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Gastric Sleevr Vs. Bypass



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I run into people on this and other forums every day who've lost 100% of their excess weight. Granted it is NOT easy to do, with either surgery - you really have to be committed and work really hard at it. Statistically, about 10-15% of people make it to a normal BMI - so it's not common - but it's certainly do-able.
the first 18 months is what's referred to as the "honeymoon period" when it's relatively easy to lose weight (and really push yourself to lose it then since it'll be the only time in your life when it's not that hard to do!!), but you can continue to lose weight after that. The farther out you get from surgery, the more of a challenge it is to continue losing, but it's definitely possible.
Wait, you mean to tell me most people who start at 300 don't reach at BMI under 30??? 10-15% only??? Thats not what I'm seeing across these boards, both surgeries people losing most if not all their weight , including my friend who had bypass 10 years ago she was 450 lbs, still having trouble putting back on weight since hes only 70 lbs now, but on here and on YouTube I see most people reach their goal with the surgeries...to me its a matter of keeping it off , and I wanted the bypass because it's easier to lose 20-30 lbs more than ur goal weight so that when u regain a few, you stop at your goal weight. Due to the malabsoprtion qualities it's easier to lose passed your goal weight in that first year so I wanna take advantage of that first year but I can't get malabsorption due to the meds I'm not willing to stop forever

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K, I'm going to echo what was said by several posters: its not the surgery that dictates success, it's the individual.

I was sleeved over 2 years ago. I chose sleeve because:

  • The idea of re-routing my intestines freaked me out (but for some reason removing most of my stomach didn't. LOL)
  • I wanted to keep my pyloric valve intact, as I was taking NSAIDS and another time-release med (but surprise, surprise I ended up not needing them anymore after surgery)
  • I was scared of dumping syndrome (again, suprise, surprise, I dump anyway)
  • I was NOT prone to GERD
  • My surgeon was completely comfortable doing either surgery on me.

I started off at a BMI of 43 (235 lbs). I got to goal of BMI 23 by 7 months post-op. Lost a few more pounds figuring out what my caloric level should be but finally settled into BMI 21, and have been maintaining my weight of 115 (+/- 5 lbs) for over a year and a half. I am 2 years, 3 months post op. I have stayed below my goal weight (more than 100% excess weight lost) the entire time.

I have read accounts from other sleever's and rNy'ers similar to mine. I have also read accounts from both sleever's and rNy'ers who reached goal and regained, or never reached goal at all....I also don't see an obvious co-relation of results to the type of surgery underwent. (On another note, I have to date only read of ONE person who was more than 2 years out who was under BMI 18 AND had difficulties keeping weight on...but I digress).

Barring any medical issues, so long as you maintain a caloric deficit, you should expect to lose the same amount of weight with either surgery.

Good Luck!

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2 hours ago, NYCGirl9269 said:

Wait, you mean to tell me most people who start at 300 don't reach at BMI under 30??? 10-15% only??? Thats not what I'm seeing across these boards, both surgeries people losing most if not all their weight , including my friend who had bypass 10 years ago she was 450 lbs, still having trouble putting back on weight since hes only 70 lbs now, but on here and on YouTube I see most people reach their goal with the surgeries...to me its a matter of keeping it off , and I wanted the bypass because it's easier to lose 20-30 lbs more than ur goal weight so that when u regain a few, you stop at your goal weight. Due to the malabsoprtion qualities it's easier to lose passed your goal weight in that first year so I wanna take advantage of that first year but I can't get malabsorption due to the meds I'm not willing to stop forever

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You need to look at the statistics from large research studies and not base it on what you see on the boards. Long time vets who are still hanging out here after several years post-op are likely to be patients who were very successful. And it could be that for many if us, staying active in the bariatric community might be one factor in our success.

The statistics show that the average RNY patient loses about 70% of their excess weight, and the average VSG patient loses about 65%. Most patients end up somewhere around that peecentage. Of course you will always find people who end up above or below the average, and some WAY above or below that. The percentages get smaller the further you get away from the average. A 100% loss is a couple standard deviations from the mean, so you're not going to find a ton of people who end up there.

My surgeon discouraged me from my goal of 100% loss, saying that only about 10% of his patients make it the far. But, i did it. And so did a few others from my clinic. But we're not the norm.

I've checked the research. Studies show that about 10-15% make it to a normal BMI. Most end up overweight or class I obese (both of which are infinitely better than weighing 300+ lbs). But some of us do make it. But it takes some serious commitment and hard work. You can do it.. but it'll take a lot of dedication and effort.

