Re-sleeve or SADI

[PLP 4]

Hi,

I'm after some advice. I was sleeved in 2015, lost 55kgs and kept that off for many years. I have re-gained almost 20kgs in the last 1.5 years. I met with my surgeon and he'd recommending a re-sleeve, but I wonder if I should go for a SADI by-pass. He said he can do either BUT not together (as my BMI is too low)- so either re-sleeve or the conversation part of SADI only.

Any feedback?

[Arabesque 7,617]

What about trying a GLP-1 versus surgery? Check out Dr Matthew Weiner’s Pound of Cure website, podcasts & you tube channel. He’s been speaking a lot about recommending sleevers with regain to use GLP-1 meds instead of a revision surgery. You may find it interesting & something to discuss with your surgeon as another option.

PS. Out of curiosity what was your original starting point weight, your maintenance weight, and current weight?

[PLP 4]

Thanks, that's a really interesting point. I've heard some shocking stories re. glp1 but maybe i need to dig deeper?

HW: 105kg

LW: 54kg

CW:74kg

I'm only 162cms though

[Arabesque 7,617]

Speaking as someone who is 161 cm, you’re never ‘only’ 162cm. 😁 Your other stats aren’t that far off from where I was too initially.

I understand your reticence about GLP-1s as I did too when I first heard about them. However, from what I’ve since read and know from those who use it, or have used it, it can take a little time to work out what is the right dose for you (re side effects, maintenance, long term needs, etc.). It does work and is amazing at stopping the food noise in your head if you experience that.

[PLP 4]

Thanks Arabesque, nice to know there's a fellow "shortie" here and yes, it's all relative right - but I'm aware some people see the #'s and assume its "too light".

My main issue with GLP-1 is that it's an ongoing shot versus getting it sorted and re-setting and then re-working the system - does that make sense?

[GreenTealael 25,622]

Did your surgeon explain why he thought a re sleeve would be appropriate/help? Was there any mention of RNY bypass? Are you self paying or going through insurance? Let us know how it goes!

Edited October 21, 2024 by GreenTealael

[PLP 4]

Hi, he thought as i had great success and no complications initially, as as my restriction was gone, it would be the best option for me. Paying myself

[GreenTealael 25,622]

9 minutes ago, PLP said:

Hi, he thought as i had great success and no complications initially, as as my restriction was gone, it would be the best option for me. Paying myself

Ok, I thought so. TBH the only time I have seen re-sleeves posts, people are usually self paying. I don’t think insurance will even cover them. Do you know if insurance will cover SADI?

[PLP 4]

Not sure if you're in the US but in Australia, our insurance is different. Top level insurance covers all weight loss surgeries, but i only have mid-level so have to pay myself

[GreenTealael 25,622]

31 minutes ago, PLP said:

Not sure if you're in the US but in Australia, our insurance is different. Top level insurance covers all weight loss surgeries, but i only have mid-level so have to pay myself

Well then crunch the numbers with your surgeon (costs, outcomes, risks, etc) and choose the best. After all you want the best option for your money (present and future)

Edited October 21, 2024 by GreenTealael

[PLP 4]

Thanks, makes total sense!

[ShoppGirl 5,073]

I had sleeve revision to SADI (just the bypass portion) and I am really happy with my decision. My surgery was August 7th so I am about 2.5 months out and including my preop loss I have lost 55 pounds. I am over halfway to my goal. I have been eating 100% on plan though and exercising a pretty great amount (2.5-3 hours a day). The revision surgery gave me the metabolic Hca Hes tk actually do Al of that though. I never exercised or prepared fresh homemade food with my sleeve. Didn’t have the motivation. It made a pretty huge difference for me. Did your Dr do a endoscopy, barium swallow and gastric emptying study? Mine did those tree before deciding I was a candidate for SADI or Bypass. If the sleeve didn’t work for you long term then I would probably lean away from a ReSleeve. Just thinking why repeat history. Try something different but that’s just me. The research does say that the loss is more durable witb the SADI revision than the Bypass. Not certain about the ReSleeve but my guess is that too since the Virgin Sleeve doesn’t have the best statistics for durability. Also, resleeve is kinda risky. My Dr said he wouldn’t touch the sleeve with the SADI not because of my BMI but just because he doesn’t think it gives that much more benefit to justify the risks so that’s something to look into as well.

Ooh and if you do have coverage for the GLP-1 and you can tolerate them, they do work. They don’t have to be long term for everyone either. If you take the time on then ti make real lifestyle changes you may be able to go off of them and maintain. Ibvuously If you just eat a few French fries for your meal you will lose, but will obviously eat more when you don’t have the meds but if you genuinely change your habits then people do maintain the loss. I have a friend that is almost to goal and she has been asking me for advice of what foods to choose to be sure to get her Protein in. Kinda odd because she is smaller than me but I have heard a couple success stories with them. My friend has to force herself to eat. It’s a chore. If you do go that route, talk to your doctor about staying on the lowest dose that works for you. That’s the thing that many bariatric doctors usually recommend and it makes sense to try to avoid the side effects. . And some people go onto a maintenance dose after they reach their goal if they need it. Also, see about a three month supply when you do get to the dose that works because for my friend it’s cheaper that way. I strongly considered them but I didn’t have adequate coverage. I even considered postponing to see if things would change but my family Dr advised against waiting since these things can take a long time.

There are pros and cons of each option but do your research. This is a good start but make anothet appointment with you surgeon if you have more questions. I did several before I decided. You probably only have this one more shot at this. Not a lot of surgeons will do a second revision ooh and that is one thing to consider if you do go with SADI, it’s newer so ask your surgeon if you had a complication god forbid what you would do. Mine actually brought it up that he would send me to another hospital to someone with more experience with the surgery. I mean obviously he would stabilize me but if I needed a revision because of malnourishment or something he would send me elsewhere. I kinda respected the fact that he would admit what his limits were and appreciated it but maybe you feel differently about that. Or maybe your surgeon is fine with revising if necessary but I would for sure ask.

Edited October 21, 2024 by ShoppGirl

[Arabesque 7,617]

Hey a fellow Aussie. Where are you @PLP. I’m in Brisbane.

[ShoppGirl 5,073]

12 hours ago, PLP said:

Hi, he thought as i had great success and no complications initially, as as my restriction was gone, it would be the best option for me. Paying myself

Ask him about the statistics of long-term success with the sleeve. The sleeve is great for many people don’t get me wrong, but I believe it was 26% of sleeves that need to be revised. If I’m not mistaken, this included because of Gerd as well, but also inadequate weight loss to begin with or weight regain, which was more common with sleeve than with the other surgeries. When I talk to my surgeon about revision, I wanted assurances that I wasn’t just wasting my time going to lose all of my weight. Only to turn around and gain it back and he said the sleeve does not have the same metabolic changes that the SADI or Bypass offer. While the. Sleeve is enough of a change for many people it’s just not enough for some. In my case when I lost my weight, I was basically on a diet with the sleeve which was a little bit easier because I wasn’t hungry, but once the hunger came back, so did the weight for me so this may be different for you because you did keep it off for a while, but I would ask what the statistics are in terms of people who gain it back down the road with sleeve is that more common than with the other surgeries? I guess one kind of pro for doing the sleeve would be that if you did regain the option for a revision would probably be a lot easier. Not trying to say that you want to think of that before you even start but it is a possibility for all of us I guess. It’s a lot of questions and a lot of information when you start weighing more than two options especially but just be thorough and ask all your questions you will know which option is best for you once you feel educated about them all. Best of Luck.

Edited October 22, 2024 by ShoppGirl