Confused , Which is better ??!

Hey guys, i am little bit confused between then the VSG and the gastric by pass surgery , My surgeon gave me the choice and i am not sure which procedure is better for me , I weight 374 pounds and i am 26 years old , Thanks to god , I don't have any medical history .I am a bulky eater as well, so what do you think ??, Please help me you can , Thanks in advance :)

I'd ask your surgeon which he thinks is better for you.  He knows your  medical history better than we do.

I have never been a fan of a restriction only procedur...  I would have an Rny or Ds

WLS is not one-size-fits-all, so these procedures address obesity differently.  VSG simply restricts how much you can eat, while gastric  bypass (and Duodenal Switch) give not only restriction but also metabolic changes by way of malabsorption to give faster and more sustained loss over time.  I recommend learning everything you can about all three procedures and compare that to what you know about yourself and how your body reacts to your efforts to lose weight.

It isn't a question of which is "better", it is a question of which one will give you the best chance at losing the weight and keeping it off, how much you are willing to do to your body, and what kinds of potential side effects you are willing to risk having.

This question comes up several times a week, and many people (myself included) have written lengthy responses to the question in the past, so I would suggest using the search (the magnifying glass near the top of the page) and search on "sleeve or bypass" or something similar.  That will give you hundreds of responses to read.

Personally, I had RNY (and don't regret having has WLS) because sleeve wasn't an option 7 years ago, but if I were making the decision now, I would opt for the sleeve.  IMO, the temporary caloric malabsorption (and therefore slightly faster weight loss) isn't worth the permanent vitamin malabsorption of the RNY and the risk of kidney stones and reactive hypoglycemia.

Lora

Also go to the revision boards and see what people are revising from and going too

The best possible surgery FOR YOU is the one that best suits what changes you are willing AND able to make permanently in order to maintain your weight loss. Most people can lose a significant amount of weight with any form of WLS. The real trick is keeping it off long-term.

All forms of WLS restrict how much you can eat at one sitting. None of them keep you from grazing, or choosing to eat badly. Each of them has a somewhat different post-op 'diet' you'll need to follow.

The RNY and the DS also make some changes in how your body metabolizes food. They do this by bypassing some of your small intestine, and this also causes permanent malabsorption of certain vitamins and minerals. This means that you simply MUST commit to taking vitamins and minerals daily for the rest of your life. You must also get regular blood work done to make sure you're taking the right things for YOUR body, because we're all different, and our malabsorption can increase over time. (You will also need vitamins and minerals with the Sleeve, simply because you can't eat enough to get all you need.)

The RNY/gastric bypass and the DS also cause malabsorption of some of the calories you eat. (The VSG/Sleeve does not.) For the RNY, this malabsorption is fairly small, and temporary---it only lasts for about 18-24 months. For the DS, the malabsorption is pretty high---about 40% of complex carbs, about 50% of proteins, and about 80% of fats. With the DS, this malabsorption is permanent.

Long-term weight-loss stats for the VSG and the RNY are about the same. The DS has the best long-term stats, both for weight loss and for remission or prevention of diabetes and high cholesterol.

Visit the various surgical boards, including the Revision board. Talk with some folks who are 3 or more years post-op. Find out what they like and don't like about their surgeries, if they have regrets, etc.

In short, RESEARCH EVERYTHING.

Different surgeries are best for different people.  Here's what factored into my own decision... but your decision process might be different.  

The four WLS are - sleeve, gastric bypass (RNY), lapband, and duodenal switch. My insurance covers the first three, but not the DS.

I ruled out the lapband immediately because the only people I know who have had it are miserable or have needed it removed. The complication rate is atrocious and it only lasts for 10 years or so. It's billed as being a "reversible" surgery, but the damage it can cause, like from erosion into your esophagus, is permanent. So no lapband for me.

The choice really boiled down to RNY or VSG and I chose the sleeve for a number of reasons. (Even if DS had been an option, I would not have chosen it.)

1. I really like the simplicity of the sleeve. All it does is remove 85% of your stomach. That's it.
2. I dislike the idea of having my intestines rerouted.
3. The "good" malabsorption that the bypass gives (of fats) is a temporary thing that only lasts for a few years whereas the "bad" malabsorption (of vitamins and minerals) lasts for forever. That's not worth it to me.
4. The sleeve is restriction only, no malabsorption. This also means that I CAN eat anything at all. Fats and sugars won't screw up my bowels the way they can for the bypass. (Of course I still need to make healthy choices, but that's a choice, not something that my surgery requires.)
5. With the bypass, you're left with a remnant stomach that can't be scoped. That scares the crap out of me. First, the idea that I have this weirdly connected non-stomach but then to not be able to get it checked out with an endoscopy if there's a problem? Eek. Do not want.
6. My understanding is that complication rates with the bypass are significantly greater, especially longterm due to malabsorption. While I will be taking vitamins for the rest of my life, chances are that I won't end up in the hospital if I stop because the sleeve has no malabsorption involved.
7. For the most part (and there are exceptions) the people I know in real life with the sleeve look and seem healthier than the people I know with the bypass. That's nothing scientific though.. just a gut feeling.
8. The sleeve leaves you with a fully functional pyloric valve at the bottom of your stomach whereas the bypass gives you a stoma which can stretch over time.

Neither! They are just different! Get your doctor to talk you through it properly rather than just offering a choice! Then use the search function on here to find the hundreds of threads on this - that way you will access all the pervious answers to this,