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Reading through this whole thread...Honestly NY, you seem to have convinced yourself the sleeve won’t work. With that initial mindset, it probably won’t. Sorry, it sounds brutal, but attitude is half the battle. This is only a tool (whichever surgery). The real work is in the lifestyle change. That much is up to you. Your success or failure is YOUR choice. NOT the surgery.

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K, I'm going to echo what was said by several posters: its not the surgery that dictates success, it's the individual.
I was sleeved over 2 years ago. I chose sleeve because:
  • The idea of re-routing my intestines freaked me out (but for some reason removing most of my stomach didn't. LOL)
  • I wanted to keep my pyloric valve intact, as I was taking NSAIDS and another time-release med (but surprise, surprise I ended up not needing them anymore after surgery)
  • I was scared of dumping syndrome (again, suprise, surprise, I dump anyway)
  • I was NOT prone to GERD
  • My surgeon was completely comfortable doing either surgery on me.
I started off at a BMI of 43 (235 lbs). I got to goal of BMI 23 by 7 months post-op. Lost a few more pounds figuring out what my caloric level should be but finally settled into BMI 21, and have been maintaining my weight of 115 (+/- 5 lbs) for over a year and a half. I am 2 years, 3 months post op. I have stayed below my goal weight (more than 100% excess weight lost) the entire time.
I have read accounts from other sleever's and rNy'ers similar to mine. I have also read accounts from both sleever's and rNy'ers who reached goal and regained, or never reached goal at all....I also don't see an obvious co-relation of results to the type of surgery underwent. (On another note, I have to date only read of ONE person who was more than 2 years out who was under BMI 18 AND had difficulties keeping weight on...but I digress).
Barring any medical issues, so long as you maintain a caloric deficit, you should expect to lose the same amount of weight with either surgery.
Good Luck!

First of all I just wanna say congratulations on your success! All of the points you gave on why you chose to go with the sleeve sounds a lot like me which is why I know my Dr. Is gonna push for the sleeve lol. And im less afraid to go with that too. I'm afraid of dumping syndrome, of meds and Vitamins not being absorbed enough, or having my intestines rerouted. Etc. The only thing that bothers me is why the statistics say the sleevers lose 60-70% excess weight and bypass lose more. I'm asking from a completely objective standpoint - if both surgeries are just as easy to fail as they are to succeed, why do the research charts show this difference?

Also, I wanted to ask, did you get to choose the size boujie you wanted for your sleeve or know what size Dr used for you??

Also, did you cravings and hunger completely return after 6 months or it does but slightly?


Lastly, can you just do complete Keto during the first year after surgery so you stay under 20 net carbs and in ketosis? Or our body doesn't need to be in fat burning mode because of the surgery?

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2 hours ago, MandoGetsSleeved said:

Reading through this whole thread...Honestly NY, you seem to have convinced yourself the sleeve won’t work. With that initial mindset, it probably won’t. Sorry, it sounds brutal, but attitude is half the battle. This is only a tool (whichever surgery). The real work is in the lifestyle change. That much is up to you. Your success or failure is YOUR choice. NOT the surgery.

I echo that it is a mindset/attitude battle and what Ms. SSS said. I started with very similar stats to you, I am 5'7 as well. I discussed it with my surgeon and he echoed that the individual dictates the success and not the surgery. I chose the sleeve because:

  • Like Ms.SSS said, I didn't want to have my intestines messed with. It freaked me out.
  • My surgeon said I would lose roughly the same amount of weight either way, if I followed their plan.
  • I am not prone to GERD and did not want to spend extra time under anesthesia.
  • I didn't want dumping syndrome. Thus far, I don't think I have experienced this yet. Things have set wrong in my pouch but that's about it.

I specifically asked them in depth would I be able to lose the weight that I wanted and they confirmed, yes. The surgeries are much more advanced than even 4-5 years ago. There is no 18 month window where you start to regain. If there was for everyone, then why would anyone ever do this? The 18 months is a honeymoon period, as someone else said. In either surgery, you will have to have discipline. This isn't a miracle cure. Both can be stretched back out. Anecdotal experience isn't indicative of success or failure. If that were true, all the RNY friends that I have regained almost all their weight back (both were over 400lbs) while my one sleeved friend has kept it off. I don't think that means RNY doesn't work. They just fell back into poor eating choices and never truly changed their mindsets. They thought it was the easy way out and it's not. Gastric sleeve has been the right choice for many, myself included.

