Hello,

I'm still in pre-op with a bmi of 54, aged 48, no co-morbidities. I met with the surgeon yesterday and he said that people that have the bypass have better long term results and suggested that to me rather than the sleeve which is what I was originally set upon. He did say that folks still have good results on the sleeve but not as good as the bypass. He said he would do the sleeve on me as well if I wanted. I was pretty much set on the sleeve for the slightly lower risk factors, and the vitamin absorption issues.

Anyone have a similar experience?

I was pretty sure I wanted bypass then when I met with my psychiatrist and therapist, they both suggested the sleeve instead, saying it was "less radical" although it seems to me it's "more radical" because it permanently cuts out part of your stomach, but I listened to them and did the sleeve. No regrets. No complications, No problems.

It’s most likely your higher BMI that is causing your surgeon to recommend bypass. Bypass patients generally lose more quickly. So you will be better able to utilize your honeymoon period and be more likely to get to a healthier BMI

I chose the sleeve because I didn't want to mess with the rearranging of the intestines in RNYGB. The research I read said that the complication rate was lower. Friends that just went ahead with bypass asked me why not just get the 'gold standard' since its reversible and some sleeve patients have to convert to bypass anyway. The way I figured it, I had a less than 5% chance of needing a revision to RNY from GERD. Then if I was that 5% and needed bypass then I would have a 20% chance of any complications from RNY. I didn't want to jump to that 20% complication risk right from the get go.

I didn't care that the sleeve wasn't reversible - why would I want to reverse it? Some people need to have their bypasses reversed because of malnutrition, but because the sleeve isn't malabsorptive the risk of losing TOO much isn't nearly such a problem. There are a lot of surgeries that aren't reversible and no surgery has zero risks involved.

Both surgeries are a TOOL. And your long term success is determined by how you use it when making a lifestyle change in eating habits. Those friends that had their "gold standard" surgery? They follow an everything in moderation diet and some are still working to get to their goal weight. I've eliminated a majority of sweets, breads, rice, potatoes, fried foods from my diet. I've reached my goal and have lost an additional 14 pounds beyond it.

1 hour ago, KCgirl061 said:

I chose the sleeve because I didn't want to mess with the rearranging of the intestines in RNYGB. The research I read said that the complication rate was lower. Friends that just went ahead with bypass asked me why not just get the 'gold standard' since its reversible and some sleeve patients have to convert to bypass anyway. The way I figured it, I had a less than 5% chance of needing a revision to RNY from GERD. Then if I was that 5% and needed bypass then I would have a 20% chance of any complications from RNY. I didn't want to jump to that 20% complication risk right from the get go.

I didn't care that the sleeve wasn't reversible - why would I want to reverse it? Some people need to have their bypasses reversed because of malnutrition, but because the sleeve isn't malabsorptive the risk of losing TOO much isn't nearly such a problem. There are a lot of surgeries that aren't reversible and no surgery has zero risks involved.

Both surgeries are a TOOL. And your long term success is determined by how you use it when making a lifestyle change in eating habits. Those friends that had their "gold standard" surgery? They follow an everything in moderation diet and some are still working to get to their goal weight. I've eliminated a majority of sweets, breads, rice, potatoes, fried foods from my diet. I've reached my goal and have lost an additional 14 pounds beyond it.

Just want to congratulate you on reaching your goal.

Bypass all the way! I see way too many revisions from sleeve to bypass on this board. I decided on bypass and never looked back

I did sleeve. I figured why change the plumbing.

Seriously though, my surgeon recommended the bypass because of the malabsorption would help the rest of my life. He said that RNY tends to loose more and keep it off overall compared to sleeve. That comparison he said was his experience and was just letting the surgeries work. He said there is usually regain after people start eating off plan years later and that the bypass malabsorption would help with less regain compared to the sleeve. But in the end he said it was my choice.

@Panda333

I’m a sleeve five years out maintaining in the 130’s. I am type one diabetic. My surgeon suggested the sleeve because there are times, I need to eat sugar to raise my blood sugars. WIth the sleeve, my intestines are not altered, I don’t have dumping syndrome with sugar. I am now well controlled and hardly use insulin.

I want people that are researching weight loss surgery to know, many of us have had no complications and have maintained years out. Weight gain or need for a revision does not happen to all of us. Do your research, trust your surgeon’s advice do what’s best for you.

Any type of bariatric surgery may need a revision due to complications, surgery not performed correctly, eating to the point of stretching your surgery (big debate on this issue) Grazing/eating around your surgery, eating disorders, or simply not following your surgeons plan.

Only my opinion: For some, the sleeve is the wrong choice for them. Things I wish people knew about the sleeve.

Your sleeve restriction will become less over time. you can hold more food. (it’s not back to full size) Long term success will be diet and behavior change. Just because you have more space does not mean you have to eat over your calories and macros to gain weight.

If your surgeon has diagnosed that you stretched your surgery. Get counseling before a revision to make sure you don’t stretch a second surgery.

Your intestines are not altered with the sleeve. Most of us can tolerate sugar without dumping. If sugar is an issue for you, investigate surgeries that give you dumping syndrome.

You will feel real and head hunger at times (true with any surgery type) Hunger is more manageable after surgery.

age 45 day of surgery 2014 - age 50 2019

@Panda333

Positive WLS stories

https://www.bariatricpal.com/topic/423992-what-you-had-no-surgery-complications/?tab=comments#comment-4758950

12 hours ago, AggiG said:

Just want to congratulate you on reaching your goal.

Why thank you!

hi panda, i’m in a similar position to you and also trying to decide ... so thankful for your question and the responses. Wishing you all the best in what you go ahead with

My doctor suggested RNY, but I preferred VSG. He said his suggestion was because I was on 4 diabetes meds.

I had the sleeve 9 months ago and have lost 94# so far....just 15# more to goal. I'm off all meds and sugars are 70's-100! Sleep apnea gone...GERD gone!! No matter which one you choose, you'll still have to change the way you think about food and exercise...instead of loving food and not loving exercise, it'll have to become the opposite or you'll be back where you started. Food is just fuel. I've seen friends gain their weight back many times and am determined not to let it happen to me.

Edited May 11, 20197 yr by Beachyfe

I decided on the sleeve, because it seemed like the less extreme of the two. I was very intimidated b the idea of the bypass, and my doctor said for my size the sleeve seemed like the better option anyway. I have days where I regret it, simply because I feel like I am failing. But other days I am glad I did it.

My surgeon let me make the choice, but gave recommendations. I choose sleeve before I met him. It's less risky, less long term factors of malnutrition. The success rates are within 10% of each other after 10 years.

Regrets... I loved food, still do, but this has given me a reset on what's needed, not wanted. But honestly, if I had to decide it over again, most defiantly I would do it again, best choice I've ever made. I'm now reaching my health and weight goals/dreams. Life has changed, restaurants no longer interest me like they use to... nothing comes in "Shawn" portions.

But it has empowered me to get in shape. I swim every other day, and life weights every other day so I'm working out 4 days a week at least. My typical meal... It's not a "meal" but a snack for most people. I'm a one-taco person, 4 chicken nuggets, 1/2 a cup of orange chicken and I'm done.

What really effect my are sweet liquids - ice cream. and I LOVE some ice cream. But it makes me SOOO sick that I have to stop at 3 table spoons, otherwise I'm in a fetal position in bed for two hours. But I still get it, just in moderation.

But that was my problem - no moderation and I blew up to 330lbs. So yes, I'm very happy with my health now.