DS for lightweights?

 Would anyone here recommend DS for a lightweight (BMI 38.1) with no co-morbid conditions?  I am 48, and have been overweight since childhood.   I am not a classic overeater or a binger.  I am definitely a grazer (which I know I will have to learn to control for success with any WLS), and have never had much of a sweet tooth.  I have about 80 or so lbs to lose.
I am currently scheduled for a sleeve with an excellent surgeon who does many of them.  He also does the DS, and is one of the recommended docs on dsfacts.com..  During my consultation, I mentioned in passing that I assumed that my insurer would not approve a DS for me with a BMI below 50 and no co-morbids.  (Altho my current BMI is 38.1 it is "officially" 40.1)  He said that my insurer would in fact approve it, and that if I had diabetes, that would be the surgery he would be recommending for me.  I did not discuss the possbility with him further because i was pretty much set on the sleeve.   I am wondering now if I should consider it.   I want this to be my one and only WLS and I want to reach goal, stay there and be done with my weight struggles.  Revsising to a DS down the line should the sleeve disappoint is not a realistic option because i would have to regain every ounce i lost to get to a BMI high enough for insurance to re-qualify me. 

With a strong incidence of osteoporosis in my family, metabolic bone disease is what scares me the most about DS.  From what I've read, this can be a difficult to treat problem even for people who are diigent with their supplements.  But all the glowing testimonials on the boards from DSers are hard to ignore.  

By the way,  I was initially scheduled for an RNY on 9/12 with another doc who does neither the sleeve nor the DS.  It was a link posted by a DSer to a presentation by Dr. Roslin (http://vimeo.com/25570146) that got me to cancel that surgery and look for another doc.  So thank you to all the people who take the time to post!   (I am cross-posting on DS and lightweights forum.) 
 

Hi there! I just answered you on the Lightweight board. DS is the best decision I've made for myself in a long long time. Your BMI isn't too low.

--gina

If you know you're not an overeater nor a binger, then I think that's very telling. You would probably lose weight with the VSG, but if you're a grazer, my concern would be KEEPING the weight off in the long term. Lots of DSers are grazers and do just fine - you jut can't graze on carbs/sugar all day  ;)

I was another lightweight with a BMI of 39, but had diabetes, hbp, high cholesterol, so I really needed the DS to deal with my comorbids.  It did and I'm a happy camper.  I only lost 65lbs, and am still 6-8lbs from a normal BMI, but this is where I stopped.  The DS is what keeps me maintaining at 139-142 for the last 2.5 yrs.  Best decision that I made.

I was at 39 with high blood pressure as my only co-morbid.  Getting the DS was the best decision I've ever made.

I am at LESS risk now of bone loss than I was pre-op.  Why?  Because I take 600 mgs of Calcium SIX TIMES A DAY along with my Magnesium and D and other bone preseving vites and get my labs checked quarterly.

I think the sleeve is better than the RnY and obviously better than the crap band but I wanted the FINAL ANSWER and I'm not sure the sleee is it for a lot of people.  I know I needed the malabsorption for life and that restriction alone was not good enough.

And since I actually have a sleeve I can tell you that they really do stretch and I can (and do) eat an awful lot.  I can eat an entire restaurant meal, salad, steak, potato and no one would ever guess I had  WLS.

~Becky

From reading your post, I get the impression your only long-term successful choice is DS.  

If you're not an overeater/binger and all you do is graze all day long, then restriction alone may not do much for you.  It sounds like you already volume-restrict per se out of habit.  You'll still absorb every calorie you put in your mouth after VSG; therefore, you risk losing weight initially only to experience regain without significant dietary modifications postop.  So, if the restriction isn't going to do much for you, the malabsorption component becomes all-important.

My wife is a lightweight DSer as are many here on the boards.  She is extremely content with her decision and will be posting her 1-year surgiversary update soon.  I'm sure many other lightweights will chime in here also.  I'm glad you're on the lightweight board as well.  You'll find excellent support here.  

MOST medical providers know very little about DS, so you have to be willing to stay up-to-date on DS issues.  Ultimately, you are your own best advocate.  Your family member(s) need to be knowlegdable about DS also.  DS requires more vigilance and supplementation to prevent complications.  Even with hypervigilance and supplementation, you may still develop vitamin deficiencies, iron deficiency, protein malnutrition, osteopenia/osteoporosis to name a few potential long-term complications.  If you're willing to accept those risks, I'd say consider DS.  

Good luck and keep us posted!    

my bmi was 36 and the ds has worked very well for me. 

Mty BMI was a shade under 40 when I had my revision, and I'm really happy with my decision. I haven't lost down to goal, but I understand that that can be common with revision patients.

 Thanks so much for the responses.  A lot to think about here.  I don't think -  no I know -- that I could not rely on myself to take supplements six times a day like Becky, so perhaps I am not well-suited for DS. I am consistently inconsistent, and it is the character trait I'd most like to change about myself.  Grazing is second!  Any DS lightweights without co-morbids?  Does insurance ever approve us?  It may be worth having another convo with my surgeon about this.