Hello, I’ve been doing research for years now on the pros and cons that come with WLS as a whole and I finally decided to make an appointment and see what the doctor says. I thought of going with VSG, that’s what I found more research on from actual patients, surprisingly since RNY has been around much longer. I’m on the lower BMI side without too many medical issues so I didn’t think they’d agree at all. But the doctor gave me a surgery day and all the tests and pre-op things to do. She also told me the requirements are the same for both surgeries and somewhat hinted the weight loss would be larger with RNY and just went along with my choice of VSG, now I’m questioning if I didn’t do enough research and if I should pick RNY instead. How did you made a choice? How did you know it was the right one? These are pretty serious surgeries, I want to know I’m making the right choice long term. What advice would you give your pre-op self about what’s to come?

My wife and I chose VSG because we didn't have excessive heart burn. We also have the ability to transition to RNY if an issue did occur. We also know that the recovery/complications from VSG are slightly less than RNY. You can find studies that RNY does result in slightly more weight loss than VSG does but since my wife and I are working together we are working with each other to get to maintenance weight. I am almost at maintenance weight already after having surgery on 11/11 last year and my wife is well on her way there too.

That’s wonderful to hear. I’m glad both of you have an accountability partner along this journey. Thank you for your input!

I started this process originally thinking I wanted the bypass. But it wasn't until I spoke to my surgeon for the first time that he suggested the sleeve because I am anemic and also because I take Diclofenac (NSAID) for my back twice a day every day. He said if I even THINK that I will continue to need them that he will not do the bypass and instead the sleeve. Which in the end is ok by me.

if you have GERD, consider RNY. VSG can (and it doesn't always, but there's about a 30% chance) make it worse. RNY often (not always - but usually) improves if not outright cures GERD.

outside of that, it comes down to personal preference.

I went with RNY because I did have GERD - but I would have chosen RNY anyway because at the time I had surgery, VSG was just becoming popular, and I was a little afraid of it becoming "Lapband 2". However, it's been around long enough now that it's proven itself.

there's actually a lot more research on RNY since it's been around much longer - but VSG is the most popular surgery right now, and has been for a couple of years, so you're going to find a lot of info on that.

and yes - statistically people lose more weight with RNY, but success is more dependent on your level of commitment than it is on surgery choice. There have been people wildly successful with both surgeries, and people who have failed both surgeries, and lots of people in between. If you're committed, you can definitely be very successful with your VSG...just as successful as you likely would have if you'd chosen RNY instead.

Thank you everyone! Your comments are greatly appreciated. I’ll make sure to use that knowledge for what’s to come. I’m really excited now:)

I'm 24 (F) with no comorbidities and I went RNY because my sister had VSG 3 ish years ago and her weightloss has all but stalled. Also, I have 130-ish lbs to lose. Many factors played into this choice. I factored in my work (academia aka student for life i.e. sedentary M-F) and lifestyle (mostly active on weekends), and we decided that the RNY would be the best tool for me.

I'm only 3.5 weeks out so I can't offer an educated opinion on my choice (especially during a stall), but if you have a lower BMI then I would say VSG is much more accommodating and still quite effective. However, there aren't as many long term studies on VSG so 7-10 years out is no man's land.

I really wanted the bypass, but it turned out that it was medically contraindicated for me. I even got a second opinion and that doctor agreed that the bypass was not safe for me. So I had the VSG as my second choice. I started with a BMI of 47 and 118 pounds to lose. VSG worked out very well for me - I lost all my excess weight and had no major complications. The surgeries have pros and cons but both can be effective.

I was considering sleeve, but am getting gastric bypass a week from tomorrow, During the process I had an endoscopy and they found a hiatal hernia that was causing heartburn. Therefore bypass was better. Also, if I’m doing this, I want the weight loss to be worth it. My BMI is right under 38 today (198.5 lbs). I got two opinions from bariatric surgeons at different practices and both recommended bypass.

Edited March 14, 20215 yr by HeatherE

I was having gastric sleeve but after doing my research. I found out that the bypass would benefit me better considering my condition. I talked to surgeon who also advised me gastric bypass would be more beneficial.

From the people I know who’ve had the sleeve, they haven’t lost as much weight as they could have with RNY. I’m 8 years post op RNY and am doing pretty well keeping my weight off. I got down to 148 (TOO thin), am now at 176, need to take about 12 lbs off now. It will always be a balancing act, no matter which procedure you choose. Good luck!

On 3/13/2021 at 10:02 PM, catlover12 said:

Hello, I’ve been doing research for years now on the pros and cons that come with WLS as a whole and I finally decided to make an appointment and see what the doctor says. I thought of going with VSG, that’s what I found more research on from actual patients, surprisingly since RNY has been around much longer. I’m on the lower BMI side without too many medical issues so I didn’t think they’d agree at all. But the doctor gave me a surgery day and all the tests and pre-op things to do. She also told me the requirements are the same for both surgeries and somewhat hinted the weight loss would be larger with RNY and just went along with my choice of VSG, now I’m questioning if I didn’t do enough research and if I should pick RNY instead. How did you made a choice? How did you know it was the right one? These are pretty serious surgeries, I want to know I’m making the right choice long term. What advice would you give your pre-op self about what’s to come?

I’m also pre-op, but similar in height and weight to you and also without many medical issues. I started the process at the end of December and surgery is this Monday, March 22.

The only reason I considered weight loss surgery initially is because I found out it’s possible to do an endoscopic sleeve and I was too scared to do laparoscopic surgery. Endoscopic is not covered by insurance, but very little recovery time.

After attending intro sessions for different bariatric practices, I decided on gastric bypass laparoscopically. My surgeon said he could do the endoscopic procedure and has taught people how to do it, but it’s not as precise and not worth the out of pocket cost. Weight loss is also less.

