sleeve vs bypass

Due to the A1C, I would also recommend RNY.

To me, there are a lot more scarier words to be worried about, but yes, feeling scared of surgery is totally normal. However since I knew I was going to be surrounded by medical professionals whose sole job is to help me thru surgery & provide pre op & post op care, surgery was a little less scary.

Complications can happen with any surgery. Do your research & pick the surgery that is best for you. I also had diabetes (in remission) & went with the VSG surgery. It was thru lifestyle dietary changes & getting off the excess weight that I was able to get off of all diabetes medication, but everyone is different, so your results might be different from mine.

For me a restriction only type of procedure was what was best for me, the rny & the ds is good too, some people do need the malabsorption part to help them get the weight off & keep it off.

Good Luck with whatever you choose to do.

My team explained a couple of differences between the RNY and the VSG.

RNY:

• weight loss is through food restriction and malabsorption so greater life long reliance on and more types of vitamin and mineral supplementation
• food no longer goes through the sphincter like opening at the bottom of the stomach (entrance to the small intestine) so post recovery soup and drinking after eating are forbidden
• remainder of stomach remains in your body so if necessary in extreme cir****tances it is reversible)
• 6 incision spots (if done laproscopically)
• has lots of long term study results
• not appropriate for anyone reliant on NSAID medications (like anti-inflammatory)

VSG

• weight loss is through food restriction only, still need life long supplementation but the variety and amount are less
• the sphincter like opening remains intact which meaning food passes into the intestinal tract only after it is well mixed with digestive juices and enzymes. AND it is possible to have soup in the future (though not recommended) and if by accident you consume liquid after eating (while uncomfortable) will not immediately flush the food through to the intestine
• the remainder of the stomach is removed from your body (ie: this is a permanent surgery)
• 5 incision spots (if done laproscopically)
• has 10 years of study results but because those results don't qualify as being "long term information'. Yet, I was told (with a 'this is very likely' undertone) it may some day soon become the 'gold standard' of bariatric surgeries
• The full functions of your stomach remain intact (except for the hunger hormone generating location which is removed) it is simply very much smaller. This means one can better tolerate NSAID medication and can potentially swallow pills (post recovery) instead of having to chew them

Here in Canada with our 'universal healthcare' we are fully assessed by the bariatric team and then told which surgery they are willing to do. At the moment everyone is expected to get the RNY it is only by exception the VSG is offered. I am one of those 'exception' cases and am fortunate enough to be getting the VSG.

Please if I have made any errors in my 'facts' please know I am not a medical professional and am only forwarding information I was told.

I personally believe the VSG is better because the food gets to churn in the digestive juices before moving into the intestine, I feel this is more 'natural'. It also leaves the option of having the RNY in the future if necessary.

There are plenty of great success stories (before & after) on the site. Good luck for which ever you choose.

P.S. Which are you more afraid of... living as you have been at your weight or having a real shot at the life you want for yourself, the life you feel is truly worth living. That's the decision I used to get over my fear of the surgery itself.

I'm guessing you meant this for the op?

A few comments on your information:

• Caloric malabsorption is not necessarily permanent with RNY. Most people seem to have it at maximum for about a year before the stomach villi begin to grow back.
  
  
• While the stomach is removed with a VSG, it's possible to revise to an RNY or DS, so you're not necessarily limited to a VSG forever.
  
  
• I've never heard of any other sources saying soup is off-limits after RNY. Ability to eat a single type of food doesn't seem like a good argument for or against either procedure.
  
  
• Newer guidelines advise against NSAIDS for VSG patients as well.
  
  
• Recent supplementation guidelines are the same for RNY and VSG patients (as far as I've seen).
  
  
• Hunger hormones are not removed permanently with the VSG. Ghrelin is produced elsewhere in the body, including the brain, and many people have a return of hunger post-op. Some people never lose the hunger in the first place.
  
  
• RNY patients are able to swallow pills with no problem. Folks may need chewables immediately post op, most RNY'ers can and do take regular pills.
  
  
• Both surgeries are inherently "unnatural." I'm not sure that stomach function is really a good argument in either direction.

Thank you to everyone, I truly value all advice!

I'll be completely honest with you ... your current health situation is scarier than the surgery. 300 thousand people die every year from obesity related conditions. That is a death rate of .2% EVERY YEAR. And I'll be honest .. the higher your weight goes and the older you get the odds only get worse for you. The death rate for weight loss surgery is also about .2% ... but its just that one time.

I'm not going to candy coat the surgery ... they put you under anesthesia and cut you open. Its a risk so go with a reputable surgeon/hospital setting. That is CRITICAL in your outcome. Follow your doctors orders.

As for the question of which surgery to get ... if you have diabetes get the bypass .. if you are borderline you might want the sleeve instead. That is really something to discuss with your doctor.

Thank you, I value All input seriously!

I am 64 years old. My surgeon recommended a by pass but I elected to have the sleeve because it doesn't alter the natural anatomy as much.

On "average" the expected weight lose for a person my size was 40 lbs in the first 6 months and 80 lbs in 18 months. I just made up my mind NOT to be average.

Yes, I am probably losing weight slower that I would have with a by pass but this is not a race...my A1C was 8.7 on my surgery day, it was 5.7 by my 3 month post op visit. Last month I went off ALL medications for the first time in 17 years.

That is totally AWESOME! Congratulations! I bet you're thrilled! Keep it up!