Gastric Sleevr Vs. Bypass

[catwoman7 11,284]

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

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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.

[catwoman7 11,284]

6 minutes ago, NYCGirl9269 said:

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

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I know you didn't ask me this, but I've been hanging out on BP for several years. A lot of people (although I obviously can't speak for alissajs specifically) choose the sleeve because they feel it's less invasive than the bypass. Although I think they both could be considered pretty invasive - cutting out 80% of your stomach and throwing it in the trash seems pretty radical, too - at least to me...

I think a lot of people also know about horror stories from 30+ years ago, when they used to do severe intestinal bypasses. The RNY is actually a gastric (stomach) bypass, so it's not the same "bypass" surgery they did years ago. They DO bypass part of your small intestine in an RNY - but we're talking about maybe a foot (to do the "Y"). Years ago, with those old intestinal bypass surgeries, they used to bypass many feet of small intestine (and the stomach wasn't bypassed at all - so very different surgery). No one does those anymore....haven't in a really long time. Anyway, a lot of people who had those ancient surgeries got very sick from malnutrition - and some died - and I think some people are remembering those and think that's what they're doing now with the RNY. But they're not..

[alissajs 231]

41 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

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Well I never had GERD, and really thats the primary reason for a revision. I may develop it later on, but only 30% of sleevers have this issue.My sleeve was done right, so it definitely isnt an inferior surgery.

30 minutes ago, NYCGirl9269 said:

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

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Actually, the weight loss between GB and GS is very very similar at 5 years post op. Because it is so similar and the rate of complications with a sleeve is lower than with a bypass, this is why my doc recommended it.

47 minutes ago, NYCGirl9269 said:

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.

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Weight regain is not a side effect of the surgery (either one...regains happen with bypass just as often), but rather choices made by the patient. I am still losing. I'm confident in myself and my choices. I will check back in July 😊

[AZhiker 2,253]

4 hours ago, NYCGirl9269 said:

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

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Yup, I got an ulcer in the first year. I don't smoke, don't drink alcohol at all, no caffeine at that time, so soda - absolutely no risk factors, but there it was. Doc thinks maybe one of the stitches didn't heal well and caused a spot for irritation, Anyway, a couple of months on omeprazole and that was done. Never had a problem since. I drink small bits of Decaf coffee now, but not much. No alcohol, no soda.

I also developed blood clots in my legs about 10 days out. Again, no risk factors except obesity, major surgery and varicose veins. I was out of bed walking the halls within a few hours after surgery and doing 10,000 steps a day by day 7. 3 months on a blood thinner that that was done. However, I developed phlebitis in those darn veins again just a couple of weeks ago. So I think I just need to have the veins taken care of with an ablation.

[NYCGirl9269 0]

Weight regain is not a side effect of the surgery (either one...regains happen with bypass just as often), but rather choices made by the patient. I am still losing. I'm confident in myself and my choices. I will check back in July [emoji4]

You definitely will gain back 10-15% at the 18 mark, thats stated as a fact by all Dr's but from bypass it happens after 3 or 4 years and with bypass, from what I've researched, many lose much more with bypass and then when they gain back the 10-15% it's not over their goal weight, as opposed to sleeve, most lose less than 80% excess weight and then gain back 15% after 18 months and I just didn't wanna risk it. I know 3 people personally who had the sleeve, no GERD, and got resleeved or went to get a bypass all because they all gained 4o, 50 even 70 lbs back after 3, 4, 5 years and they dieted and did everything accordingly. I rather just get bypass the first time as it does have a more effective and higher rate of success. It's still the gold standard. But a part of me considered the sleeve mainly due to less complications, however I dont want the weight to creep back in so fast at 18 months that I didn't have enough time to lose all the weight. Again, every body is different.

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[NYCGirl9269 0]

For me to stay at my 150 loss goal I would need to lose 170-180 so when I regain I stay at 150 and I see bypass being more effective at that for my starting weight as opposed to sleeve I'd def regain more than where I need to be.

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[cellbell 113]

49 minutes ago, NYCGirl9269 said:

I know 3 people personally who had the sleeve, no GERD, and got resleeved or went to get a bypass all because they all gained 4o, 50 even 70 lbs back after 3, 4, 5 years and they dieted and did everything accordingly.

