I have a question that's been haunting me for a while.

Why would anyone pick the least effective surgery for their particular needs (obesity level, food addiction, prior health issues, other mental health concerns,etc)?

Is it lack of research or self sabotage?

Edited August 20, 20188 yr by GreenTealael

4 hours ago, Missouri-Lee's Summit said:

There is one thought I can't get out of my head. What are the long-term effects of weight-loss surgery? Because WLS is still in its infancy in many respects, none of us can predict the outcome of our decision when we become old and frail and we are in need of all the nourishment we can get.

I had serious misgivings about this as well. My mom passed away last year and for about her last 12-18 months, it was a struggle to keep her at about 105 lbs. She had been about 5'6", 135 lbs. for most of her life. I had forgotten that this was one of the things that steered me toward a sleeve - to preserve as much of my digestive system as possible and still lose enough weight to make me healthier.

Edited August 20, 20188 yr by Orchids&Dragons

4 hours ago, summerset said:

I think this is the problem: you won't know if it's the right procedure for you until you had it for a while.

People are absolutely gung-ho about the whole WLS thing, motivated, enthusiastic, unstoppable, indestructible... until this honeymoon phase (that every diet in the past had as well) is over and the darker sides and ho-hums show their faces. The thrill is gone and there you are with maybe a lactose intolerance, pooping issues, adhesions, GERD, diarrhea, malabsorption issues even though you're taking your Vitamins etc. etc. etc.

Was the lap-band the right procedure for me? Well, at first it seemed like it, but after some years it became clear that it wasn't. (However, it was also the only WLS procedure that you could get covered as a young woman back then if you were lucky enough and/or persistent enough with getting on the nerves of your insurance company, that is. Nobody even talked about the DS in these days).

Now I have an MGB - do I know if it's the right procedure? Or would the RNY have been better? No one can tell. I made the decision together with my surgeon. It might be that I will need a different anastomosis later (GERD, reflux, don't ask...) or it might not be.

So you choose MGB vs RNY, but will consider it down the line? May I ask what influenced your decision?

Edited August 20, 20188 yr by GreenTealael

Everyone here seems well educated on their reasons why they wanted/chose the surgery, question anyone have unresolved maladaptive eating practices prior and was steered one way or an other (surgery choice) because of this? Has you choice of surgery changed/resolved this?

08/20/2018 10:11 AM, summerset said:

I think this is the problem: you won't know if it's the right procedure for you until you had it for a while.

People are absolutely gung-ho about the whole WLS thing, motivated, enthusiastic, unstoppable, indestructible... until this honeymoon phase (that every diet in the past had as well) is over and the darker sides and ho-hums show their faces. The thrill is gone and there you are with maybe a lactose intolerance, pooping issues, adhesions, GERD, diarrhea, malabsorption issues even though you're taking your Vitamins etc. etc. etc.

Was the lap-band the right procedure for me? Well, at first it seemed like it, but after some years it became clear that it wasn't. (However, it was also the only WLS procedure that you could get covered as a young woman back then if you were lucky enough and/or persistent enough with getting on the nerves of your insurance company, that is. Nobody even talked about the DS in these days).

Now I have an MGB - do I know if it's the right procedure? Or would the RNY have been better? No one can tell. I made the decision together with my surgeon. It might be that I will need a different anastomosis later (GERD, reflux, don't ask...) or it might not be.

Exactly this. We can’t tell ahead of time what surgery will work for whom. Hopefully one day science will advance enough that we will have better predictors.

I chose the sleeve because I didn’t want the possible nutritional deficiencies that a bypass is more likely than a sleeve to leave you with. I also wasn’t comfortable with the increased risk of other side effects that both DS and RNY have over the sleeve.

I had considered RNY for almost a decade and had never been convinced because of the risks and side effects. As soon as a learned about the sleeve I knew that was something I could get behind.

I was a binge eater. Obese from early on. Snacky slider foods were my jam. As I’ve said I still can’t let Cheez its in my house.

The sleeve has worked wonderfully for me for five years.

56 minutes ago, jess9395 said:

Exactly this. We can’t tell ahead of time what surgery will work for whom. Hopefully one day science will advance enough that we will have better predictors.

I chose the sleeve because I didn’t want the possible nutritional deficiencies that a bypass is more likely than a sleeve to leave you with. I also wasn’t comfortable with the increased risk of other side effects that both DS and RNY have over the sleeve.

I had considered RNY for almost a decade and had never been convinced because of the risks and side effects. As soon as a learned about the sleeve I knew that was something I could get behind.

I was a binge eater. Obese from early on. Snacky slider foods were my jam. As I’ve said I still can’t let Cheez its in my house.

The sleeve has worked wonderfully for me for five years.

Would you ever consider revisions (based on weight issues alone) vs continuing to work with your current surgery?

I don't think it is self sabotage for most people. I think it is fear. It is a scary thing. I am pre-op. During the seminar the surgeon gave us the info and stats for the various surgeries. He seemed to not think much of the band and suggested the switch for those with a BMI of 50+. During my consult he asked which surgery I was interested in, and I said I was leaning toward the sleeve but still undecided. He talked about the upside of dumping as a tool, but also told me about malabsorption and post op pain. I told him that I liked the idea of the sleeve being shorter surgery time, and he said that really isn't a big factor because a bypass doesn't take that much longer. He said based on my history I would be a good candidate for the sleeve but that a bypass would be ok for me too. He left it up to me and didn't really push me in either direction.

My doctor recommended the sleeve until I told him my insurance only covers the bypass. With Gerd the sleeve doesn’t seem like the best answer.

