Choosing between Bypass and Sleeve
With your BMI, seriously look to a procedure that gives you a degree of malabsorption in addition to restriction to help you reach your goals. The two procedures that give your BMI the best chances of a normal weight would be the bypass or the duodenal switch. The DS, however, is a more complicated procedure and not as common even though it's been around since 1988 and holding the best long-term statistics.
Valerie
DS 2005
There is room on this earth for all of God's creatures..
next to the mashed potatoes
The surgeon's skill with the operation makes a big difference to your surgical outcome. You are not mentioning any other complications like diabetes, pre-diabetes, heartburn/gastric reflux that would suggest one over the other. Here is one surgeon's way of thinking between the surgeries. This guy was not my surgeon, but his info may give you additional specific questions to help understand why your surgeon is recommending a sleeve for you and have a more complete discuss with your own surgeon.
http://drmatthewweiner.com/how-to-choose-the-right-bariatric -weight-loss-surgery/
About malabsorption:
With the sleeve, all the calories you eat will be absorbed by your body.
With RNY Gastric Bypass, long term, your body will absorb all you carb and protein calories, however you will poop out about 25% of the fat calories you eat. This is from a study done at Baylor Univ, I can find the link if you want it. Maybe this will save you 50-100 calories a day, and may help ward off a 5-10 pound a year gain. (There is not enough malaborption to fight off a really bad diet.) But for me, someone who saw her first bariatic doctor at age 6, I was doing everything possible and chose the GBypass. My BWI was ~47. I did not know know enough to investigate DS before surgery, and my surgeon didn't mention it. I am down 122 pounds and doing everything I can to make the GBpass work and be enough for me.
At one year out after GBypass, my greatest concern is regain and if I need the DS, it is difficult to go from a GBypass to DS (difficult enough that is not done laproscopically, or so I've read). It is easier to switch from sleeve to DS.
This is not an easy decision and takes some investigation as well as some self-reflection to match your challenges with the best surgery.
Also, I suggest that you discuss what is a reasonable weight for you after surgery, while some get to that magical goal weight, most people do not, but end up maintaining at a much lower number than their pre-surgery weight.
All the best, whichever you decide.
Sharon