Too young for gastric bypass??

Unlike the others who have posted, I do understand your surgeon's POV.

The malabsorption process, which can lead to faster weight loss initially, can have some significant life-long effects, like the inability to process iron, calcium, or other vitamins/minerals. For some of us, oral supplementation does not work effectively. Further, not all PCPs are on board with ordering the right blood tests, nor will refer you to other specialists even when said blood tests show issues. The longer your body malabsorbs these nutrients, the higher the likelihood that you will suffer some consequence.

Further, he mentioned the possibility of a third surgery because you have demonstrated difficulty with weightloss with the band. All of the surgeries can be eaten around; one has to address the head issues along with the ability to consume. With the VSG, you can add the malabsorption process later, with the DS, if necessary. But, RNY is not the secret to lifelong weight loss, so considering it over the VSG for that reason alone is not sufficient.

Finally, while everyone should avoid NSAIDs, you can never tell what the future holds. As you age, having the option of taking them, which you can not do with the RNY, is helpful. Further, because of malabsorption, taking some drug prescriptions, such as those that are extended release, can also be affected.

I'm sure there are other reasons he is recommending the VSG over the RNY that he didn't share with you. He might be getting pushback from insurance companies, who do not want to deal with the costs of RNY aftercare. It could be that VSGs are faster/easier surgeries than the RNY to perform.

Full disclosure: I have a distal RNY, and while I am very appreciative of it and would make the decision again, I also have struggled with the effects. VSG was not an option for me because of GERD/Barrett's Esophagus.

Wait a minute. You are diabetic? RNY is the better choice, no question. However, I think his hesitation still has some merit for those on the fence between the two.

I admit, when I opened your post I was expecting to read that you were 14 or something. 32 is DEFINITELY NOT too young. So weird.

Ha ha, me too! I was going to do the whole maturity speech

This doctor likes to do a sleeve even when the patient has clear indicators that RNY is the way to go. I'm not sure I would trust the opinion of someone who thinks I'm destined to have a third surgery!!!!!!

Amen.

I'm glad that your surgeon is saying he won't refuse to do an RNY, if that is what you choose. Because you have diabetes, really take some time to look at the results for RNY and VSG for reversing diabetes. It was a tipping point for me. Take a look at the Stamped trial: http://www.nejm.org/doi/full/10.1056/NEJMoa1600869 My doctor was one of the doctors involved in this. If you are insulins, multiple oral medications, like I was, you have a significantly higher chance of reversal of diabetes with the RNY. In the end, you have to take a look at your health, where you want it to be in the future, and make your own decision. Whatever the decision, though, you have a great support system here, so come in often and utilize it! :)

Improving/reversing diabetes is a major consideration for me. I am not on insulin but I am currently taking 2 medications. Thanks for forwarding this study, it is very helpful!

This is such a personal decision, as others have said, only you can know what's best for you! I had my RNY at 36, 4 years and 4 months ago. I chose RNY over the sleeve because I wanted the additional malabsorption to assist me in losing weight and I thought maybe just a smaller stomach wouldn't be enough to get me to my goal. I weighed 351 the day of my surgery and I set a personal goal of 160, which I reached about a week before my one year surgiversary. I did that through eating high protein, low carb and following the advice I got on OH.

I was a little lax with my vitamins along the way - I would take them most days, but sometimes forgot, so when I learned about the PatchMD vitamins, I immediately thought "perfect!". For a year I put on an iron, a multi, and a calcium patch. I didn't get my bloodwork done, like an idiot, just coasting along, feeling generally good, and working daily to maintain my weight loss (I maintain in the mid 170s, but would love to get back to 165).

I finally got labs drawn in December and SURPRISE, I have some deficiencies. I have to add B12 and D to my daily regimen, and my iron is low enough that I am having an iron infusion tomorrow. This may not have happened if I had VSG, though it appears that even VSG patients need to be vigilant with supplements. But clearly I am not absorbing enough and have to closely monitor my diet and supplements and do the bloodwork.

Is it worth it? 10000000%. Would I have RNY again? 1000000%. Would I choose VSG this time around, knowing what I know now? I don't know. RNY has worked for me. I wish I had done it at 32, and not 36. If you are committed to being healthy and changing your lifestyle and diet, then go for it. I don't think VSG or RNY would be bad, but please don't do VSG so that you can eat more food in 10 years and have a revision. Only you can decide if you are willing to work your new tool and reach your goal and even more difficult, maintain at that goal. Both surgeries will give you the tool and it's up to you to do the work!

I am sure I didn't help you make a decision, but I wanted you to hear from a VERY happy RNY patient who had surgery in my 30s.

Whatever you decide, don't be like me and assume your levels are good. I recommend using this amazing lab tracking sheet that Julie SparkleKitty provided recently. It helps you see changes over time.

Good luck!

You are not too young. Pick the surgery you want and think of it as your golden opportunity. A 2nd WLS surgery was never a possibility in my mind. Take the opportunity and run with it. I think I would look at other surgeons as well, I don't care for his logic.

i was 41 when I had RNY surgery. Wish I had done it 10 years earlier!

Really, really do your research. My surgeon is a teaching surgeon at a university hospital and he would not even consider a sleeve for me since I have/had type 2 diabetes. I had RnY 18 months ago and have had normal blood sugars since surgery.

You are not too young. I expected you to be a teenager... you are lucky to have the opportunity to have a much longer life if you get the weight off now. Avoid all the complications that being obese puts on our bodies... high blood pressure, osteoarthritis. I waited until 57 and have many complications now that I get to deal with for the rest of my life. Once your body breaks down from the added weight some things cannot be fixed.

Be compliant with your program after surgery and you will be successful. I think it is a horrible thing to suggest you can always have another surgery. And, most insurance companies will only cover one, ever.