Next I was leaning towards sleeve laparoscopically, but I’ve had Gerd which made me a better candidate for bypass. An endoscopy revealed the Gerd is from a hiatal hernia which they’ll fix during my weight loss surgery. Also, if I’m going to brave surgery, I want the surgery that will give me the best results, which is bypass. I got a second opinion from another practice, and they agreed bypass is my best option. I was hesitant because of the required vitamins, but I’m convinced now that it’s worth it.

I am 5 ft 1/2 inch and was 226 in December. In January I started a pre-op low calorie diet and I’m about 12 days into the dreaded liquid diet now. Today my weight was 193.5.

I think sleeve and bypass are both good options and whatever you decide will be a good choice. It doesn’t hurt to get a second opinion either. I totally trust my surgeon and selected him over everybody else. Still I wanted a second opinion to be sure.

Good luck!

Edited March 19, 20215 yr by HeatherE

I have 150+ to lose, am pre-diabetic with hbp and periodic reflux.
I was thinking sleeve because the idea of malabsorption scares me and the need for supplements feels restrictive. And i am afraid that I will not enjoy dinners out and even have difficulty getting enough macros in with the small pouch.
but I have a lot to lose and felt “in for a penny, in for 150 lbs.” ?

I also like that it is reversible (technically) if I have serious problems.
I have been wavering since the beginning too, but am settled on the GB as the best option for successful long term outcome. my surgeon did not push one over the other, but clearly agreed that GB was a better option for me once I indicated I was leaning in that direction.

surgery is 3/26 and I just want to be 6 mo post op already!!

good luck. I think either choice will get us to a much healthier place.

49 minutes ago, Pilot my best self said:

I was thinking sleeve because the idea of malabsorption scares me and the need for supplements feels restrictive. And i am afraid that I will not enjoy dinners out and even have difficulty getting enough macros in with the small pouch.

I don't think there's a difference between the amount of food sleeve patients can eat vs. bypass patients. I have no problem with dinners out. The first few months you're not taking in very much food regardless of which surgery you have - but after that, your volume becomes more "normal". I eat about the same amount as my "light eating" never-been-obese women friends do - no one would be able to tell I had surgery at this point (and wouldn't have been able to tell for a long time - after the first few months, anyway). I've eaten dinners out hundreds of time since surgery. Also, you need to take supplements with VSG, too. Our clinic has both types of patients on the exact same vitamin regimen. Some clinics have the VSG patients taking fewer vitamins, but they still have to take them.

44 minutes ago, catwoman7 said:

I don't think there's a difference between the amount of food sleeve patients can eat vs. bypass patients. I have no problem with dinners out. The first few months you're not taking in very much food regardless of which surgery you have - but after that, your volume becomes more "normal". I eat about the same amount as my "light eating" never-been-obese women friends do - no one would be able to tell I had surgery at this point (and wouldn't have been able to tell for a long time - after the first few months, anyway). I've eaten dinners out hundreds of time since surgery. Also, you need to take supplements with VSG, too. Our clinic has both types of patients on the exact same Vitamin regimen. Some clinics have the VSG patients taking fewer Vitamins, but they still have to take them.

Aahhhh. Music to my ears! And why this site is such a godsend.
Being able to dine out normally! thank you for that perspective!

and my program recommends supplements for both surgeries but It seems more critical for GB because there is such decreased area for absorption to occur. I am a terribly forgetful pill taker so I have been focusing on improving that these past months. In preparation. I hear some lucky few are able to get their nutrients without need of pills. But it seems rare.

Alot of folks already said more or less the same thing, but I'll throw in my 2 cents anyway:

I chose sleeve because:

• I was afraid of dumping (but...I dump anyway)
• I wanted to continue using NSAIDs (but...I ended up not needing them anymore anyway)
• I was personally freaked out a bit by the re-routing of my intestines (but...not cutting out my stomach? lol)
• I DID NOT have GERD.
• I only had a choice between sleeve and bypass cuz those were the only ones covered by my insurance, so I didn't consider any other procedure.

I think that one's results with WLS has more to do with the person, than with the type of surgery. I'm convinced I would have had the same result if I had the bypass. But that's just me.

Some background and current statuses:

I'm 5'2", almost 50yr old female, started off at 235 lbs at the beginning of my 2 week pre-op diet...2.5 years ago.

I got to goal of 127 lbs in 7 months (108 lbs lost at that time).

I settled into 115 lbs by 10 months post-op and stayed there basically since...but not without a bit of effort on my part. 3 times I got up to 120 lbs for a few consecutive days, and subsequently made efforts to get back down to 115. And 4-5 times I went sub-110 lbs for a few consecutive days, but didn't have to make any effort at all to get back to 115, go figure. This morning I was 109.2 lbs.

I consumed very little calories during weight loss phase, and exercised regularly starting month 3 (running/walking mostly, and minimal strength training daily). No complications, nor issues other than those expected (dump with sugar, foamies/chest pressure if I eat too much or too fast, need to barf if I drink with my meals, burp like a teenage boy)

At 2.5 years out, up until a month ago, I was averaging around 1800 cals a day with regular exercise (running & strength training 4-5 times a week). Currently I'm playing around with calories as I'm sidelined on the exercise front, which explains my lower weight these days cuz I haven't figured it out yet. I mostly eat salads (by choice, I LOOOVE salads!) , but I also eat desserts, spicy stuff, fried stuff, fatty stuff, drink coffee, alcohol and carbonated water. On rare occasions I eat bread or potatoes, but I don't eat rice nor regular pasta. I max out at about 1 to 1.5 cups of food per sitting (more if its salad)

My lab results have consistently been uneventful (my last one was in November last year).

So....so far so good. I have no illusions that I will be like this forever...but that's on me, not my sleeve.