Time To Join the Losers Bench

Hello All my name is Jordan,

Like most of us here I have struggled with my weight my whole entire life. Over the last few years my weight really got out of control and I tipped the scales a 600 pounds. It was then I decided to make a change in my life. I live in Maryland, and looked up the top surgeons in my area. There I found Dr. Kuldeep Singh with St Agnes hospital. I saw rave reviews everywhere online and on this website about him. I went to his consultation, and had a one on one with him the next day.  I was almost sure I was going to do the gastric bypass. I thought it was the best of the best. I thought the RNY was the only thing that could get 350 pounds off me and keep it off.  Actually after speaking with the surgeon, and researching online. It seems like the Vertical Gastric Sleeve is going to be the new gold standard in the next 10-20 years. Its extremely popular, and is suggested by most surgeons over RNY now. I was told the sleeve would get me faster weightloss and keep it off better than RNY. Really RNY is only still done because its still considered the gold standard and a lot of insurances only cover the RNY. Thank God for working for Wells Fargo Unitedhealthcare and Optum. I did not have to do a 6 months supervised diet. All I had to do was a psych exam, and my surgeon suggested a aleep test. I started this journey in July, and now I will be having surgery mid september. I am waiting on the exact day. I am excited, and I am nervous.. But im ready to start the journey 

Welcome.

RNY versus VSG isn't really that simple! They work in different ways and so suit different people. Doctors offering RNY aren't just being rather old-fashioned! They may feel a particular patient requires malabsorption rather than just restriction. And for people with GERD, the sleeve can be a poor choice. I have seen no evidence that loss with the sleeve is faster but it is true that after a few years the malabsorption of the bypass decreases.

Given the choice, I'd have the RNY again in a second. I've researched the sleeve since it became popular, and know a few people who've had it done. It's a very personal decision between patient and doctor. I just know my own situation with the RNY, even with some pretty serious complications in the past few years (all resolved now) I wouldn't trade it for the sleeve or the band. I'm maintaining a 190 lb loss, almost 9 years out. Best wishes to you in whatever you choose!

As someone who has the sleeve and did tons of research prior to making my choice, I can tell you that there is no empirical evidence out there that the sleeve helps you lose "faster".   In fact, most of the scientific research actually shows faster initial weight loss with RNY but the end result (meaning weight) tends to be the same over a longer length of time.  

One of the main things you should consider in choosing the surgery is the type of overeating you are most prone to do.  If it's simply a matter of massive quantities of ANY food then VSG will probably work for you.  If you have a strong preference for sugar, pastries and bread, RNY with its malabsorption and potential for "dumping" may be a better fit.   

However, have you even considered the Duodenal Switch?  It's been proven to be extremely effective for the SMO and it's malabsorptive property lasts a lifetime whereas RNY malabsorption ends after a couple of years.  

Best of luck on whichever one you choose! 

Congrats on getting things scheduled!

There are still many reasons surgeons perform the RNY; I would hope that someone smart enough to attend med school would be able to recommend a procedure best-suited to a patient, rather than doing one by default! The ASMBS is transparent about the medical risks and benefits to each type of surgery, and there are unique aspects to each (such as "dumping" with the RNY, grehlin reduction in VSG) that would hopefully guide that decision :)

It's great that you are on your way. Congrats!! 

I'm 15 months out from RNY-so I'm a newbie still-but I know that it was the best choice for me. I wanted to get VSG at first, but since I had been diagnosed with GERD, and my surgeon felt that with that particular co-morbidity, RNY would be the better choice. I also needed the malabsorption provided by RNY. I trusted my surgeon and have been very happy with my RNY. 

Like Kate said, they work in different ways to suit different needs. WLS is not one size fits all. 

The sleeve is not going to get weight off of you, it is just a tool that will make it easier to stick to a food plan (not politically correct around here to call it a diet).  You will lose weight because you will eat less food.  With RNY you will eat less food and you will not absorb all of the calories for the first few years.  That gave me a big head start on getting to goal.  RNY is faster than the sleeve because of initial malabsorption. 

Both RNY and the Sleeve are great and popular options.  But your initial weight loss and how well you keep it off will depend on how well you use your tool.

Different strokes for different folks. You didn't mention the DS, which is also a sterling surgery.

I'm surprised that your surgeon told you that you would lose weight faster with the VSG rather than the RNY.  My surgeon told me the polar opposite.

He said that people lose weight faster initially with the RNY, but at the two year mark the results are comparable.

Many surgeons are performing the VSG because it's a much quicker operation than the RNY and the amount paid for each is the same.  Whichever surgery you choose, please keep in mind that it's only ONE component to successful weight loss.  Most of the hard work has to be done with your head, not your stomach.  Good luck!

"Many surgeons are performing the VSG because it's a much quicker operation than the RNY and the amount paid for each is the same. "

I totally agree. It is quicker and I think it is "easier" to perform. Just cut and sew. No re-routing of anything. I definitely think the skill of the surgeon matters, which seems to be evident by the higher success rate of some surgeons. It will be interesting to see the long term data now that so many more people are having it done. In 2007 when I was making my decision, most insurance companies did not cover VSG.