Where do I even start?

Lots of good info here already!

For me, step 1 was exploring the hospital/surgeons available. I went with a bariatric surgery center (that's all they do!) based on the recommendation and good experience of a friend. 

Please be sure to choose a doc that:

(1) does a LOT of bariatrics. You don't want him/her to rush from your procedure to an appendectomy and on to someone's liver. Some general surgeons do bariatrics, but our needs are highly specialized and you DO want a specialist. 

(2) offers a full range of support pre and post op. This includes support groups, nutritionist/dietitian consults, and most of all a staff that is available to you when questions arise - even if it is well after your surgery. 

(3) is able and willing to answer questions. Can speak to success rates and risks. 

(4) works with your insurance if you have it. My insurance journey was hellacious and I was so glad to have a good contact at the surgery center.

In addition....

(1) Read the forums and keep a list of questions you may have. 

(2) Keep a good balance - sometimes the forums tend to draw a lot of questions/issues from people with problems or struggles. Know that many, many of us are out here quietly doing just fine. 

(3) Ask your questions here for good input from those who have walked the walk. But remember, the ultimate authority is your doc. 

And finally start keeping a journal!

You can get a good introduction by attending a seminar put on by a surgeon in your area. They often do them once or twice a month and the doctor will give an overview of the surgery, the prep and approval process, fees and insurance, and the like, and there will usually be some Q&A as well. Even if you don't end up having your surgery performed by the doctor giving the seminar, it's often a very helpful first step.

Pricing for people who are self pay varies tremendously (as does the wait time from one surgeon to another) so the only way to really find out those things are to contact surgeons in your area and ask THEM.most surgeons have regularly scheduled information sessions wherre they provide information and give prospective patients the chance to ask questions.

Do some research online about each surgery to find out the pros and cons of each, what the requirements are (e.g., vitamin supplementation) of each individual surgery, and what the long term statistics are (generally, from most to least successful for long term weight maintenance, is DS, then RNY, then VSG, then band), and if you are considering the band be sure to do some research on how high the statistics are for additional surgeries for complications, band removal, and/or revision.

Just a couple of things to be aware of that surgeon's info sessions, etc. will likely NOT tell you unless you ask:

1) Most RNYers do not dump (only about 30%), so that shouldn't be a huge consideration when selecting a surgery.

2) the bulk of the caloric malabsorption of the RNY is overcome by the body after about 18 months (a small amount will remain), but vitamin malabsorption is permanent

3) if a surgeon is pushing you hard to have one particular procedure done when you have no specific medical condition that makes one surgery preferred (e.g.people with GERD dont do well with VSG), be sure you ask which procedures that surgeon does, how many of each procedure that surgeon does, and how long (s)he was been doing each surgery. Sadly, some surgeons push one surgery over another simply because it is their preferred procedure (and, sometimes, how much money they make on the individual procedures colors their recommendations)

4) the long term statistics for RNY vs VSG show that RNYers lose more quickly, but that the weight loss is comparable by about 2 years put, and that by 5-7 years out, which surgery matters very little... What matters in terms of weight maintenance is how compliant people are in changing their eating habits.  None of them are magic. 

Remember, this isn't a race to lose as much weight as quickly as possible no matter what the cost long-term. This is about choosing a surgery that you can live with, and be successful with, for the rest of your life. Ask yourself if you can live with the worst possible complications or side-effects of each surgery. If you cannot commit to taking vitamins 4 times a day, for example, DS and RNY are not for you. If you cannot live with knowing that the rest of your stomach has been removed (and therefore does not exist to be put into service in the rare case of injury/illness that renders the pouch or sleeve unusable), then DS and VSG aren't for you.  

Lora