HELLO I'm getting very close to surgery but thought I'd ask to find people who had the sleeve and can tell me they still felt a lot of restriction post op like I'm looking at RNY but still curious if the sleeve stomach as the sleeve isn't like the pouch in size and if sleeve really makes that much of an impact on your portion control for the first say 6months?

I'm torn as the bypass has many advantages but it is more effort to keep up with vitamins and worry about deficiencies!

I just spoke to Dietitian today she was very full on about how hard it will be to keep up with all the vitamins and living off like 1/4 cup food and sipping water all day chewing food heaps.

I've got about 90lbs to lose to reach my end goal but I feel the bypass has more long term advantages not sure if sleeve will have enough restriction say after 12 months???

any help appreciated also the weight loss I'm looking at is someone who needs to lose 100-150lbs max to match with me? As I know the higher weight usually means higher losses.

cheers.

I had originally planned for the sleeve but during my research I found that my existing GERD would be better with RNY and possibly worse with sleeve...that's why I chose RNY. I also had about 150 to lose so I opted for the smaller stomach.

I’m 10 months out and have lost 90 lbs. plan on losing 20 more. While on liquids and soft foods I didn’t think my restriction was very good but once I started eating regular food it really kicked in. I still get hungry, some days more than others, but I get full very quickly. You just have to be careful because there are ways to “eat around” the restriction and you can still over eat if you are eating the wrong foods. I’ve not had any regrets thus far!

the stuff the dietitian told you is puzzling. She must not have much experience with bariatric patients. First, you have to take vitamins for the rest of your life regardless of which surgery you have. And yes - it seems overwhelming at first, but you get used to the routine very quickly. I don't find the vitamin routine difficult or confusing AT ALL. I'm pretty much on autopilot with them.

also, the 1/4 C thing is really just during the first few weeks after surgery. At four years out, although my portion sizes are that of a standard "light eater", they're not 1/4 C or anywhere near as restrictive as they were for the first few weeks or months post-surgery. No one would be able to tell anymore that I'm a gastric bypass patient if they were to watch me eat. I eat about the same amount as my "light eater" normal weight friends - which is of course much less than what I ate pre-surgery - but certainly more than 1/4 C. For example, for lunch today I plan to have half a turkey sandwich and a side salad with light dressing. For dinner I'm thinking a "Beyond Meat" sausage with sauerkraut wrapped up in a Flat Out Fold It wrap....maybe with another side salad (although one of those sausages usually fills me up - so I may skip the salad). About 3 oz of meat plus some vegetables or a side salad with light dressing is a pretty standard dinner. At restaurants I'll often order an appetizer - or if I'm really hungry, I'll get an entree and take half of it home. Really no different than my normal weight friends who are watching their calories.

so suffice it to say, you're getting incorrect info from that dietitian. She must have some bias toward the sleeve - or just hasn't really worked with bariatric patients before.

Edited to add that I've been hanging out on various bariatric boards for about five years. The diets for sleeve and bypass patients are the same - both early post-op and years out. As for vitamins, some surgeons have VSG patients taking fewer than bypass patients (but others, like mine, have them on the exact same vitamin regimen). But either way, you are taking vitamins for life.

Pardon my French, but I think the dietitian you saw is full of crap...

Edited October 1, 20196 yr by catwoman7

Well she did say she's not specialised in this area but she had a bunch of papers telling me what to do for every little phase I will go through but overall she was a little negative I feel I just wanted more "real" world information from you guys here before I decide.

It was rather overwhelming with her giving me so much information and being a little pushy about it like she said this is the particular brand you need of vitamins and I'm like I think I can find alternatives that aren't so dear...

I've already got surgeons approval this is just for a little extra support...

Edited October 1, 20196 yr by Mikeyy

I was 492 on October 2 2018 and today I just weighed 5 min ago and Im 314 so minus 178 so far.I did the sleeve and no trouble feeling hungry and can eat anything I want but still get full very quick if I eat the proper foods.Protein first the non starchy vegetable and if I have room then fruit .You will have to work at this it is not a majic pill .I can eat bad things and eat more of them like ice cream,chips, ect cause they are easy and soft but when you eat dense protein I get full quick.Just do your resurch and listen to your doctors .

@Mikeyy

Congrats on your upcoming surgery. Most of us have pre surgery anxiety and question our decisions. Its normal.

Both surgeries are great options. I’m a sleeve five years out. I have less restriction but its still there. (My stomach is not back to full size) I’m still maintaining my 120 pound loss. @catwoman7 has Bypass and experienced less restriction.

Weight loss is not restriction alone. It's eating your food plan and stages, staying with in your weight loss/maintaining calories, behavior change, vitamins, exercise and hydration. This is the same with any type of surgery.

Here is a video that may help.

Gastric bypass surgery ended up being the choice due to severe GERD, metabolic disorders and extremely slow metabolism. My nutritionist gave a list of brands for protein and vitamins, but it’s a suggestion not a rule. As long as you get the protein and vitamins you need and there isn’t too much sugar. Usually no more than 4 grams. I think my papers said no gummy vitamins but I did my research to find a combination to work for me and showed my nutritionist and she said it’s fine. She is a nutritionist that works with my bariatric surgeon. But she is also open to new ideas that might be helpful for the bariatric patients she sees. She does nutrition classes for bariatric patients. I was required to attend before surgery. The difference between sleeve and bypass is less about amount restriction but more the bypassing of part of the small intestine and rerouting of digestive juices. If your gut says RNY Stick with RNY and you will do great.

Now that I've had both ... No difference detected in capacity or ability to keep up with fluids/vitamins/food

But if you really have food addiction, poor long term habits, etc IMHO choose the most powerful surgery you can otherwise you may end up where you started in a few years

1 hour ago, GreenTealael said:

Now that I've had both ... No difference detected in capacity or ability to keep up with fluids/vitamins/food

But if you really have food addiction, poor long term habits, etc IMHO choose the most powerful surgery you can otherwise you may end up where you started in a few years

yes - I was going to say I think capacity might be more of an individual thing than surgery-dependent. I know sleevers who are 2+ years out who eat as much as i or any other bypasser does - some more, some less. One would think it would have something to do with how big the surgeon made the sleeve, but I've heard that doesn't really matter, either...there's not a big enough difference in the various sleeve sizes to make a difference.

1 hour ago, catwoman7 said:

yes - I was going to say I think capacity might be more of an individual thing than surgery-dependent. I know sleevers who are 2+ years out who eat as much as i or any other bypasser does - some more, some less. One would think it would have something to do with how big the surgeon made the sleeve, but I've heard that doesn't really matter, either...there's not a big enough difference in the various sleeve sizes to make a difference.

Oh its totally individual. I never had amazing restriction with VSG (likely my vagus nerve was severed? Idk) and I have mostly the same feeling with RNY but I never relied on the surgery to do 100% of the work so never mourned restriction

Probably depends on your eating patterns as to what’s best. I’ve lost just over 100lb with sleeve and still losing 18mth later.

My main problem was eating ridiculous portions as rarely felt full so having the restriction from sleeve was plenty. Now I can eat a fairly “normal” portion but probably about 1/3rd of what I used to be able to pack away!

I certainly wouldn’t change my mind if I had to choose again

I quit taking all vitamins except a multi and occasionally a vitamin D. All my levels were fine at 9 months. With the sleeve your body will absorb the nutrients from your food so as long as you eat a healthy diet you shouldn’t need too many supplements.