Deciding between bypass and sleeve?

[Pines 37]

How did you decide? My doctor said I have no issues/conditions that would make him recommend one over the other and it’s completely up to me. I’m doing lots of research on both and am really unsure - thought I would ask here. Thanks in advance for sharing your thoughts and experiences!

[catwoman7 10,867]

you'll likely get several different answers here, but here are mine:

1) I had GERD prior to surgery. I knew there was a 30% chance it would get worse if I'd have had sleeve, and I wasn't willing to take that risk (some people are, though - and some luck out)

2) VSG was still pretty new when I had my surgery eight years ago. It didn't have much research behind it yet, and I was a little afraid it might turn out to be "Lapband 2" (it's been several years now and VSG has proven itself, so I wouldn't have this particular concern if I were choosing between surgeries now)

that said, I'd still choose RNY because of reason #1. Plus, I've been really happy with my RNY. I did far better with it than I ever dreamed I would!

[SuziDavis 544]

I chose the sleeve due to the recovery and complication rate being lower, and having more options for revisions, if needed, later down the road. I knew I would probably take longer to hit my goal weight, but I was ok with that.

[NP_WIP 273]

I was ignorant about the differences between procedures when I was looking into doing the surgery, however had a close friend and family member who each had done one procedure both in April of last year.

Based on their experience post op, the rerouting of the intestine and the fact that I didn't want to loose it to fast with the idea of giving my skin time, and learning to fuel my body, I went with the sleeve.

[The Greater Fool 1,952]

I was four square opposed to WLS because I told myself that if I got serious I could do it with diet and exercise. The problem I kept running into was I could go a week and be completely compliant with my plan, but it only took one moment of lost focus and the resultant binge undid the whole week of perfection. Eventually an article about weight loss turned out to be an article on WLS and my interest was piqued. I then began my research.

Back when I had surgery VSG was not a thing. My choices were Lap-Band, RNY, or DS. I researched each thoroughly, to the extent that when my surgeon asked my preference and why I was able to go into detail about each procedure and why I chose what I chose.

Initially I wanted the Band because it was 'less invasive' and it could be easily reversed. I decided 'less invasive' was not a reason to have one surgery and not another, what was important is which surgery would give me the best results. In relation to the Band specifically, after some soul searching I knew that if things got hard I would sabotage myself until the Band just had to be taken out and I would be worse off than when I started. While the other surgeries can technically be reversed, it is much more difficult and only done in extreme circumstances. Basically, no matter what happened I would have to make the best of it, which really is my default outlook. I needed a surgery that was forever.

So I was down to RNY and DS. The DS generally had better long term results. Back then their was no restrictive aspect to the DS it was totally malabsorption. There were also many reports of some patients losing too much weight and having issues getting up to a healthy weight. Even then surgeons were getting better at preventing that, so this was probably not going to be an issue for me. But, DS folks often talked about being able to eat anything in just about any volume and still losing weight. This was a problem for me, because I was a binge eater and I wanted to change my habits and I didn't feel the DS would push me in that direction.

Here I am at the RNY. I wanted the malabsorption to give me that slight edge to get my digestive system on board with my goals. Of course the restriction was what I wanted to teach me to limit my portions and prevent my binging. I also wanted the 'complication' of dumping as this would keep me away from sweets. Binging and sweets are a bad combination and I felt the RNY would address both. So I chose RNY.

As it turned out I do dump on both sugar and fats. It took an amazingly few dumping episodes to learn to stay away from sugars and fats, so that problem was addressed quickly. It also took amazingly few episodes of one bite to many to learn not to, so my binging was addressed. I got everything out of my RNY that I hoped I would. Here I am 20 years later, and my restriction is still in full force. Eating to plan is so natural and normal I don't even think about it.

Good luck,

Tek

[CarmenG 149]

In 2009, I chose the sleeve because it's less invasive and there's less maintenance involved. Some say you lose more with the bypass, but I lost 149 lbs. in the first 18 months with a sleeve. Now, due to my life taking the turns it did, 14 years later I regained all my weight. But that wasn't the surgery, it was all me. One month ago, I had a revision from sleeve to bypass. And I can tell you this... if I could go back in time and take care of my sleeve like I should have, I would absolutely, positively do it. I'm not liking this bypass one bit, and I would never recommend it over a sleeve. Just my 2 cents.

