Hello,

I'd like peoples advice on which surgery to go with. Here's. My stats. I'm 5'7, 295 lbs. My BMI is 46. I need to lose 150 lbs to be at 150. I'd like to get the sleeve but with 60-70% excess weight loss plus 10-15% regain, I'm looking at being around 220 lbs when this is all said and done.

With bypass, I know several people who have lost 100% of their excess weight and had it easier keeping it off. The problem is they have bad vitamin deficiency even a decade later and can't even take some antidepressants.

My question is to you is, how many of you got sleeved with a 46 BMI? Did you lose more than 70%?

And for the bypass patients, if you've had the surgery over 5 years ago, how restricted are you now?

All I can say is that I am 2 years post bypass. I lost 100% of my excess weight in 7 months, am keeping it off, and am not deficient in vitamins or minerals. The restriction is much less now than it was a year ago. I focus on whole, plant based foods which allow a tremendous amount of volume. I can eat basically as much as I want, and control weight by monitoring the grains, nuts, nut butters, and seeds. Those are the most caloric dense foods I eat, and it is easy to tweak caloric intake up or down by adjusting those.

I think the people you know who have had bypass and are vitamin deficient are the exception to the rule. Are they taking their supplements? The malabsorption part of bypass gradually goes away, but bypassers are still supposed to be taking their vitamins unless directed otherwise. You do not see all the other bypassers out there who are doing fine, look great, and are not deficient.

I had bad GERD, so bypass was my only real option. But I would have chosen it anyway. This is major surgery and I only wanted to do it once, and get all the weight off once and for all.

vitamin deficiencies are actually pretty rare as long as you keep on top of your supplements. The one exception seems to be iron - some people don't absorb iron from oral supplements well, so they have to go in for occasional infusions. The vast majority of us absorb iron from oral supplements just fine, though.

by "restricted" - do you mean what kinds of foods are restricted, or how small our pouches still are? If you're asking about food, there are no restrictions once you get a few months out. I can eat anything, just not huge portions.

P.S. if you are talking stomach volume, I can definitely eat a lot more than I could the first few months post-surgery, but not nearly as much as I could pre-surgery. For example, pre-surgery I used to be able to eat half a large pizza at one sitting. No way could I do that not - it'd be physically impossible. I can manage 1-2 pieces, though.

also, AZHiker mentioned GERD/heartburn - yes, if you have that, you should seriously consider getting RNY as VSG could make that worse (not guaranteed, but it happens to enough people that they'll usually warn you against that). Otherwise, it pretty much comes down to personal preference. You'll find success stories with both - and unfortunately, failures with both (as long as you're committed to the rules, though, you'll do fine with either surgery)

also, yes - you may have to change a few of your meds....but it depends. Most meds are fine. Extended release versions usually have to be replaced with something non-extended-release, though. They should be able to find a substitute for you if the one(s) you take aren't going to "work" after RNY.

1 minute ago, catwoman7 said:

P.S. if you are talking stomach volume, I can definitely eat a lot more than I could the first few months post-surgery, but not nearly as much as I could pre-surgery. For example, pre-surgery I used to be able to eat half a large pizza at one sitting. No way could I do that not - it'd be physically impossible. I can manage 1-2 pieces, though.

I agree. Although I can eat as much as I want, I cannot eat nearly the volume that I did before - it is impossible and if I do overfill, I am very uncomfortable for several hours. I used to put away several large plates of food at a family dinner or holiday meal. Now, one small plate is enough, and I usually leave food on that. It's so strange, but you can be eating along, and all of a sudden you know that one more bite is too much. Like, I will be literally sick if I eat one more bite. Never had that before. I don't know where all that food went, but it sure doesn't work that way anymore.

And you may well find that you will not need a lot of your meds after surgery, including antidepressants. Did you know that most of your body's serotonin and dopamine are actually made in the gut? The gut biome is extremely important in regulation of so many functions, and all that is going to change. You are going to lose all that stored estrogen that is hiding in fatty tissue, and your gut biome is going to get an overhaul as you eat healthier foods.

Thank you so much to all of you for your replies. My consult is next week. I hope Dr. approves me for bypass as that is my primary preference but I know many Dr's push for sleeve nowadays. How about eating high fat low carb? Since high cat curbs your hunger and keeps u feeling fuller longer, can any of you eat traditional keto now years later? Or you still have to keep the fats low?

I personally can't eat a ton of fat at one sitting, but I do know RNY "vets" who eat Keto, so evidently it's do-able!

There's no general requirement to keep fats low with either surgery, that I'm aware of. Programs vary a lot, but they all seem to be fairly high protein. Some programs are also low carb, but not all (mine was pretty balanced - and I eat a pretty well-balanced diet now, at almost six years out). I don't think most programs have much to say about fats. It seems like everyone talks about protein - and many (but not all) about carbs.

Edited January 16, 20215 yr by catwoman7

Have you had any issues with kidney stones or ulcers or hernias after bypass??

5 minutes ago, NYCGirl9269 said:

Have you had any issues with kidney stones or ulcers or hernias after bypass??

no. I've never had any issues with mine.

I can only answer for myself, but I too flip flopped between the two. My doctor suggested the sleeve for me, and that what I ended up doing. I had a bmi of 47. I am 5'4 and I was 284, now 152.

I am barely over a year out (1/7/20) and I have not only met, but surpassed my goal in 11 months. I have had no issues at all and I am still losing (albeit very slowly now)!

Edited January 16, 20215 yr by alissajs

I can only answer for myself, but I too flip flopped between the two. My doctor suggested the sleeve for me, and that what I ended up doing. I had a bmi of 47. I am 5'4 and I was 284, now 152.
I am barely over a year out (1/7/20) and I have not only met, but surpassed my goal in 11 months. I have had no issues at all and I am still losing (albeit very slowly now)!

I would like to see your results post 18 months and then perhaps I'd consider it. Seen too many regains too fast with the sleeve.

I can only answer for myself, but I too flip flopped between the two. My doctor suggested the sleeve for me, and that what I ended up doing. I had a bmi of 47. I am 5'4 and I was 284, now 152.
I am barely over a year out (1/7/20) and I have not only met, but surpassed my goal in 11 months. I have had no issues at all and I am still losing (albeit very slowly now)!

The only good thing I know is with the sleeve the appetite is suppressed better due to the ghrelin being removed, but I see so many sleeves then getting bypass a second round so I rather just get it done right the first time

I can only answer for myself, but I too flip flopped between the two. My doctor suggested the sleeve for me, and that what I ended up doing. I had a bmi of 47. I am 5'4 and I was 284, now 152.
I am barely over a year out (1/7/20) and I have not only met, but surpassed my goal in 11 months. I have had no issues at all and I am still losing (albeit very slowly now)!

Whyd you choose the sleeve if you know the weight loss rate is not as much as bypass? Or whyd your doctor recommend it?

18 minutes ago, NYCGirl9269 said:

The only good thing I know is with the sleeve the appetite is suppressed better due to the ghrelin being removed, but I see so many sleeves then getting bypass a second round so I rather just get it done right the first time

most often, it's revised to bypass due to GERD. Most sleevers don't get GERD, but there's a significant minority who do. Often it can be controlled by meds, but sometimes a revision is the only option for dealing with it.

I chose bypass from the start because I had GERD even before I had surgery - didn't want to risk it getting any worse.