Too young for gastric bypass??

Hi, I'm Steph, I'm 32, 5'4 and 260lbs. I have high blood pressure, diabetes and sleep apnea. I'm currently in the process of getting my lapband removed and revising to another surgery. I did a lot of research and decided that the RNY was the best option for me, that was until I recently met with my surgeon. My surgeon strongly recommend and is pushing me to go with the sleeve. This is primarily because of my age. Although, the surgeon did say that he would do either surgery and the final decision is up to me.

He talked about our body's setpoint and how obesity is a chronic disease that even with surgery, the weight tends to come back over time. He is worried if I do the RNY and gain the weight back in 15 or 20 years there is not another WLS surgery option. Where if I got the sleeve instead, I always have the option of an RNY in the future (however it's not likely insurance will pay because of the current once per lifetime limitation). He thinks that with the sleeve now (and future RNY option) I may not lose as much weight as if I had the RNY now, but I have the best chance of keeping my weight in a healthy range over the course of my lifetime. I don't have GERD so I don't feel that I should completely eliminate the option of the sleeve. Logically and statistically I understand where he is coming from, he gave me a lot of information that I hadn't considered and while I am grateful, I am now torn and confused. I do have a concern with not being able to lose enough or sustain my weight loss with the sleeve. I also don't like that there is not as much long term data available. After being burned by the lapband (which was strongly recommended at the time and now they no longer use) I feel little hesitant about the sleeve. He also told me that the 10 year data they are seeing on the sleeve is that 1 in 5 are gaining their weight back (he did however note that the data is skewed because fewer people come back after they are 2 years post op). While I realize that you get out what you put in, that's still concerning to me.

I want to go with my gut and get the RNY but again, I am afraid of ignoring this advice and gaining weight back in the future and not having any other options. While I can tell myself I won't let that happen, I also never intended on being as heavy as I currently am but I ended up here nonetheless. I'm so sorry for the long post, I've tried talking to friends and family but in this scenario I feel I need the advice of people with actual experience.

Has anyone had Gastric Bypass surgery in their 30's and have remained successful long term? Do you think I am too young for the bypass? Im open to any advice, experience, opinions. Thanks!

OK that is some of the most unusual logic for suggesting a sleeve. I know my surgeon likes to suggest the sleeve to younger women because of the iron deficiency issue and the many years of menstruating ahead of them. That being said that's not the only thing he considers.

I have women who are in my support groups that are 15 years out from surgery and still a normal weight. Are they at their lowest? IDK. But note they are still getting support.

Go with your gut.

Did your doctor seriously use "set point" with you? No. No. No. Your body doesn't have a "set" weight that will not change no matter how hard you try. What you do have is a psychological food comfort level with how much food you like to eat. That you can definitely change.

I had my RNY when I was 40, so only a bit older than you. I'm kind of annoyed that your surgeon is all, "Hey, if you regain weight with the VSG, we'll just cut you open again and do what we should have done in the first place!" This seems very short-sighted and inconsiderate given the insurance situation in this country.

At the time of my surgery nearly five years ago, my surgeon was focusing mainly on the RNY as he felt it was the gold standard with the most long-term evidence of success, but he has been evaluating evidence and is now doing more VSGs and I know a lot of VSG people here on OH have been very successful. You are correct in that you get out what you put in.

If you truly feel that RNY would be best for you, then there is nothing wrong with pursuing that option. Honestly, I would look at another surgeon or program if you have a choice as this one has some questionable theories and is clearly not listening to you. You will have a long time of being diligent about your supplementation and blood tests, but that's good because you'll be extending your life by losing weight!

Is there a local WLS support group? I'd go to that and ask some people to share their stories or if you can chat with them directly. Also, ask your surgeon for specifics about why he's concerned about you having the RNY at your age. Don't let him give you any mumbo-jumbo, either.

Do your research, ask your questions and read all of the posts you can on here. The book WLS For Dummies is really good, too. I read it before my surgery and it's pretty much no BS. Either surgery can be successful, but you need to make sure that you choose the right one for you to ensure the best chance of lifelong success. :D

Jen

I'm 32 also and just had RNY. I feel like your doctor is almost setting you up with an "excuse" to regain. Will you stay at your lowest weight? Maybe not. But to suggest you can just have another surgery later is very disheartening coming from that doctor!

i got some push for the sleeve, but only from my surgeons nurse practitioner who suggested that since I still want to have kids, to go with the sleeve so I'd have less malabsorption and nutrition issues, however, my surgeon said with closer monitoring, there's no reason I couldn't have a successful pregnancy after RNY.

My biggest deciding factor was that I also was diabetic, and the chances of that going into remission with RNY are a bit higher. I'm 5 weeks out, and already off all meds with normal blood sugars.

I'm a RNY post-op, and was not a revision; this is just one person's opinion based on observing the revision post-ops here.