I'm struggling with this statement because it would be really unusual to follow the program's diet and gain back 70 lbs. On the other hand, it seems like it's really easy to gain 70 lbs by slowly letting your food habits creep back to your pre-surgery ways, and it can happen slowly enough that it still feels like you're following the rules!

Regardless, it sounds a little bit like you already know you want the bypass and just want everyone to confirm your decision, which is totally relatable but just thought I'd point it out. The choice is really individual since we all have different bodies.

[NYCGirl9269 0]

I'm struggling with this statement because it would be really unusual to follow the program's diet and gain back 70 lbs. On the other hand, it seems like it's really easy to gain 70 lbs by slowly letting your food habits creep back to your pre-surgery ways, and it can happen slowly enough that it still feels like you're following the rules!
Regardless, it sounds a little bit like you already know you want the bypass and just want everyone to confirm your decision, which is totally relatable but just thought I'd point it out. The choice is really individual since we all have different bodies.

I am more leaning towards the bypass but I just wanted to see opposing views and see someone who had the sleeve maybe 3 or 4 years ago with my starting weight and see where they are now, I still have yet to. It's not even that the people I know didn't follow the diet, but overtime the stomach stretched and they said the appetite control is completely gone at that point, whereas with bypass I still see patients after 5 years more successful at keeping the weight off and their stomachs not as stretched as with sleeve due to smaller portions than with sleeve so that still keeps them eating fewer calories. But I'm not knocking the sleeve, I just wanted to be challenged in my perspective and the research I've done and see people who have been successful at it 5+ years cus I've seen plenty of bypass patients who have but not sleeve, if that makes sense

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[NYCGirl9269 0]

I know you didn't ask me this, but I've been hanging out on BP for several years. A lot of people (although I obviously can't speak for alissajs specifically) choose the sleeve because they feel it's less invasive than the bypass. Although I think they both could be considered pretty invasive - cutting out 80% of your stomach and throwing it in the trash seems pretty radical, too - at least to me...

I think a lot of people also know about horror stories from 30+ years ago, when they used to do severe intestinal bypasses. The RNY is actually a gastric (stomach) bypass, so it's not the same "bypass" surgery they did years ago. They DO bypass part of your small intestine in an RNY - but we're talking about maybe a foot (to do the "Y"). Years ago, with those old intestinal bypass surgeries, they used to bypass many feet of small intestine (and the stomach wasn't bypassed at all - so very different surgery). No one does those anymore....haven't in a really long time. Anyway, a lot of people who had those ancient surgeries got very sick from malnutrition - and some died - and I think some people are remembering those and think that's what they're doing now with the RNY. But they're not..

Yeah I kinda initially also related tue RNY to death risks based on what I remember from the 90s...when it was still an open surgery...
Does the ghrelin hormone also get reduced as with sleeve? Or is the appetite and cravings persistent all your life with the RNY?

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[catwoman7 11,284]

2 hours ago, NYCGirl9269 said:

Does the ghrelin hormone also get reduced as with sleeve? Or is the appetite and cravings persistent all your life with the RNY?

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most people lose their hunger for a few months up to a year, regardless of the surgery (and a few lucky souls lose theirs forever, but that's not common). I know they talk about the reduced ghrelin with the sleeve, but RNY people lose their hunger, too - so I don't know why they make a big deal about the ghrelin reduction with the sleeve since it happens to both. Or perhaps the hunger reduction you get from RNY is due to something else - I don't know. But most people lose their hunger for quite awhile, regardless of surgery. I lost mine for five months.

once hunger comes back, for most people it's not as intense as it was pre-surgery.

[catwoman7 11,284]

2 hours ago, NYCGirl9269 said:

see people who have been successful at it 5+ years cus I've seen plenty of bypass patients who have but not sleeve, if that makes sense

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part of the reason you may not see that is that the sleeve wasn't widely done until 6 or 7 years ago. It's been phase 1 of the duodenal switch for longer than that, but as a standalone surgery, it's still pretty new. It came into vogue when the lapband started to fade. It's more-or-less replaced the lapband as the non-RNY option.