Whatever you choose in the end, know that it has to be mentally first and it is basically a reset to unlearn bad habits, train for good habits, and give you 6 months to a year head start on your weight loss. Just like with anything, like Mando said, the success is your choice.

Edited by ANewJourneyAwaits

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Reading through this whole thread...Honestly NY, you seem to have convinced yourself the sleeve won’t work. With that initial mindset, it probably won’t. Sorry, it sounds brutal, but attitude is half the battle. This is only a tool (whichever surgery). The real work is in the lifestyle change. That much is up to you. Your success or failure is YOUR choice. NOT the surgery.
I'm just worried because most people I see on here who had the sleeve whicb I'd feel more safer getting, none of them were as heavy as me with as much to lose as me and thats why I want the sleeve but keep pulling back...I'd love to see a woman on here who had the sleeve with a 46 or higher BMI who now has. 20 or 25 bmi. That's all I'd like to see so that I don't go into this always paranoid it won't work enough cus im too big. That's all . My appt with my surgeons January 27th and ultimately he will leave it to me to decide but I just want real testimony from real people who were as big as me . I'm 5'7 293 lbs, and I want to be 150 lbs. If I follow the guidelines they tell you that sleeve will give you a 60-70% excess weight loss, that means I'd be 220. So I don't know why they put 60-70% if so many people lose all of it and it's more common than it says

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You need to look at the statistics from large research studies and not base it on what you see on the boards. Long time vets who are still hanging out here after several years post-op are likely to be patients who were very successful. And it could be that for many if us, staying active in the bariatric community might be one factor in our success.
The statistics show that the average RNY patient loses about 70% of their excess weight, and the average VSG patient loses about 65%. Most patients end up somewhere around that peecentage. Of course you will always find people who end up above or below the average, and some WAY above or below that. The percentages get smaller the further you get away from the average. A 100% loss is a couple standard deviations from the mean, so you're not going to find a ton of people who end up there.
My surgeon discouraged me from my goal of 100% loss, saying that only about 10% of his patients make it the far. But, i did it. And so did a few others from my clinic. But we're not the norm.

I've checked the research. Studies show that about 10-15% make it to a normal BMI. Most end up overweight or class I obese (both of which are infinitely better than weighing 300+ lbs). But some of us do make it. But it takes some serious commitment and hard work. You can do it.. but it'll take a lot of dedication and effort.
I'm afraid I'll fail cus im always hungry, always eating the next meal every 3 hours and my cravings are out of control. What do you think I should do?? Does the hunger control with the sleeve last long enough to lose weight easier than how im struggling now everyday??

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6 minutes ago, NYCGirl9269 said:

I'm afraid I'll fail cus im always hungry, always eating the next meal every 3 hours and my cravings are out of control. What do you think I should do?? Does the hunger control with the sleeve last long enough to lose weight easier than how im struggling now everyday??

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most people lose their sense of hunger for several months. And when it comes back (it doesn't always, but it does for the vast majority), it's usually not as intense as it was pre-surgery. As for dealing with cravings, a lot of WLS patients work with therapists on that (I never have, but many people do...)

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most people lose their sense of hunger for several months. And when it comes back (it doesn't always, but it does for the vast majority), it's usually not as intense as it was pre-surgery. As for dealing with cravings, a lot of WLS patients work with therapists on that (I never have, but many people do...)
Thanks for letting me know...and when you're in the first year out of surgery would staying in ketosis help burn the fat more? Like staying under 20 net carbs...or does that not apply once you get surgery?

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36 minutes ago, NYCGirl9269 said:

< — >

- if both surgeries are just as easy to fail as they are to succeed, why do the research charts show this difference?

Research is based on averages. The numbers you are quoting do not apply to everyone in exactly the same way....it is an aggregate of those who reach goal AND those who don’t. 1 person loses 100 lbs. Another loses 40 lbs. Average weight loss of this “control group” is 70lbs...which is no where near what each person actually lost. @catwoman7 probably explained this better than me In her earlier post, lol

Second, if you need to rely on averages for your peace of mind, it may be worth your while then to look into the makeup of the studied. Age, gender, starting weight, lifestyle habits, medical conditions, genetics, etc. Daunting, yes, but more informative and contextual.

But really, wanna beat the average? Stick to plan more consistently than the “average” person (barring any medical conditions of course).

