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Too Big for Sleeve?



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Hey guys,

Just some details: I've only just met with the surgeon a couple weeks ago and am still completing my appointments and tests. I am female and currently weigh 375lbs and am 5'5. My surgeon said I would have great success with either sleeve or bypass with the bypass yielding most weightloss.

I am still very unsure as to which one I want, but am leaning more towards the sleeve since the surgery doesn't seem as intense as bypass. I am nervous, however that I won't have significant weightloss with the sleeve since I am starting at such a high weight. I totally understand I will need to put in work for either one and everybody's body is different. Am I over concerned? Any thoughts or opinions? Thoughts on Sleeve vs. Bypass in terms of surgery and recovery? I truly appreciate any help and insight!

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I know some surgeons wont do surgery if you are super big. The one i remember said anything above 57 BMI they dont do surgery. But i seen tons of people loose a lot of weight being in the 300's. I am about 320lb and i am 5'4. doing pre op testing now. But as long as you stick to it you will loose weight.

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I had the sleeve 7 years ago and will be converting to bypass in 10 days. This is because of severe GERD. If you have heartburn at all, go for bypass as the sleeve will very likely make heartburn or GERD worse. A lot of people have had to convert for this reason.

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I was over 400 and had to get down to 360 for them to do a bypass, they said I was too heavy for a sleeve and that long term for people my size the sleeve did not show great results. It was sad to hear but I'm not the doctor so I was hopping he just wanted what was best for me.

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Seems some surgeons recommend bypass over sleeve based on the patient’s weight loss history as well as their health. Bypass is generally considered the stronger surgery but the stats on the success of either surgery & how much weight loss is possible are pretty similar.

I mean, they do sleeves on people who started at more than 600lbs on My 600lb Life & they lose weight.

Yes, sleeve changes less of your digestive system & malabsorption issues rarely occur, but your general health status, like pre existing reflux/Gerd, may mean bypass is your best way forward.

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4 hours ago, liveaboard15 said:

I know some surgeons wont do surgery if you are super big. The one i remember said anything above 57 BMI they dont do surgery. But i seen tons of people loose a lot of weight being in the 300's. I am about 320lb and i am 5'4. doing pre op testing now. But as long as you stick to it you will loose weight.

I worked with the pre-op classes in my clinic for about three years (until COVID hit and they went online). Yes - tons of people have their surgeries in the 300s. It was unusual to see someone who appeared to be 400+ (I saw maybe a handful the whole time I did it - and I don't think they were *much* over 400..or didn't appear to be. Certainly no one approaching anywhere near the size of the folks on "My 600 lb Life"). I'm guessing my clinic had a cut off, but I'm not sure what it was. I was over a 60 BMI at my heaviest, so I think my surgeon had a slightly higher ceiling than yours. Whatever they're comfortable with, I guess. But yes - I imagine at some point they refer patients to someone like Dr. Now, who specializes in high risk bariatric surgery.

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I did the sleeve at over 400 lbs. Reasons to pick sleeve:

1. It's a shorter operation time so safer for a high-risk person under anesthesia.

2. If you don't lose enough you can convert to bypass whereas bypass is a one shot deal.

Bypass does yield faster results though. As you can see my weight loss is still going in the second year. I think for some people that would be discouraging but I'm looking at this as a marathon.

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