[catwoman7 11,284]

2 hours ago, NYCGirl9269 said:

Yeah I kinda initially also related tue RNY to death risks based on what I remember from the 90s...when it was still an open surgery...

yes it was an open surgery in the 90s (and thus more risks), but a lot of people in my generation remember the intestinal bypasses they did back in the 60s and 70s. Those were the ones where they didn't bypass the stomach at all, like they do now - they bypassed most of the small intestine. Those surgeries were very risky - but those aren't done anymore. But I think when some people say "bypass", those are the ones us old farts remember - so that's why a lot of people - esp older people - think weight loss surgery is really dangerous (for the record, it's not anymore - they do them completely differently now)

[blackcatsandbaddecisions 854]

I started at 48.6 BMI and I chose the sleeve. My doctor says that regain is about your choices in what you eat, not your choices in your type of surgery. Anyone can screw up either surgery.

There are plenty of people on this site who lost all their excess weight with either type of surgery. There are also plenty who regained it all with either type. Both are very valid forms of surgery, if you have reasons to pick one over the other then do so. It sounds like you’re pretty set on the bypass. You should advocate for yourself for that surgery.

[Arabesque 7,604]

I didn’t start at as high a bmi as you but I still thought I’d share my experience so far.

I chose sleeve with my surgeon’s support, even though I suffered from stress related gerd. Yes, I have some issues but manage it with medication. I chose sleeve surgery because it doesn’t change the digestive tract as much as other surgeries. Yes my stomach is smaller but it is the same length as it was as are my intestines. I think this is why absorption is not as great an issue with sleeve. My nutrient absorption is good. I haven’t taken Multi Vitamins since I reached my goal a year ago & my blood work come back fine.

Yes, bypass patients do tend to lose weight more quickly to begin but the 5 year average of weight lost & maintained across both surgeries is about the same - 60-65% of the weight initially to be lost. Dr Vuong has a great video that explains this very well. Think it’s called how to maximise your weight loss.

The amount of weight you successfully lose & maintain really comes down to the individual. Even though I’ve exceeded my original goal (lost about 135%), I’ve had the view that I would find a place of balance between maintaining my weight & maintaining my lifestyle. I believe that if you restrict your food choices & intake to a point you can not enjoy your life & the things you like to do your diet will fail because you will consciously or subconsciously revolt against the restrictions you employed. Honestly, my diet is still pretty restrictive but I’m not quite 2 years out so I have a long way to go to find the balance of what works for me.

Currently, I eat low sugar & artificial sweeteners, low fat, moderate carbs (whole or multi grains but no breads, rice, pasta), fruits, vegetables & of course I’m Protein & Portion Control focussed. I have the odd glass of alcohol but I often don’t finish the glass. It’s easy to manage & doesn’t affect how I socialise so far.

The Keto debate is an interesting one. My 3 week pre surgery diet was keto but I know I could not maintain the high fat requirement long term but that is me - I don’t like overly fatty foods. But it certainly gave me a kick start. There is research that says the high fat content causes cholesterol problems. There’s research that shows that while it may help people with diabetes to begin, long term it can cause erratic insulin levels due to the low carb intake. And of course there’s research that it’s great. I think you have to find the diet that works for you.

Good luck whichever surgery you choose.

[NYCGirl9269 0]

I started at 48.6 BMI and I chose the sleeve. My doctor says that regain is about your choices in what you eat, not your choices in your type of surgery. Anyone can screw up either surgery.

There are plenty of people on this site who lost all their excess weight with either type of surgery. There are also plenty who regained it all with either type. Both are very valid forms of surgery, if you have reasons to pick one over the other then do so. It sounds like you’re pretty set on the bypass. You should advocate for yourself for that surgery.

Not really set on the bypass, I keep going back and forth between the 2 each day, I see all kinds of weight lost and weight regained with both but what gets to me is how it says with sleeve patients lose 60-70% and with bypass its 70-80% and I just keep looking at that 80% ...but for me most important is hunger control. I've read somewhere on here people who complained about when they had a sleeve and then got a bypass, they miss the hunger control they had with the sleeve that bypass didn't give them...but bypass gives you a smaller pouch than the sleeve so makes you full much faster....ugh decisions decisions...

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