Sleeve surgery-BMI over 60?

Before surgery my BMI was 70.9. I'm about 10 months post op and it's now 48.8. I don't think that's bad considering it hasn't been quite a year yet.

My BMI was 78.9 the day of surgery and I wound up losing about 140 pounds post-op. I lost 27 after doing lymphedema treatment which I put off forever because I was annoyed by the compression, and I am still losing quite a bit (1-3 pounds a week). I have not had regain aside from carb bloat when I rarely made poor choices. Prior to that I lost about 300 on my own doing a ketogenic/low carb diet. I have two autoimmune metabolic disorders, so the doctors are stunned I lost weight at all.

The sleeve and bypass have about the same weight loss. A DS tends to have better sheer weight loss outcomes, though. I've seen people successful with sleeves, bypasses, SADIs, and DS procedures alike. Myself, I was actually going to revise to a DS down the road myself, however I have utterly crippling GERD that will not go away even with weight loss, so they are revising to the RNY instead.

What matters in terms of outcomes is more your behavior than the surgery. Those of us with much higher BMIs typically have worse eating habits for obvious reasons, and the DS counteracts eating habits far better than any other surgery. I have seen people with a sleeve lose like 300 pounds over four years, though, and I've seen (more rarely) DS patients regain or lose slowly. Intestinal bypasses (regardless of WLS or not) cause metabolic changes a sleeve does not - the sleeve has it's own though, too. So, it depends?

Behavior is always the biggest factor, you must realize. Surgery type is far less relevant than one might imagine.

Having said that, if you are concerned, I would begin to explore the possibility of a duodenal switch procedure. The loop/SADI/etc is newer (only about 10 years old) but still is promising, however the DS is the gold standard for high BMIs. The loop also requires diligent vitamins and protein/fat consumption...you don't get off easier than with a DS, I'd argue. If you're worried may as well explore the DS before you commit to get a variety of options.

I started my journey at 62 BMI. I was at 59 day of surgery. I chose to have the sleeve, wanting a safer and effective surgery. I see many people on these boards and on bariatric pal who have reached goal. Statistically I think my surgeons office said 60-80% of your excess weight, but a I plan to be 100% like the many I see who have reached 100%. Claim what you want and get it!! I had the option of RNY or Sleeve, and I chose sleeve because I feel that is the best choice. I'm surprised your surgeon has such a pessimistic view. You can certainly reach goal if it is within you to do so. It is a tool. It is not a perfect system, but many succeed when they could not have without it. It is helpful, and it will work if you work it!!!

Many with the higher BMI do very well with the Duodenal Switch. It has a sleeve stomach, and aggressive intestinal bypass to change the way you metabolize food. It sounds like your surgeon doesn't do the DS, otherwise they would have insisted you have it.