deciding

I am 28 years old and pursuing weight loss surgery. I was planning to do the Roux-en-Y, but I felt like the surgeon was pushing me to think more about the sleeve gastrectomy. He didn't specifically recommend one or the other though. I have had people tell me their opinions and such, but am still unsure. I feel like it is easier to be unsuccessful and re-gain weight further post-op doing the sleeve gastrectomy, especially since at this point I like sweets and don't want to fall to temptation by knowing I would be able to tolerate them. What do you think? How did you decide?

What is your BMI and do you have any co-morbidities?

I myself would prefer the VSG over the RNY, because I want to keep my pyloric valve..

Have you read about the Duodenal Switch... It involves the sleeve with a malasorptive component... which will help keep the weight off long term.... you are less likely to regain with the DS than you are with the RNY...

www.dsfacts.com

My BMI is 45, and I don't have any co-morbidities, I am just pre-diabetic. The thing about the RNY is that it is reversible if needed. I don't think the Duodenal switch is an option where I am at. Had never heard of it until I read a book, and also on here.

Most people DO have to travel in order to get a DS, but we all think it was worth it. (*grin*) Also, the DS is much better at resolving or preventing metabolic disorders like diabetes and high cholesterol. And it has the very best long-term, maintained weight-loss stats. Definitely research it as well.

The intestinal portion of the DS is reversable, and I can't imagine any cir****tances where you'd actually WANT the rest of your stomach back. In the DS, the stomach is generally left larger than it is in the VSG.

I saw 3 surgeons before I decided.  The first one only did RNY and the second one did RNY and duodenal switch.  I felt that both of them were "pushing their agenda" vs. advising me what was best for ME.  Also, each asked me what kind of surgery I wanted and I told them I really needed their advice.  I didn't feel that I really got that.

When I saw the third surgeon, he broke down each type of surgery, told me the advantages/disadvantages of each, and recommended RNY for me and told me EXACTLY why this was best for me and my health issues.  And after 9 years of considering this, I had RNY 5 weeks ago today.  I am very grateful and know that I was in the right surgical hands for me. 

My suggestion to you is to see another surgeon if you can and see what he/she recommends to you.  Don't be afraid to be your own advocate and ask questions about WHY he/she is recommending this for you SPECIFICALLY.  Why is this surgery right for you?  Why not something else?  I think you have to be able to engage in that kind of dialogue with a surgeon to trust in taking the next steps.  It is a big decision and you have to fully understand what you are getting into and why a procedure is best for your unique situation. And, if you can't have that level of discussion with your surgeon, who can you have it with?

I am the kind of person who needs to know those answers. I research diligently and always have a lot of questions - I've been diabetic for 25 years and believe that taking charge of my own health is vital. But, that is me, but that is not how everyone feels.  Your post does suggest that you are looking for more info though. 

Congratulations on getting this far - that is a very big step.  Keep looking for the right answers for you.  Check out some of the reviews on surgeons and facilities - I think that might help you as well.

Best of luck!
Terry

I'm not sure you are going to get the fairest and most unbiased opinions on the Main Board. I would encourage you to check out the different forums, and ask your questions there. Above all, do your own reading and research as much as possible.

Did your surgeon say why he suggests the sleeve for you? Also, only a percentage of people dump on sweets after the RNY. I only dump on ice cream, many people don't dump at all.

No matter which surgery you choose, you will have to do a lot of work afterwards with regard to diet and exercise and supplementation and hydration and lifelong follow up. WLS is only a tool, and it matters how you use it.

I do think the choice needs to be yours, though in my case insurance made the choice- they only would cover the RNY and the lap band. Obviously, I could have gotten any kind of surgery self pay.

Good luck with your search!

Hi there,

What is your BMI?

The behavioral modification aspect of dumping syndrome is pure myth. Dumping syndrome does not protect against regain. In fact, dumping syndrome is associated with regain. www.dssurgery.com/newsletters/dumping-syndrome.php

The RNY and VSG have shown to have similar success rates long term. I believe the sleeve is a better option because it keeps a fully functioning stomach, so will be at much less risk of having dietary complications, dumping syndrome and reactive hypoglycemia. Also the malabsorbtion of calories is only temporary with the RNY, but you will always malabsorb vitamins.

Another option is the duodenal switch. dsfacts.com

Why do you think it would be easier to be unsuccessful and regain with VSG?  Are you basing that on facts or just a feeling?

Are you assuming that with RNY you would not give in to the temptation to eat sweets?  Are you assuming you'd dump and that would keep you from eating them?  Only about 30% of RNY folks dump on sugar, and most of those can eat small amounts of it.  So you would probably be able to eat one cookie, at least.  With either surgery, you'll need to find ways to deal with temptation - the surgery won't get rid of temptation for you.

 Hi there!!  First of all please research, research, research all 4 surgery types and when you finish that research...do it again.  You can never been too informed with your life and your health.  

That being said, I had VSG a little over a year ago.  Honestly, it was the only surgery I was willing to accept for me (notice I said for me) even though the doctor tried to encourage me to have RNY because I have PCOS.  I chose the VSG because I felt like it would leave me the most "normal".  I knew I might or might not be 100% with vitamins and I felt like it would be riskier to get slack in that dept with a malabsorptive surgery.  That theory was put to the test over the summer when I did in fact get slack with my vits and some of my levels had dropped on my last labs.  I feel like I would have been in deep trouble if I had done that with either RNY or DS.  Also, I just didn't like the idea of having anything re-routed in my body - personal choice.  

Every one has a different experience with their surgery as far as what they can/can't tolerate so know that I am giving you information based only on my experience since you mentioned sugar.  Before I had VSG I was a total sugar addict.  I truly believe that sugar got me to nearly 300lbs.  Since my surgery sugar is a no ma'am for me.  If I have anymore than a tiny bit of sugar I get nauseated and within 5-10 minutes I'm camping out on the toilet for a while.  

I don't know if I'm an unusual case because I haven't bothered to find out because for now it saves me from eating a bag of M&M's and washing them down with a McDonald's chocolate milkshake. (well that and the fact that my stomach couldn't hold that much)  Also know that only 30% of RNY patients dump.  It's really a crap shoot on what your results would be. (sorry no pun intended)

You have to consider the state of your health before you can make a decision.  How much do you have to lose?  Do you have diabetes or other conditions?  Personally, my only issues were high blood pressure and swelling of the ankles and knees.  I had surgery in September and by November I was only taking a half dose of my BP medicine and was completely off of it by February.  My BP is completely normal now and the only time my ankles swelled this summer was when my clumsy self would fall and twist one.

Use the different boards here on OH to learn about everyones experiences.  Check out the boards for failed WLS, WLS regrets and revisions just so you can see that not every surgey works for everybody.  

Sorry to be so long winded but I remember being in your shoes and not knowing which direction to turn so I hope this helps you if only a little bit.  

Good luck!

I chose the RNY one it was one of the choices from my insurance company.  VSG and Lap-band were the other 2. 
With the PCOS, DIabetes, High Blood pressure, Insulin resistance and managery of other health issues it was the obvious choice for me.
Please research every surgery, talk to as many people as possible, research success and failure rates of each surgery.
This is a tough decision and one that noone else can truly make.  Also you know you better than anybody, how well will you do with supplements?  What are your eating patterns?  Do you need the possibility of "dumping" or other negative feedback from your body to keep your eating on track?
Good luck to you and i hope you find your answer, i would suggest going to the different surgery boards and asking about the benefits and challenges of that particular surgery.