Why didn't you get the DS w/ sleeve?

I am considering the sleeve after a failed band. I lost only 20 lbs w/ the band and had nothing but problems with it and had it removed after 4 years. I was also self pay which my husband is none to happy about. He has serious reservations about me getting another WLS when the first was such a failure. I personally am terrified of making the wrong decision. Do I get the sleeve and call it a day or go all out and do the DS as well? I don't want to give up eating healthy fats and am not sure if that is an issue with DS but not with sleeve. Any input is appreciated!! This time around I have insurance to cover so that's the one good spot of news!

Deciding between the VSG and the DS is a personal decision that requires you to do some real soul searching and serious research.  You can gain your weight back with either surgery, but DS is a great deal more forgiving and is a good answer for many people.  I think that people that have difficulty losing weight on low calorie diets, and are SMO and the SSMO should seriously look at the DS option.  

It is my opinion, and my opinion only, that patients with a lower BMI, who have had success in losing weight in the past but have not been successful in keeping this weight off, and are willing to commit to a lifetime of mindful eating, are best served with the VSG when performed by an excellent surgeon. There are trade-offs to having VSG and the DS, I strongly encourage you to look up lifestyles (long-term) with both procedures and decide on what will best fit your needs and expectations.  Don't let anyone proselytize one surgery or the other to you, do your own homework, read medical journal articles and become a real expert.  

I chose the VSG and not the DS because I believed that it was strong enough to have me reach my goal and that I could maintain my weight with some extra help (given by the VSG).  I am five years out, and so far so good.  However, I was a lightweight, and I had lost weight easily before this surgery.  I knew that I would be committed to keeping my calories in a range (maintenance range for me is 1200-1500 with most days falling around 1500 when I count).  I was also willing to go hard core in the losing phase and kept my calories very low, under 800, all the way to goal. I have seen this work for higher BMI people too, but I have also seen people that were not able to reach goal, and more importantly, not being able to maintain.  You have to figure out why you only lost 20 pounds with the band.  Is it possible that a smaller stomach is not enough for you and that you need additional help?  I don't know the answer for you specifically, I could/should only answer this question for myself.  I would spend a few months really looking at this and figuring this out.  Good luck to you in whatever choice you make.  I hope you make the right decision or at the very least make your decision right.  :) 

I was interested in the DS -- I think it is a great surgery -- but a couple of factors kept me from choosing it.

First (but not foremost) - the horror stories I read about people having constant gas after that surgery - that it makes it hard to work closely with people because of all the gas passing that you do. Well, I work closely with people all day, five days a week, and that made me nervous. But that was a very superficial concern and one that I am sure I could have put to rest with more research and talking to people who actually have a DS.

Second - and definitely most important - my insurance only pays for DS if you have a BMI of 60 or higher. I had a BMI of 59 so it was not an option for me as I could not afford it.

I am very happy with my sleeve and think it was a great surgery for me, even with my SMO status. But I also think the DS and bypass are great surgeries and I would not hesitate to consider either one if I felt, down the road, that I needed something more. Good luck to you!

Elina makes some great points in her reply to you.  For me, I wanted to go with the least invasive procedure possible that would give me the best results.  The DS is only performed "open" in my city and I definitely didn't want that.  Open procedures (rather than laparascopic) tend to have more complications and it takes longer to recovery from them.    I also didn't want to have my intestines re-routed in any way.  

The DS is a great surgery for people with higher BMIs that need the restriction and permanent malabsorption component.  I would suggest you get on the DS forum here and do your research, ask a lot of questions and then go with the one that feels right to you.  

Good luck!  

I wish I would have got both

I had my sleeve done Nov 2q10 and i lost 125 pounds and I've gained back almost 50 pounds of it and am very unhappy about it it is so easy to gain your weight back and it is tremendously hard to lose it again I .was scared and didn't want to do the D.S either because .of what I heard but now I wish I would have