Weight Loss Comparison Between RNY and VSG

Well, the Realize Band is there too, but that's not my bag so we're going to ignore that right now. 

Would you say these are accurate stats for excess weight lost for each? Do Sleeve patients really statistically lose more excess weight than RNY patients over time? 

Did you get this from a peer reviewed medical journal?

BTW, I thought you already made up your mind?

All I can offer is that several of both have gone back into surgery to get a DS because they didn't get the results they'd hoped.

I can also offer that the sleeve is the newer as a stand-alone procedure, so you're not going to find as much long-term data...probably less than a decade's worth, so you're not going to get a true comparison.

Oh, my here I go again! In interests of balanced presentation for the DS:

Quote from AMSBS clinical guidelines, 2013 update: "Physicians should exercise caution when recommending BPD, BPD-DS, or related procedures because of the greater associated nutritional risks related to the increased length of bypassed small intestine."    

*****    

JAMA Surgery Releases for September 17, 2012  Study Compares Duodenal Switch vs. Gastric Bypass for Morbid Obesity   "Although researchers note a relative increase in the use of the DS, this procedure is still used much less in theUnited States compared with gastric bypass. The researchers suggest that is likely due to several factors, including the technical difficulty of the procedure, the higher reported rates of short-term complications and concerns about the longer-term nutritional consequences of a primarily malabsorptive procedure (where absorption of calories and nutrients is reduced)."     

*****   

Duodenal Switch vs. Gastric Bypass There are higher complications with the duodenal switch as opposed to a gastric bypass or a laparoscopic sleeve gastrectomy or a lap band.  There is a higher risk of leak and a higher mortality with the duodenal switch versus the gastric bypass. Also, there are many more nutritional and vitamin deficiencies with the duodenal switch. Duodenal switch patients have a higher incidence of diarrhea after the procedure, as well.    David Buchin, MD Long Island Bariatric Surgeon    

******      

I think it is essential that a person be as informed as possible regarding the risk/benefit ratio with whatever they undertake, especially in the case of extensive and complicated surgery such as weight loss surgery. Weight loss surgery is also an elective surgery- personal informed awareness is even more important in undertaking it. In the case of the sleeve, the RNY, and the DS, the impact is irreversible. Even if a reversal surgery is performed, it can only be like repairing a broken vase.      

I'm not saying that the DS doesn't have benefits, especially with diabetes and sleep apnea and long term weight loss. It's just that a person needs to be aware of the costs and to look at the possibility from many different aspects.      

The DS is by far the most extensive and complicated of all the weight loss surgeries. There are only around 50 surgeons worldwide who are willing to perform it and it is by far the least performed of all the available weight loss surgeries- why is that? Clearly it is not seen as a moneymaker, let alone something most surgeons want to undertake. I don't think that has much to do with skill level, either, because many thousands of surgeons perform operations even more complicated and extensive on a routine basis. My Bariatric surgeons won't do it at all, and say the added weight loss from DS compared with gastric bypass is offset by risk of complications that far outweigh any potential benefits.      

Plus the jury is still out with regard to the long term effectiveness of all the weight loss surgeries, impact on long term health, and effect on longevity.       

Professional research backed knowledge and opinion with a qualified Bariatric surgeon, several if necessary, is the primary place people should want to go in making a choice that impacts every aspect of a person's health, well-being, and life. Personal experience is all well and good and often useful, but not sufficient, and can only be an opinion, including this one.  

Not, not, not intending this in any offensive way!  Are you in danger of over-thinking all this? You have done an enormous amount of research and asked a great many questions. Then, I thought, you decided!  There are always going to be more questions but IMO the amount of average weight loss is actually the least relevant because that is the one which is down to you. 

Once you have surgery, you make choices. And averages disguise the extremes. For example, I lost 100% of my excess weight and I know others who did the same. Yet the band stats usually say 40-50%. Clearly there are some who lose nothing!  I lost because I did the work, the band made it possible for me. This applies to all surgeries. Average loss is actual meaningless if it is a mean average. A mode average would have significance but I have never seen one if those! 

Apologies on sounding like a broken record. No, I am not 100% anymore. 

I probably am over thinking things. I appreciate the feed back on the chart here. Thanks for keeping me grounded.

The sleeve was not available to me, but I am certain that I would not have done as well with the sleeve as I did with RNY.  The malabsorption was an answer to a prayer after a lifetime of dieting.  Dumping an answer to a lifetime of wanting to eat sugar.

The malabsorption that everyone says goes away did not go away for me.  My body stopped where it was happy.  It regained during the 3th year and stopped at my goal weight.

I still live the same lifestyle through all of this. I have come to accept that as I grow older I need less food and that is true of everyone, so I eat less and my tool makes that easy to do.  I weigh myself daily, have no desire to overeat, have lots of energy and feel great.  If I get into a mood of wanting to eat a lot of sugars or candy, I pay the price with dumping.  It takes away any desire to do that again.

I know that the sleeve is the current surgery of choice and that everyone loves their surgery for the first few years.  I do not know how many sleevers are out there going on seven years from surgery or how they are maintaining their loss. 

I am happy with my RNY, have no complications and still would do it again with no hesitation.  I would not get the sleeve, even if I needed to choose a surgery again.  I hope to be out here someday posting a 30th surgiversary post.

Unlike the person above me, I would urge you to keep as much of your natural anatomy (e.g., get the sleeve) as possible.  Yes, RNY does have malabsorption, but that doesn't last forever.  Your body will adjust, and you will begin to absorb everything you eat after a while.  There's mild dumping, and then there's near comatose low blood sugar from reactive hypoglycemia, which I have.  My blood sugar has gone as low as 23 -- my doctor was amazed that I was still conscious. Had I known all the facts beforehand, I would have fought for my insurance to cover the sleeve, as a couple months of malabsorption is certainly not worth my end result.  Yes, I lost about 70% of my excess weight and I've kept about 65% of it off for seven years, so I'm a success, but I'm also a mess.