[catwoman7 10,867]

1 hour ago, CarmenG said:

In 2009, I chose the sleeve because it's less invasive and there's less maintenance involved. Some say you lose more with the bypass, but I lost 149 lbs. in the first 18 months with a sleeve. Now, due to my life taking the turns it did, 14 years later I regained all my weight. But that wasn't the surgery, it was all me. One month ago, I had a revision from sleeve to bypass. And I can tell you this... if I could go back in time and take care of my sleeve like I should have, I would absolutely, positively do it. I'm not liking this bypass one bit, and I would never recommend it over a sleeve. Just my 2 cents.

you're not very far out yet - you may change your tune about the bypass. The first few weeks can be rough, regardless of the surgery type.

[CarmenG 149]

3 hours ago, catwoman7 said:

you're not very far out yet - you may change your tune about the bypass. The first few weeks can be rough, regardless of the surgery type.

I sure hope so. I know I need to get back my positive attitude (like during my pre-op dieting, when I lost about 30 lbs in as many days). It's just hard with all the other things happening to me right now with the weight loss stall, insomnia, night cramps, skin issues, and lack of energy. I really just want everything to balance out already. Thank you for the encouragement, though.

[Midwest Grateful 48]

15 hours ago, CarmenG said:

I'm not liking this bypass one bit, and I would never recommend it over a sleeve. Just my 2 cents.

I appreciate your input on this topic, @CarmenG. 1) Is there one or two main things you don't like about the bypass, or is it just more restrictive overall? And 2) Have you done much exercise in either case? Just wondering if that was a factor in your weight loss.

[Midwest Grateful 48]

2 minutes ago, Midwest Grateful said:

I appreciate your input on this topic, @CarmenG. 1) Is there one or two main things you don't like about the bypass, or is it just more restrictive overall? And 2) Have you done much exercise in either case? Just wondering if that was a factor in your weight loss.

Actually, you may have answered most of this with your previous post. I hope things level out for you soon! ((hugs))

[CarmenG 149]

33 minutes ago, Midwest Grateful said:

Actually, you may have answered most of this with your previous post. I hope things level out for you soon! ((hugs))

I feel "less" restriction with the bypass. That could be because I still felt sleeve restriction, even after all these years. Up until this second surgery in June, I could never eat more than 1/2 a burger. I couldn't eat more than 1 slice of pizza, with maybe just the toppings of a second slice. So, now, I don't feel any different as far as restriction. What's different this time is the constant worry that whatever I eat is going to make me sh** myself or cause extreme nausea, vomiting, and pain. I didn't have that fear with the sleeve. When I got the sleeve, I was really very careful with my eating (just like now), but I would feel restriction more quickly up in my chest. This led to the "foamies" once or twice, but I never puked, felt nauseated, got sweaty, had abdominal pain, or got diarrhea . Also, the sleeve is NOT a malabsorptive surgery, so I knew I was going to absorb everything I consumed seeing as my intestines were complete and intact. I never feared malnutrition like I do now. With the sleeve, I didn't take handfuls of pills all day long. I took one Multivitamin a day, and that was it. With my sleeve, I didn't exercise for like the first year and a half, I just lived my daily life going to work and back. The weight fell off daily. I kept that 149 lbs off for 6 years. Now, with the revision, I've been stalled for a month. I don't know if 45 lbs is all I'm ever going to lose. It's a possibility seeing as my body is already used to the limited calories. I am exercising now, but the scale isn't budging. I did and do understand that because it's a revision the weight loss will be slower, but a whole month with only a 2 lb loss is even worse than a regular person with no surgeries who just diets. A kind person mentioned that it's still very early for me in this bypass experience and things may get better. I'm hoping and praying that they do.

Edited July 22, 2023 by CarmenG

[Tomo 1,137]

In 2009, I chose the sleeve because it's less invasive and there's less maintenance involved. Some say you lose more with the bypass, but I lost 149 lbs. in the first 18 months with a sleeve. Now, due to my life taking the turns it did, 14 years later I regained all my weight. But that wasn't the surgery, it was all me. One month ago, I had a revision from sleeve to bypass. And I can tell you this... if I could go back in time and take care of my sleeve like I should have, I would absolutely, positively do it. I'm not liking this bypass one bit, and I would never recommend it over a sleeve. Just my 2 cents.

