Contemplating Surgery

Good Morning,

My name is Brian C. I am interested in having a form of weight loss surgery, but haven't decided which is the best option. I have tried about every diet you can think of and I have tried exercising but nothing seems to work. I am looking for opinions as to which surgery would be the best option. I really feel like I have exhausted all options because i typically lose the weight but then it comes right back again. I've gained about 150 lbs in the last 2 years. I have an aunt that recently tried the lap band surgery & she had wonderful success & another person that had the gastric bypass. Can anyone kind of give me the run down on what my options could be if i do decide to have surgery?

Thanks,

Brian C.

it always depends on your lifestyle and personal choice, how much you have to lose, etc. now I am not a doctor, but when I was contemplating either the sleeve or the gastric bypass, they laid it out.

the sleevers seem to have bad heart burn after, I already had bad heart burn so I didn't want that.

both options make u take vitamins forever.

my surgeon said that whenever people are "teetering" between two, he always advises the bypass. in his opinion, its more sustainable weightloss.

that's all I can say, good luck!

Two suggestions:  1)  Go to an WLS Orientation Meeting - they will discuss the options, requirements., etc.; 2) Read, read, read, and then read some more.  (Click on Resources at the top of the page, then Weight Loss Surgery, then read the boards.

Also......check your insurance coverage to see if you have coverage, and also what their specific requirements are. Another thing - the Lap Band is not done much anymore due to the band itself failing - generally your options are RNY (ByPass) and VSG (Sleeve) -- and some doctors do DS.

WLS will change your life, as long as you are committed to following your surgeon's plan.  Good Luck to you.

Mary, the band itself doesn't fail, it's made of silicone and pretty indestructible. The reason it is not done so much now is because it can cause damage to the body and it is also too easy to " cheat" so even  if there are no physical problems, some people find it gives them insufficient help, 

You're right, of course, Kate.  I mis-spoke (or mis-typed).....the "failure" is the damage it causes, and the trouble some people seem to have re fills, etc.  It seems many Banders have a lot of post-op issues they have to deal with.

Here is a great link you can use for research. This is the website for the American Bariatric Surgeons Association. https://asmbs.org/patients

Unless you are rich, first check insurance. It's not a .... Hmmm I will have WLS. I had to have a 6 month supervised by a nutritionalist, exercise program , behavioral therapist and shrink first. A lot of hoops but I have not regretted a day. 12 post op RNY and still at goal

Every single one of us had to think if it was what we even wanted first. Insurance comes second.

I can share with you the reasons I chose VSG, but these are just my reasons - we've all got to choose for ourselves (preferably with a surgeon's input) what our best option is.  

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. 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. Here's an article on that topic.

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 with the sleeve look and seem healthier than the people I know with the bypass. That's nothing scientific though.. just a gut feeling.  (Since writing this, I've met lots of healthy RNYers through these forums.  But pre-op, all the people I'd met IRL with the RNY were not healthy at all.  I think people who stick with OH just tend to do better.  Maybe because of the accountability.)
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.

It is a very personal choice but after much research(and living 7 years with someone who did the Bypass), I did the sleeve. When you look at the success rates,  the bypass and sleeve where the same @70% success but the band success rate was only 40%.  The bypass has many more side effects (like loose stools and smelly gas) that the sleeve does not have.  I personally think, from the people I talked with before and after my surgery, that the Bypass works better for people that have 200+ pounds to lose and the sleeve is more successful for those that have less than that to lose (between 100 & 200 lbs to lose).

I have been very happy with my choice and know it was the right thing for me.