rny or ds for bmi 50+?

i'm wondering what wls is more successful for people with high bmi's and around 200 or more lbs to lose, or if both operations have the same success.

I think you can hear statistics and stories of pro and con on either side.  For me, it came down to knowing what eating habits I had to change; I knew I had to break my sugar addiction and being able to still eat sugar would be a bad, bad thing for me.  Also, there are no doctors in my area that do the DS so that was a consideration when choosing the type of surgery.  I was also self-pay and I had to consider the chances of complications.  I felt more comfortable with the long-term studies on the RNY, the proximity of my doctors and the success rates.  However, there are people who will give you just as many reasons (and probably more!) on why they chose the DS.  Their reasons will be just as justifiable and right for them as mine were.

To me, it comes down to you doing your homework, knowing the pros and cons of each (some the same, some very different) and choosing what works for YOU.  I don't believe there is one right (or wrong) surgery for any group as a whole - just the right surgery for YOU.  Remember, when it all comes down to it, it's only YOU that matters in your decision.

Happy Researching!
Jana

Hi Rachel,
I was 440 pounds at the time of surgery, and my BMI was 73. That was last summer.

I am now 310 pounds at one year out, BMI 51.

It boggles my mind how effortless the weight loss was during that first year. The weight just melted off, and I ate (mostly) what I wanted.

Please feel free to look at my profile. There are lots of links to learning about the DS, plus there are lots of links to published medical research articles regarding the DS.

I chose the DS because the statistics of a higher percentage of excess weight loss, long-term weight loss, and less regain.

Come on over to the DS Forum - there are several over there who started with BMI's over 50, and they can chime in to let you know what their experience has been with the DS. 

:)
anne s. 

I want to preface this post by saying this is totally my opinion and non-scientific observations....

People with larger BMIs (Mine was 57.9 at time of surgery and much higher at one time!) have a harder time getting to goal and MAINTAINING once they lose -- with ANY surgery. 

(I know for me it's because I have a binge-eating inclination I fight against.... surgery doesn't fix head-issues!)

For me the DS offered the best hope -- it would allow a more "normal" method of eating afterwards so my relationship with food wouldn't be so corrupted I'd have depression or other problems dealing with it.    DS also offered me the greatest chance of losing all my excess weight and maintaining once I had stopped losing. 

The DS gives me the chance to make mistakes and not ruin my weight loss.  If I have a bad day or two (or a bad week) I don't start to regain.  My body can handle the mental eating I sometimes do. 

I am 3.5 years out and able to eat a lot (volume) wise.... not as much as pre-op and I choose to eat "healthier" foods.  For a DS patient, however "healthy" foods can contain more fat.  I don't feel bad eatinig bacon and eggs.  I don't feel bad having a second helping of meatloaf or putting butter on my carrots or cooking my greenbeans in bacon fat. 

The DS is a great "tool" to get to the weight you want to be.... and a great "tool" to help you stay there.  It's not fool-proof... if you are constantly drinking sugary drinks and eating sugar you can and will regain. But that being said I haven't seen a DSer gain back all their weight and those who do gain admit to abusing sugar.  I eat 5,000 - 6, 000 calories a day most days.  But it is cheese, meats, bacon, nuts and seeds, whole grains and veggies/beans with plenty of butter.   (Most days I stay around 100 to 200 grams of carbs a day now --- I do enjoy cookies, cakes and dessert several times a week) 

I have lost 200lbs since DS and about 250 lbs total and 3.5 years out and maintaining easily.

Good Luck in your research!

Cindy

Hi-nice to meet you!!

I started my jouney at 422 lbs and a BMI of 73 in May of last year(2007). I was going to at first have the band-until I researched it and learned that it is not really that great for people with over 100lbs to lose. I then looked at the RNY. It was not for me because of the strict restrictions on the types of food you can eat without getting ill as well as a not-so-good maintance rate for those of us who started off with higher BMI's. It was a big choice for me just getting to a doctor because if I would have had the RNY, I could have gotten it done 50 miles away, but I traveled about 600 for my DS. The DS offered me the best hope at getting to a weight that I could live with. I had to do mine in two stages because of surgical complications(due to my size-not the surgery), but I am now fully switched. I have lost nearly 190lbs and i have a great life. I am still losing-I just got the actual switch part of my surgery done 2 months ago-and hope to get to around 130-135 lbs. Feel free to click on my photo and read some of my blog if you want to just see what the journey for me has been like.

Life with the DS is good. Of course you have to eat differently than before surgery, but you will find that with any of the 3 most popular surgeries. I can eat and not feel condemned.  I can even have chocolate on occasion and enjoy it. I am still losin, so those times are few for now, but I like the freedom. The stats are out there and they are the best of any of the surgeries when you look at % of wight loss acheived and % kept off after 5 years.

