Bypass or Sleeve? Surgery is in 10 days.

I am still uncertain which surgery I need to have. My BMI is 49. I have sleep apnea, elevated blood sugar, blood pressure and cholesterol. My eating weakness is sweets. I am concerned whether the drastic bypass is needed or if the sleeve will be sufficient. Thank you for any recommendations.

So having 80% of your stomach removed is not 'drastic'??

Either will help you lose weight and improve your comorbidities. If you have acid reflux, you may want to steer clear of the sleeve.

niether surgery will protect you from the cravings of your mind completely. I can still eat sweets- so I have to maintain self control.

You are so right...having 80% of your stomach "is" also drastic. Thank you for your reply.

My dr told me the gold standard is the rny as they have been doing them for along time. They also stated that because sleeve surgery is fairly new they do not know the long term effects. In the end they are both major surgeries.

I agree - I think they're equally drastic, but in different ways. I don't think removing 80% of your stomach is any less drastic that stapling off part of your stomach and moving your intestine up.

I did the RNY because I had GERD pre-op, and also because they knew a lot more about it at the time because it'd been around a lot longer. But the sleeve has been around now for awhile, too, so maybe that's not as big an issue anymore...

One thing to consider is that it is not uncommon for people to have to revise from VSG to RNY due to GERD that worsens or develops post-VSG. I had pre-existing reflux so my surgeon refused to do VSG on me. As well, many insurance companies only pay for one bariatric surgery per lifetime so if you require a revision it may end up being self-pay.

Other decision points: RNY does a better job of resolving/mitigating diabetes compared to VSG, and the amount of weight loss is usually higher with a malabsorptive & restrictive surgery (RNY) versus restrictive-only surgery (VSG).

Thank you so much for your input.

i had gastric bypass surgery 5 1/2 months ago and my dr recommended it because i have GERD. it was the best decision i have ever made. i too had sleep apnea and high blood pressure and was on 2 meds for it. i have lost 109 lbs and only take the blood pressure meds prn. i do understand your weakness for sweets. i loved pie but now i make pumpkin pie with no crust and it just has pumpkin, stevia, eggs and fat free evaporate milk in it. i also sometimes eat a few frozen berries and that seems to help with the sugar cravings. good luck!

Congratulations on your upcoming surgery. Here are some links that detail both of the surgeries. As you read through them ask yourself, can I do this for the rest of my life? When I did, personally I knew the RNY would be a better fit for me and my habits and personality. We are excited to have you as part of our community.

• ROUX-EN-Y GASTRIC BYPASS INFORMATION
• About Roux-en-Y Gastric Bypass
• Risks and Rewards of Bariatric Surgery
• Nutritional Guideline after Gastric Bypass
• Life After Roux-en-Y Gastric Bypass
• Choosing a Bariatric Surgery Center
• FAQ
• Feature Article
• Forum Contributors

• VERTICAL SLEEVE GASTRECTOMY INFORMATION
• About Vertical Sleeve Gastrectomy
• Advantages and Disadvantages
• Frequently Asked Questions
• Forum Contributors