Bypass vs. sleeve

Consider your personal psysiology.  Is eating less all you really need to lose your weight, or do you think you need a metabolic boost. 

For restriction-only procedures, the sleeve is the top pick

For restriction/malabsorption procedures that give your metabolism a boost, there is the RNY (Bypass) or the duodenal switch.

I recommend learning all you can about all of them and how they work, then compare what you learn to what you already know about yourself.  You owe it to yourself, because revisions suck!

Employers will chose whether or not the insurance will pay for WLS. So please call Aetna and make sure it is covered. Mine was through Aetna. I called them and they emailed a great list of all the hoops I had to jump through. I only had to pay a 500 deductible for the surgery. Plus my copays of course.

Thank you!!! I was actully wrong about the insurance its Anthem.....so have to look into it

Oh ok well calling the number will get what you need to know.

Don't forget you will have discussions with your surgeon to consider. Research is important, but it is not all about 'research'. Your surgeon may have reasons to choose one over the other. I know my surgeon will only do lap-bands if the patient is really set on it at this point. He never recommends them anymore. Some surgeons don't do DS, so if you think that's the surgery for you you may have to find a surgeon who does it. Also surprisingly I've seen on these boards some insurances don't pay for VSG because I guess it is newer. I would just make an appointment now that you have been to a seminar. Be honest when you go about not being sure about which one. Good Luck!

Thank you all for the advice and tips!! Very excited about the next chapter but of course nervous. It's been one heck of a year so far. Got married in June and now my wife and I are both ready to do this. Wasn't always heavy and was an athlete growing up and in the USN. Once I was out of the Navy over the years the weight just piled on and no matter what I did it would jsut come back. At my heaviest I was 320lbs and at 5'8 that was a lot!! On my own I was able to drop down to 250 but didnt last very long. Diets don't work in my opinion for everyone.

"Diets don't work in my opinion for everyone."

No, they don't. Oh, most people can lose some weight, and some people can even lose ALL their excess weight through traditional dieting. The hard part is keeping it off, long-term.

It's really, really hard for most people to strict to a diet for the rest of their life. WLS makes that easier---having a small stomach makes it easier to eat less, at least at one sitting.

The Sleeve is a restriction-only procedure. The RNY is primarily a restriction procedure as well, but for the first several months it also causes you to malabsorb some of the calories you do eat. Unfortunately, our bodies are really good at repairing themselves, even when we wish they wouldn't. They grow more villi in the small intestine, and by about 18-24 months they're back to absorbing all the calories. (Unfortunately, you NEVER regain the ability to absorb certain vitamins and minerals normally.)

Both the Sleeve and the RNY will make it easier for you to stick to your post-op diet, and in the long run they have about the same success rate. I personally wouldn't want the potential complications of the pouch/stoma RNY configuration. I chose the DS, so I have a Sleeved stomach and I love it. Removing most of my stomach changed my hunger dramatically.

What YOU need to decide is whether or not YOU need a big metabolic change. I knew that I did, and that's why I went with the DS. Only the DS gives permanent malabsorption of a significant per centage of calories. The DS has the very best long-term, maintained weight-loss stats, and the best stats for resolving or preventing co-morbs like diabetes and high cholesterol, two things that run in both sides of my family. It also allows me to still take NSAIDs, and I couldn't function without them.

Please carefully consider that with RNY you are trading a lifetime of lack of vitamin absorption (and taking vitamins at least 4 times a day, every day) -- and a number of potential complications/side effects such as kidney stones and reactive hypoglycemia -- for about 18 months of caloric malabsorption.  You are altering the way your body digests food and the way it absorbs nutrients and medicines. Even if you take the vitamins faithfully, you can still end up with vitamin deficiencies and physical problems because of it.

Here is a post that I wrote earlier today about having bone scans two years in a row show bone loss despite me taking more than the recommended amount of calcium daily.

I had RNY, and I have been successful with it, but I wish VSG had been an option 8 years ago. 

Lora