Decisions

What made everybody decide on the VSG instead of the bypass? I am thinking on going with the VSG but i am curious as to what others have to say. I have been watching toms of youtube videos and some people are saying that they are only losing 2-3 lbs a week. Is that true?

Here's what I've written about my choice:

The four WLS are - sleeve, gastric bypass (RNY), lapband, and duodenal switch. My insurance covers the first three, but not the DS.

I ruled out the lapband immediately because the only people I know who have had it are miserable or have needed it removed. The complication rate is atrocious and it only lasts for 10 years or so. It's billed as being a "reversible" surgery, but the damage it can cause, like from erosion into your esophagus, is permanent. So no lapband for me. Here's an article on that topic.

The choice really boiled down to RNY or VSG and I chose the sleeve for a number of reasons. (Even if DS had been an option, I would not have chosen it.)

1. I really like the simplicity of the sleeve. All it does is remove 85% of your stomach. That's it.
2. I dislike the idea of having my intestines rerouted.
3. The "good" malabsorption that the bypass gives (of fats) is a temporary thing that only lasts for a few years whereas the "bad" malabsorption (of vitamins and minerals) lasts for forever. That's not worth it to me.
4. The sleeve is restriction only, no malabsorption. This also means that I CAN eat anything at all. Fats and sugars won't screw up my bowels the way they can for the bypass. (Of course I still need to make healthy choices, but that's a choice, not something that my surgery requires.)
5. With the bypass, you're left with a remnant stomach that can't be scoped. That scares the crap out of me. First, the idea that I have this weirdly connected non-stomach but then to not be able to get it checked out with an endoscopy if there's a problem? Eek. Do not want.
6. My understanding is that complication rates with the bypass are significantly greater, especially longterm due to malabsorption. While I will be taking vitamins for the rest of my life, chances are that I won't end up in the hospital if I stop because the sleeve has no malabsorption involved.
7. For the most part (and there are exceptions) the people I know with the sleeve look and seem healthier than the people I know with the bypass. That's nothing scientific though.. just a gut feeling.  (Edit: This is based on people I know IRL, I know many healthy RNYers on the forums.)
8. The sleeve leaves you with a fully functional pyloric valve at the bottom of your stomach whereas the bypass gives you a stoma which can stretch over time.

Thank you so much. My # concern with the bypass was malabsorption i don't want to have vitamin deficiencies. It does give me alot to think about

For some people, the key to losing weight is more than just eating less.  The malabsorption adds to the formula for weight loss as well as diabetes control.  The malabsorption of the RNY and DS helps with maintaining the weight loss, long term.

Here's my list, written back before I had surgery.

"Only" 2 - 3 pounds per week is actually very good progress, things usually slow to a pound or two a week after your rapid initial loss. The RNY isn't that much faster, and if you're expecting to lose more than 3lb/week you might want to adjust expectations.

Thanks for clarifying. I didn't know the rate of weight loss. 

What Julie said. If you could sustain 3 pounds a week loss, you'd lose 156 pounds in a year. I've never met someone who wouldn't be happy with that.

I didn't even think of it that way. I have no expectations just curious as to what the rate of loss was. Thank you.

I would say "ditto" to what Gwen M. said.

At my initial consult, I wanted a lap band ignorantly thinking it would be less invasive than the others.  I asked my surgeon which procedure he recommended after reviewing my file.  He said that many people request a different procedure than he recommends, but if he were a heart doctor or other type of surgeon, most people would more readily accept his recommendations based on his experience and expertise.  My surgeon suggested the sleeve for me and he was right.