve became “the new wls “.

Along with everyone else, I wanted the restriction and malabsorption for the optimal chance of weight loss. And the negative side effect of the possibility of dumping is helpful. I feel as if the sleeve leaves one open to eat an array of things and fall back into bad habits. Although that is one’s personal mindset/decision and not a fault of the tool.

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