Good luck on your journey- hugs-Amy

My BMI was 45 but I figured I'd chime in here, too.
I chose the DS over the RNY because my problem was not related to eating. My problem was genetics and having in inefficient metabolism. I was never a binger, over-eater, or anything like that. Just the opposite, I'd been watching my diet closely all my life. I've been fat since I was 4yrs old, btw. Having a "restriction" surgery when I've been restricting myself all my life did not make sense to me. I wanted to be normal...just like any average joe out there. Average Joe can  have a cookie now and then and not worry about it, ya know? I did a lot of research and talked to a lot of people, both RNY and DS and decided the DS was for me. I wanted a fully functioning normal stomach, not a pouch. The DS leaves the entrance and exit of the stomach intact and functioning as God (or whoever) intended. It's just smaller. Mine is about 9oz. The DS has a more normal post-op eating lifestyle. I can eat like average Joe now except that pasta gives me gas sometimes, depending on the brand. The DS has better statistics for amount of weight lost, has the least amount of regain, and greater statistics for keeping the weight off long-term.

And personally.. and I know I'll **** some people off, but this is MY experience. I worked in an environment with 3 other people for years who had the RNY. I watched them live, literally, for years after their surgery with never making it to goal, eating very little, watched them dump, watched them try to get food "unstuck", etc...The reason I didn't have the DS sooner was because I thought that the RNY was the only option and from working with them and knowing what they went through, I knew I just couldn't do that to myself. I totally respect those that live like that and made that choice, but it wasn't for me.

I'm 16mo post-op now. I started at 281 and I currently weigh 140.5, exactly half my old weight. I'm 10lbs below my goal and generally gain and lose the same 3 lbs off and on, so I'm pretty stable now. I eat pretty much whatever I want...I'm not a junk food addict or anything. I just am a normal person that eats a lot of protein foods and drinks a lot of water. If, after that, I feel like having a cookie or some ice-cream, I can do that.

Anyway, good luck with your decision. Please come visit the DS board, too.

From my own pre-op research, I would say that in the long term Duodenal Switch is more effective in high BMI patients at both producing and maintaining weight loss.

Much more effective in the maintaining weight loss department, which is primarily why I chose the DS for myself.

I was 434 on 2/25 and am now 293 on 9/8. About 60% EWL over a 6 month period and still losing.

Steve

Hi, Rachel!
    I chose the DS because it has the best longterm statistics for percentage of excess weight loss, maintaining that weight loss, and resolution of comorbidities. Some people do great with RNY, but I had seen too many people struggle with weight regain with RNY. Also, DS has a better and more normal quality of life regarding eating - there are no foods that are completely off limits, no dumping, no food getting stuck. You can take NSAID's if you need them. You can drink liquids with your meals.
    You do need to make a lifetime committment to emphasizing protein in your diet, and taking vitamins and supplements. You also need to get regular lab work to make sure your vitamin levels are ok. This is true with RNY also, though the vitamin requirements are somewhat different, and probably somewhat more with DS than with RNY.
    I had my DS about 2 and 1/2 years ago. I have lost 100% of my excess weight, I am in excellent health and leading a very normal life.
    Come on over to the DS forum and learn more! Do your research about all your options. Ask questions, read medical articles, learn all you can. Look honestly at yourself, at what limitations and side effects you can life with for the longterm, and then make the decision that is best for you.

Larra

Hi, Rachel!
    I chose the DS because it has the best longterm statistics for percentage of excess weight loss, maintaining that weight loss, and resolution of comorbidities. Some people do great with RNY, but I had seen too many people struggle with weight regain with RNY. Also, DS has a better and more normal quality of life regarding eating - there are no foods that are completely off limits, no dumping, no food getting stuck. You can take NSAID's if you need them. You can drink liquids with your meals.
    You do need to make a lifetime committment to emphasizing protein in your diet, and taking vitamins and supplements. You also need to get regular lab work to make sure your vitamin levels are ok. This is true with RNY also, though the vitamin requirements are somewhat different, and probably somewhat more with DS than with RNY.
    I had my DS about 2 and 1/2 years ago. I have lost 100% of my excess weight, I am in excellent health and leading a very normal life.
    Come on over to the DS forum and learn more! Do your research about all your options. Ask questions, read medical articles, learn all you can. Look honestly at yourself, at what limitations and side effects you can life with for the longterm, and then make the decision that is best for you.

Larra

Hello Rachel and congratulations on doing your research! I choose the DS because I had already made a poor choice for myself years ago with a band. I decided if I was going to be cut open again I deserved to have the Mercedes of Weight Loss Surgery. Without a doubt the DS has been proven to give me the best possible chance to lose most of my excess weight, it offers me the very best chance of maintaining my loss and it definately offers the best quality of life. Besides all that, the DS would give me the best chance at resolving my co-morbidities including my diabetes. Mine was resolved 2nd day after my surgery.  :-) This November will be my 2nd year anniversary with the DS, and I haven't felt this good in years, I'm a new woman because of the DS!

Good luck to you!