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How’d you Choose? Sleeve v.s. Bypass?



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I had to make the same decision between sleeve and bypass. Most studies show that bypass patients loose faster and have great % of excess weight loss at 1 year post-op, but by year three the weight loss is the same for both procedures. The risk of regain is also pretty close for both procedures (although a lot of it is up to you and the choices you make). However, if you do regain weight down the road (which can happen), the options for a revision from a bypass are limited. If you have the sleeve, you can always convert to a bypass or SIPS/modified DS down the road (I think SIPS is going to be the revision of choice in 5 years). I originally was leaning towards the bypass, but my surgeon pushed hard on the sleeve. I took his advise and I don't regret it.

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On 3/1/2019 at 8:01 AM, tequillarny said:

My surgeon talked about both but even with the bmi only of 40 recomended the rny cause it's a gold standart.

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Yeah I've done tons of research and my BMI is 43 with co morbidities so I feel RNY is best I can only afford 1 surgery and only want 1 so I hope my surgeon listens to my decision wisely :)

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I initially chose sleeve but after my endoscopy they found I had Barrett’s esophagus and sleeve was no longer an option. I had bypass on 4/27/18. My results have been good but not without problems. I am just now out of the hospital from getting my gallbladder removed last Thursday. I also spent 7 days in the hospital with severe sepsis blood infection early in February because of my gallbladder. My weight loss has been great. 228 lbs on day of surgery to 162 lbs now. No sleep apnea, no diabetes; no high blood pressure, and no kidney disease. I had all-of those before the bypass! Bypass for me has been a blessing. I have relatives who had the sleeve and have regained most of their pre surgery weight back. I know I am not a full year out but my opinion is bypass is the best option. I also considered DS but my surgeon didn’t think I should go that route.

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I chose the sleeve because of long term issues I found in researching and asking my doctor about the bypass. I did not choose the sleeve because I would lose faster or slower, this is a long term losing process and I think we set ourselves up for failure if we expect to lost it all quickly. We have to make life changes as well for either surgery to be a long term success.

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On 2/16/2019 at 11:17 PM, losingtolivewithjen said:

What was the deciding factor for the surgery you chose?

i was scheduled for by-pass and surgeon was not comfortable with my choice due to issues i have with circulation below the knees. He suggested i switch to sleeve because it doesn't have the absorption issues, should i have to use blood thinners.

The sleeve worked very well for me so it turned out to be a great move on his part and i am very thankful.

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Yeah I've done tons of research and my BMI is 43 with co morbidities so I feel RNY is best I can only afford 1 surgery and only want 1 so I hope my surgeon listens to my decision wisely [emoji4]
I would go for rny aswell. Too many people going for revision and and having problems with acid reflux. [emoji6][emoji6]

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On 2/25/2019 at 12:40 PM, Greenstar said:

i had servere gerd, and the sleeve could make it worse. so i had no choice i had to get the bypass. honestly, if you do what you are supposed to the bypass isnt that bad. ive nevr had a problem with dumping and all my medical conditions are gone. sleep apnea, gerd, high blood pressure, pre diabetic, everything is gone day 1.

Thanks for that info.... I wanted sleeve and doc advised strongly, for me bypass since I had previous lap band problems and had to have removed. I must trust my surgeon I know, yet I am still scared of bypass, but your comments help me stay the course. :)

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Let’s respect each other’s choices. I’m sure we all did a lot of research, got recommendations, and made the choice we thought was best for ourselves.

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Where I'm going, the bypass is more expensive than the sleeve, which I dont mind, I said I'd be fine with either and had my concerns about sleeve revision but also dont want to need to visit my doctor every few months for B12 injections. Ive settled on the sleeve . My BMI is 36, i have no weight related illnesses other than earlty arthritis so my surgeon is confident that I'm a more suitable sleeve candidate. Especially as i quite enjoy exericise classes and am happy to be active when ive been at a lower weights, he's confident that I can do what is needed to maintain any losses and after speaking with him, I'm happy too :)

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When I first attended the free seminar and heard the options, I thought bypass was my choice because it wasn't as "permanent" as the sleeve cutting out part of your stomach. But when I talked with my primary doctor and my therapist, they both said the bypass was too severe/radical and to go with the sleeve. I mulled that over and decided they knew best, so I did the sleeve 3 months ago. I at first wanted the bypass also because it promises more weight loss.

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Bypass vs the sleeve

https://www.obesitycoverage.com/gastric-bypass-vs-gastric-sleeve-surgery/

LAP BAND SUCCESS RATE
47%
GASTRIC SLEEVE SUCCESS RATE
80%
GASTRIC BYPASS SUCCESS RATE
85%
DUODENAL SWITCH SUCCESS RATE
95%

Data Sources: PubMed: Quick fix or long-term cure? Pros and cons of bariatric surgery and International Journal of Surgery: Long term predictors of success after laparoscopic sleeve gastrectomy

The line graphs above show patients who have lost more than 50% of their excess weight and managed to keep it off for more than 5 years. The popularity of the Lap Band has dropped significantly due to the long-term complication rate and low success rate.

Sleeve and diabetes: no dumping with the sleeve. Just because you can eat real sugar without dumping syndrome does not mean you have to eat it. – Diabetes resolved.

Weight loss out comes – All surgeries give you the percentage of normal weight lost. Many exceed the norm. While other don’t meet it. Statistics are the base line of what to expect. We are all more than the statistics.

Expected Weight loss calculators – Note the percentages of people that lost more- or didn’t meet the norm

Sleeve

https://www.obesitycoverage.com/weight-loss-surgeries/gastric-sleeve/gastric-sleeves-how-much-weight-will-i-lose

Bypass

https://www.obesitycoverage.com/weight-loss-surgeries/gastric-bypass/how-much-can-i-expect-to-lose

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    • 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!
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      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

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    • 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.

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        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.
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