I can only tell you my reasons as everyone has their own story and reasons why they chose the surgery they had.

I initially asked for the sleeve. I liked the less complications and thought that was going to be good enough for me. I was doing the surgery for health reasons even more than weight loss. My DR pushed hard for RNY but I resisted until I found out in pre op tests that I had barrett's esophagus. At that point sleeve surgery was not an option. I did a 180 and started considering RNY, but then my insurance said I could have RNY or DS but no sleeve. I asked my DR for his opinion on which surgery was right for me. He still thought RNY was the way to go but he left the decision up to me and told me the benefits and risks of both. I decided RNY was the way to go and so far so good health issues resolved and weight still being lost.

I guess I am misunderstanding this string. I do t know why anyone is assuming that we are self sabotaging or making a bad choice just because they decided to have a different procedure. I am glad I got the sleeve . I researched for a few years and met with 3 different surgeons who all thought the sleeve was my best option. Since I am barely 3 weeks out this question really threw me for a loop and had me second guessing myself. Luckily I remembered the surgeons and why they all directed me to the sleeve : malabsorption, dumping , keeping my digestive system in tact, and many other reasons. Let’s support each other and our individual choices! We have enough other people second guessing us!

15 minutes ago, skylw6 said:

I guess I am misunderstanding this string. I do t know why anyone is assuming that we are self sabotaging or making a bad choice just because they decided to have a different procedure. I am glad I got the sleeve . I researched for a few years and met with 3 different surgeons who all thought the sleeve was my best option. Since I am barely 3 weeks out this question really threw me for a loop and had me second guessing myself. Luckily I remembered the surgeons and why they all directed me to the sleeve : malabsorption, dumping , keeping my digestive system in tact, and many other reasons. Let’s support each other and our individual choices! We have enough other people second guessing us!

This question (perhaps its confusing to everyone) is about revisions. My question is basically is why chose the least effective surgery (individual based) only to end up getting another surgery when the outcome is unsatisfactory.

(And i don't mean people who revised from lapbands that were installed forever ago, or revisions for GERD/Barretts, those are different)

Why does anyone chose a lapband these days?

Why choose VSG vs RNY/DS if you have A LOT to lose with a history of eating disorders, mental health concerns, lack of support, stressful lifestyle, tendency to cheat constantly, etc...?

Why not be more aggressive?

Some answers were good. Some left me with more questions, but I'm thankful for everyone who participated. This wasn't about divisiveness. This was a real question.

For me the sleeve appears to the the right decision. Granted I’m 4.5 months out and I’m way ahead of the avg loss numbers. I was already lactose intolerant so that wasn’t t a concern. I rarely got heartburn prior to my sleeve and think I’ve had maybe 4 flair ups (too many spicy foods). It came down to how much the malabsorption scares the crap out of me and rerouting my insides when I know I’m an ugly scarrer was enough to tip me to sleeve. Going in based on what I needed to loose the avg lbs difference between the options wasn’t significant enough to deal with malabsorption.

I also have 4 friends at different points in post sleeve surgery. One is extremely successful. One is still loosing but doing really well. Another was a band to sleeve revision and is the least successful. Lastly is someone who is fighting regain 2 years out. This gave me a realistic view of what is possible and what is needed to meet goal.

Can I self sabotage? Sure I could and maybe someday I might but I have different tools I didn’t have before. Will they work? Time will tell.

I had the bypass because there is long term research on it. I didn’t feel like there was enough long term research on the sleeve

The suggestion of self-sabotage doesn't make sense for me when considering one weight-loss surgery over another. Real self-sabotage is doing nothing, taking no steps toward reclaiming one's life via the tools of WLS.

I often wonder why some people have opted into a revision (from sleeve to bypass). Did they make a mistake in choosing the sleeve in the first place? I have no regrets in selecting the bypass. None. I think I'd be upset if I'd had ended up with the sleeve, though.

08/20/2018 04:49 PM, GreenTealael said:

Everyone here seems well educated on their reasons why they wanted/chose the surgery, question anyone have unresolved maladaptive eating practices prior and was steered one way or an other (surgery choice) because of this? Has you choice of surgery changed/resolved this?

I’m not sure if I’m reading your q right, but I think it applies to me. I started out at 282 pounds and felt like I’d be happy around 215-220 pounds. My surgeon and I agreed on the sleeve - my desired outcome was reasonably within the sleeve expectations, and we both felt that doing less invasive/less rewiring/less drastic was the way to go as long as it seemed to match with my goals.

When I got home and shared with my husband, he was supportive and just asked “is it possible to stretch out your stomach sleeve?” That spurred another wave of research and consideration, and I realized that given my disordered eating and types of things that were the biggest problems for me, that maybe I needed the malabsorption and threat of dumping as additional tools. I also realized that I didn’t want it to be temporary, I didn’t want to have a few years of VSG honeymoon and then have it all be for nothing. I talked about it with my therapist, and when I discussed with my PCP she also recommended RNY. I let my surgeon know before the insurance approval process went through that I changed my mind and was able to proceed with my RNY surgery.

I was glad for the six month interval between that first meeting with the surgeon and my actual surgery, because it gave me even more time to research and reflect. I find that the research and reflection time became more valuable as the prospect of surgery became more reality than day dream.

22 hours ago, GreenTealael said:

I have a question that's been haunting me for a while.

Why would anyone pick the least effective surgery for their particular needs (obesity level, food addiction, prior health issues, other mental health concerns,etc)?

Is it lack of research or self sabotage?

I went with the band back in 2011, because I didn't want a permanent changes to be made to my body, and I got exactly what I asked for, nothing permanent.