RNY/Duodenal Switch/Lapband

I am researching different types of WLS's for myself. I would like to hear from RNY/Duodenal Switch/Lapband'ers about why they chose the surgery that they did. I work for the state and currently our insurance has a total exclusion on any coverage with regards to weight control. The legislature has appointed a committee to complete a study on WLS's and to make a recommendation about making it mandatory that insurance companies in the state cover WLS. This probably won't happen this session but hopefully it will be finalized for the next fiscal year. So, why did you choose the WLS you had or are interested in having? RNY/Duodenal Switch or Lapband Thanking you in advance for your comments.

I chose RNY. My surgeon's practice didn't offer DS, but I don't think I would have chosen it even if they did. After reading up on it, I just didn't feel comfortable about DS. Plus, it turns out I'm not as good with vitamins as I thought I would be, so DS would not have been a good choice for me. That said, I totally admire the success of people who have had DS and follow all the rules. Weight loss with DS is amazing! As for the Band, although my family begged me to choose it over RNY, I didn't because (1) having a foreign object in me which I could feel under my skin would have driven me nuts, (2) there's a lot of maintenance involved with fills, etc., and (3) I have just the kind of luck whereby I would end up with band slippage or erosion, and I don't want to deal with that. On the other hand, the Band would have been a much better choice given that I want to have children. Also, because it's adjustable, if you start gaining weight a few years later, you can always get a fill to keep your weight down. With RNY, if you stretch your pouch, the only way to get it back to normal is surgical revision. Ultimately, the decision is yours to make. All three surgeries have their distinct advantages and disadvantages, but overall, all three are excellent options. Good luck!

My surgeon specifically refuses to do the band or the switch because he feels they are inadequate when compared with RNY. His reasons range from a slower weight loss rate (and thus discouragement and then non-compliance) to the increased metabolic deficiencies of the switch (compared to RNY). Before anyone judges my comments, PLEASE stop to think these are the things I was told directly from my surgeon... you're free to disagree with him, but frankly I trust his judgement without reservation. That being said, I have personally seen many Band patients do well... but it mostly depends on your eating habits... if your eating malfunction is frequent overuse of sweets... RNY is what will help you avoid doing so (fear of, and actual dumping). If that's your pattern of eating, the band is going to be much harder... you can still eat sugar and would STILL require the willpower to avoid those foods just because you know they are unhealthy. I don't have that willpower... but I do have fear If sheer volume is your problem, and not so much the sweets/carbs/fats specifically.... then the Band can help you too. Many people celebrate the freedom from required vitamins when using the band... but truthfully, a lot of band patients still end up not getting intake sufficient to match their vitamin/mineral needs.... supplements happen

my sister-in-law told me today that she is very much considering having her lapband removed and go for the gastric bypass. she has lost a lot of weight with the lapband, but she has had a lot of difficulties as well. good luck!

The newest copy of SOARD has a 5 year study showing that the band patients average (approx) 35 BMI at 5 yrs postop, while the RNY patients average a BMI of (approx) 26. Abstract link is below. This study finds that the RNY is more viable for achievement and maintenance of long term weight loss. I was very surprised at the findings that Band patients have similar complication rates as the RNY patients, also. All in all, the study finds that RNY is the better choice (of those two choices) for WLS patients to maintain a healthy BMI. For those who ask "What's SOARD" it's the Surgery for Obesity and Related Diseases journal published by the ASBS. http://www.soard.org/article/PIIS1550728906010550/abstract