I think you'd be better off with RNY given that you had a lap band. I would be hesitant to get a sleeve if I were a lap band patient looking to revise. There are quite a few revision post-ops here, and I'm sure they'll chime in with some great replies. We've got some pretty smart people here.

I don't think you're too young for RNY. It's not like you're a child or something. I don't follow that logic at all. I'm glad you are getting the opportunity this early. I think that's fabulous. I was 41-I wish I could have had it sooner, but it is what it is.

If you feel the RNY is a better fit, the doctor needs to listen to you and take that into account. If you decide RNY, be adamant. We have to be our own advocates.

I could be wrong, but it seems like a lot of people are being steered toward the sleeve instead of RNY-it's a simpler operation, but years out, if the people have put forth the effort they should, I think the results are similar. The vitamin regimens are similar, as is the no-NSAID rule. I think really-surgeons just want to perform the easier operation, but I'm cynical by nature.

Have you had your endoscopy to rule out GERD? If not, once it's done, that could help your decision along. I intially wanted the sleeve, but was diagnosed with GERD and the sleeve wasn't going to be possible. My surgeon felt like RNY was the way to go with the GERD, and my BMI being 53. I trusted him-and it's been wonderful.

I'd just go with the RNY and save myself from the possibility of the sleeve giving me problems, but I'm biased. I LOVE my gastric bypass. Best thing I ever did for myself.

As far as successful weight loss surgery goes- I think success is relative. I won't consider myself truly successful until I've lived the rest of my ( hopefully long ) life at a healthy weight and with a healthy relationship to food. People measure success differently.

Ha...I wrote a book, huh? It's way past my bedtime and I hope this all makes sense to you. Sorry for any typos...I'm sure there are quite a few.

I wish you nothing but excellent luck no matter which you choose.

I was thinking the same thing if there are certain age for Gastric bypass it says in mayoclinic site you qualifies for surgery if you can't lose weight through diet and exercise. Your body mass index (BMI) is 40 or higher. Your BMI is 35 or more and you have a serious weight-related health problem, such as type 2 diabetes, high blood pressure or severe sleep apnea. is there a certain age when to undergo with this procedure?

Just a guess but you will probably lose 100 pounds with RNY and 80 pounds with a sleeve in one year. After the honeymoon keeping the weight off means following the right food plan. I had RNY and my surgeon believes I would have done as well with a sleeve.

Just as I am gazing into the crystal ball with a weight loss predication, there are pros and cons of both surgeries.

I was 59 having surgery in 2007 and then was told if I was younger they would recommend the lapband and then convert to RNY later. But at 59 they recommended RNY first. The sleeve was not being done by my group in 2007.

I will be 70 this month. I get iron infusions and have weakened bones even though I took all of my supplements. That might not have happened without RNY.

There is a metabolic change with the sleeve. It is not as pronounced as it is with RNY. But for the most part, weight regain comes from going back to your old eating habits.

I am a LapBand revision to RNY patient. I am also the same height and was at a similar weight as you when I had both my WL surgeries. However I was 36 when I had the LB and 42 when I had my revision, and I was done having babies. I have been successfully maintaining below my goal and while I have low iron issues, I no longer have high blood pressure, acid reflux, sleep apnea and my diabetes is in remission.

I think only you can know what's right for you. For me a restriction only procedure didn't work the first time and I doubt it would have worked a second time either. For me RNY has been the best thing I have ever done for myself, my health, my future. I would do it again every year if I had to!

Regardless of your decision, you will need to be vigilant with your eating, your supplements, your lab work, your body in general and your mental health. IMO the potential complications resulting from WLS do not out way the KNOWN complications you face with diabetes, sleep apnea and high blood pressure. I am happy to share more about the difference between Band and RNY life if you want - just PM me.

Good luck with your decision.

You are not too young. NOT.

The band was a horrible device. They were all temporary, and doomed to fail. There was no question. RNY does not have the same issues. It will accomplish a great deal, but to reach 100 percent weight loss with any surgery is going to depend on rigid compliance.

For a surgeon to offer you a surgery now, saying you will need a new surgery in 10 or so years is total crap. I would run and find a new surgeon right away.

The more times you get cut open, the higher the chances are you will suffer from some serious complication. Avoid future surgeries!

You are not destined to need another surgery. But if you go into it thinking you can try this out and regain, but it's ok, because you can have another one later is a horrible mindset. It's that mindset that will lead to regain, for sure.

Have the surgery you are comfortable with. Work it like it's forever.

I don't really understand your surgeon's pessimism. It's like he's just expecting you to fail, and that seems so darn insulting to me. Get the surgery YOU want to get. Take that fear of regain and channel it into better eating habits during the amazing losing phase year. That's what I've done. My weight loss has slowed way down after a year, but that's OK with me because I took my year to learn what I needed to do to keep my body on the right track. There will always be bad days, the important thing is just to keep it at that, a bad day. Not a bad week, or month, or year.