At the beginning of my journey ... which surgery?

I'm 50 years old and 155 pounds overweight. I have been fat since I was 9 or 10 and have never kept a major loss off more than a few months, nor have I weighed less than 200 since high school.

I was planning on the VSG, but had my initial consultation with the clinic dietitian last week and she seemed to be steering me toward the RNY, mostly because the dumping syndrome acts as a watchdog against sugar binges that could slow down your weight loss.

I should add that while I do like sweets, I am more of a "huge helping" person than a dessert person, except for once in a while when I have a craving. Usually I can make do with fresh fruit (which I love) or sugar free popsicles or Crystal Light type drinks.

I'd love hearing from anyone with advice or input. Thanks.

Don't make the decision to have surgey based in dumping, most don't dump. (I don't). Personally I did RNY cause I felt I needed the dual action of restriction and malabsorption. Plus, there are many ways to slow down weight loss outside of sugar. 

My goal is to lose 160#. After seeing family members not do well with VSG and lapband I was dedicated to RNY. I had also strongly considered DS, but my surgeon didn't think it was necessary for me. 

Ditto - I took the RYN because it has stronger long term results (it has been around since 1985) while the VSG is a newer procedure without such longterm studies,although studies to date are generally good for the VSG.  Initially I worried that I should have had the DS - which has the strongest longterm results, but few surgeons will perform it.  At 15 months, I am still doing fantastically with the RNY, and I do everything I need to avoid regaining.  From what people report, the real test is more in the 2-4 years after WLS. Crossing my fingers that I will make the adjustments I need as I go along.

Did your family members who did not do well with VSG or Lapband make the behavioral changes needed - diet, exercise, vits, etc?  I would be concerned about their experiences and would want to identify what I needed to do differently to achieve longterm success.  Also, I do not equate the Lapband with the VSG.  My surgeon's recent experience is that most lapbands come out after 5 and then most people get a VSG or RNY. So when people say they had regain with the Lapband, I expect it, since most do.

Although this will vary patient to patient and doctor to doctor, the literature reports that a VSG to DS revision is an easier operation than from RNY to DS (usually an open surgery).   This may change will advances in surgical techniques, but may be something to discuss before you decide.

I had RNY in 2001.  I had a choice, lap band or RNY and I've never felt I made the wrong decision.  I dump if I push the sugar limit, but it keeps me in line and I am happy with that.  I'd I had to choose from the procedures available today, I would make the same decision!  

Make the decision based on what is best for you, but understand all aspects of each procedure.   Being informed allows us to make the best decision. 

~Nik

You crystal ball was right on.   I think today, you might not have even been told that the RNY and lapband are comprable results-wise. 

Only 30% of RNY dump. And some that do- only with some of the foods and only with large qty of sugars. 

Plus..there is way to learn to eat sweets around dumping...of someone wants to... 

Don't count on that.  It is lifestyle change. 

Hi Vibiana,

This video gives the best approach I know of to choosing a type of surgery.  He is not my doctor, and I do not get a kickback from him, it's just a short video from someone who knows what he is talking about. 

http://drmatthewweiner.com/how-to-choose-the-right-bariatric -weight-loss-surgery/

Good Luck

1) the fact that this doc even offers the band as an option makes me seriously question anything he has to say.

2) then he goes on to say that there are different levels of lifestyle change required based on your surgery choice. that's total and utter bull.

3) he then puts the nail in the coffin by saying that the band is the safest procedure. WOW. totally false. 

no bueno. 

I have not heard one surgeon say that the band is NOT the safest procedure - it has lower exposure to anesthesia and is a less invasive surgery and is reversible, although it is not without its risks.  I am not advocating the band, and would not have chosen it for me it (most people have it out in 5 years and then have a real WLS -- RNY or Sleeve) unless I could not tolerate a longer surgery - you may have more research to do on this one.  It is the only possibility for some high risk patients, although the balloons just got FDA clearance, so they may be the low risk option now (although I understand that they need to be removed after 6 months). 

IMHO, I think you are off the mark about the behavioral changes needed. But that's my opinion.  It can be helpful way to think about post-WLS life and the work that longterm success after WLS entails.

Hi there

I came across your link thanks very much it was useful ?