I'm the complete opposite. I love my revision. I literally feel normal (pre-any WLS) with the added benefit of controlling my weight loss. Literally the only side effect I have now is slight Constipation (3 to 4g Miralax a day does the trick) but I had that with the sleeve too. I wish I wasn't so scared to do the bypass in the beginning. It would've made my life so much easier. I really hope it improves for you.

[Tomo 1,137]

I feel "less" restriction with the bypass. That could be because I still felt sleeve restriction, even after all these years. Up until this second surgery in June, I could never eat more than 1/2 a burger. I couldn't eat more than 1 slice of pizza, with maybe just the toppings of a second slice. So, now, I don't feel any different as far as restriction. What's different this time is the constant worry that whatever I eat is going to make me sh** myself or cause extreme nausea, vomiting, and pain. I didn't have that fear with the sleeve. When I got the sleeve, I was really very careful with my eating (just like now), but I would feel restriction more quickly up in my chest. This led to the "foamies" once or twice, but I never puked, felt nauseated, got sweaty, had abdominal pain, or got diarrhea . Also, the sleeve is NOT a malabsorptive surgery, so I knew I was going to absorb everything I consumed seeing as my intestines were complete and intact. I never feared malnutrition like I do now. With the sleeve, I didn't take handfuls of pills all day long. I took one multivitamin a day, and that was it. With my sleeve, I didn't exercise for like the first year and a half, I just lived my daily life going to work and back. The weight fell off daily. I kept that 149 lbs off for 6 years. Now, with the revision, I've been stalled for a month. I don't know if 45 lbs is all I'm ever going to lose. It's a possibility seeing as my body is already used to the limited calories. I am exercising now, but the scale isn't budging. I did and do understand that because it's a revision the weight loss will be slower, but a whole month with only a 2 lb loss is even worse than a regular person with no surgeries who just diets. A kind person mentioned that it's still very early for me in this bypass experience and things may get better. I'm hoping and praying that they do.

I use a patch a day plus one chewable high ADEK. I don't understand a handful of day vitamins... I guess it depends on your doctor but that seems extreme.

Why did you have the revision? I had to have one for gerd. I had no choice. If you had the revision for more weight loss, the consensus is that it is usually much slower IF your sleeve was done right. The reason behind this is if one ate around the sleeve, one would have a high chance of eating around the bypass.

[CarmenG 149]

4 hours ago, Tomo said:

I use a patch a day plus one chewable high ADEK. I don't understand a handful of day vitamins... I guess it depends on your doctor but that seems extreme.

Why did you have the revision? I had to have one for gerd. I had no choice. If you had the revision for more weight loss, the consensus is that it is usually much slower IF your sleeve was done right. The reason behind this is if one ate around the sleeve, one would have a high chance of eating around the bypass.

I had the revision due to weight regain (not more weight loss from where the sleeve got me). Fourteen years ago, I had the sleeve. It was great, and I kept the weight off for 6 years. In 2014, life began to take its toll, and I gained it back. It took a decade and a half, but it happened. I still had restriction right up to this second surgery. There were other factors, however, like severe depression and anxiety after the death of my parents (18 months apart), a divorce right in between those 18 months, a job transfer I was not expecting and was not happy about the year after that, and then seriously quarantine-ing with my daughter and having to teach from home for a year and a half. Then the medications they put me on which eventually led to drinking alcohol every day.

[Tomo 1,137]

I had the revision due to weight regain (not more weight loss from where the sleeve got me). Fourteen years ago, I had the sleeve. It was great, and I kept the weight off for 6 years. In 2014, life began to take its toll, and I gained it back. It took a decade and a half, but it happened. I still had restriction right up to this second surgery. There were other factors, however, like severe depression and anxiety after the death of my parents (18 months apart), a divorce right in between those 18 months, a job transfer I was not expecting and was not happy about the year after that, and then seriously quarantine-ing with my daughter and having to teach from home for a year and a half. Then the medications they put me on which eventually led to drinking alcohol every day.

[emoji22] Big hugs.

I agree with the others and just give it time, I didn't feel nor understand the different restriction cues till a couple of months in.