Also, I wanted to ask, did you get to choose the size boujie you wanted for your sleeve or know what size Dr used for you??

Doc just did his thing with no input from me. I have no idea how what size he used!


Also, did you cravings and hunger completely return after 6 months or it does but slightly?

My hunger levels and occurrences has not returned to pre-op levels. I can’t remember when I first felt hungry though (it was months in)...but I do remember it was a rare occurrence. Even now at 2+ years out, i still have days of just not wanting/forgetting to eat. When i do get hungry, it isn’t the ravenous kind of hunger though. And it doesn’t take much to satisfy it.

Lastly, can you just do complete Keto during the first year after surgery so you stay under 20 net carbs and in ketosis? Or our body doesn't need to be in fat burning mode because of the surgery?

I didnt do full-on Keto during weight-loss phase because there was no way I could get in the percentage of fat required...but I did do ultra-low carb (20 net carbs max) during that time.

But number of grams of carbs consumed is no where near as important as total calories consumed for weight loss. Though going low carb does tend to make me look lean. For my body this is good, cuz i can see more muscle definition, but for my face, not so good, as I look Skelator-ish. Since I have been consuming a higher number of net carbs (anywhere in the 100-175 range) my face looks much nicer, but the bod looks “soft”

P.S. sorry this was so long

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I had hunger and cravings early on with my bypass, but the restriction and religiously following the Protein first mantra prevented me from indulging. The physical hunger is unpleasant now with a shaky, nauseous, generally yucky feeling. Head hunger is real and annoying. I mostly choose to not listen to the head hunger. 🤷‍♀️ If you follow the protein first rule, it is almost impossible not to be in ketosis at first. As soon as I had room I added in some carbs though (mostly fruit), as I did not want to stay in ketosis. I can’t stand the body odor when I am in ketosis 😂 I exercise a lot and lost 100% of my excess body weight in just over 6 months. I am in what I will label as the vanity phase, as I work towards my chosen goal of 150 pounds. Ultimately, I actually want to get to 135-ish so I have a little cushion for bounce back. I chose bypass due to a 15 year history of GERD. My surgeon generally pushes for sleeve, but agreed with my desire for bypass due to GERD. I think either surgery would have been effective, but I did not want to have a revision if my GERD got worse.

I hope some of that helps. 😊

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One other piece of advice I have is that you are focusing on the all or nothing approach that isn’t going to serve you well long term. Let’s pretend you only lose 90% of your excess weight. Isn’t that a heck of a lot better than where you are at now?

I started off at over 48 BMI and 339 lbs. I had 174 lbs to lose to get to goal. I knew this was a huge amount so one thing I did to help myself was I committed early to losing weight. I lost over 50 lbs before surgery by sticking to low carb, and I just hit 90 lbs overall right after my two month surgery-versary. I’m over halfway there, with 84 lbs remaining. If you’re worried about the honeymoon, you have control over that. Start today, because every pound you lose now is weight you don’t have to lose later. And stop worrying about averages or anecdotes. You aren’t an average, you’re one person being given a tool that you can do amazing things with, or you can waste entirely. The success is about the person.

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I did A LOT of research on this and I found my best option was R&Y & Im so glad I did it. I wanted the extra restrictive requirements, responsibilities and accountability for attention to my diet requirements. It's quite a commitment either way, a lifelong change to better your health. However R&Y route is a bit more intricate and to go that route does require some discipline and commitments like the taking of supplements for the rest of your life, I don't mind because they don't bother me and I've found affordable ones I like. I lose about 2.7 lbs a week and I have very little that I cannot eat, real sugar and snacking are my 2 nono's.. Dumping syndrome is no joke and makes you feel quite crappy, like the flu but worse and verry sudden, so the knowledge that if you eat too much, too fast, drink with food or the wrong foods you'll feel like absolute crap keeps me in line and accountable as well.

I seem to see a lot more ppl getting revisions these days too that had Sleeve vs R&Y (In my opinion) so its really about looking honestly at your personal relationship with food, discipline level and weighing out the pros and cons of each procedure for you Personally. Msg me anytime!

Edited by kelly Lake
Spelling lol

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Good Afternoon, I am waiting to be sched for the bypass. I have to have the bypass because I had Neiseen for repair of hiatal hernia and reflux. I am a bit nervous but looking forward to loosing weight. Not sure what I am mist nervous about, the surgery of being able to drink Protein Shakes ( I hate milk).

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