Which Surgery?

Hello all! I was just wanting to ask everyone a question and get any feedback I can. I am 25 years old. I am 5'2" and weight 380 with a BMI of 69. I am unsure as to which surgery to have. I was leaning toward the RNY but my mom wants me to have the LAP Band because she is worried about the excess skin afterwards. However, I am not really wanting to go that route because I know the success rate isn't as high with LAP. I was also kind of thinking about the Duodenal Switch because I know that it has a higher success rate and overall weight loss than any of them, however, it is a more rapid weight loss than the RNY, which leaves an even bigger chance for more excess skin... HELP!!!!! LoL Please let me know what you all think! Thanks and God bless you all! Gayla

Weight loss of any kind is going to result in excess skin. Rapid weight loss just makes it show up a little faster. Your age will make some difference in how much skin you have, but you will probably have some no matter which procedure you choose.

Its a personal choice and don't let anyone pressure you into a procedure you don't want. I knew lap band wasn't right for me, I was much too large. I considered DS and RNY and chose RNY because I was afraid if the vitamin issues. Being relatively young (29 at the time) I didn't want to be fighting vitamin levels for the rest of my life. That can happen with RNY certainly, but the risk is a touch higher with DS. Since I planned to become pregnant this was of special concern to me.

The DS does seem to have a little better record for loss and maintainance of that loss though, and sometimes I think I chose wrong. Another thing to consider is your style of eating. DS patients tend to be able to eat more food and richer food without discomfort. Neither patient should eat a lot of carbs, but DS patients do not dump from sugars or fats. Some people see dumping as a disadvantage and others see it as an advantage (keeps you out of the carbs). Dumping doesn't last indefinitely for every RNY patient, and a lot of us don't dump at all so you can't rely on the fact that you will dump for rest of your life.

I suggest reading a lot, cruising the lap band boards, the rny boards, and the ds boards. Ask questions about why people chose what they chose. Also, check whether your insurance approves all three procedures. Another one you didn't mention was the vertical sleeve. You might want to read up on that one too and see if its right for you (its the top half of the DS but without the bypass.)

All the best!

Thanks for responding. I have done a lot of reading on all of them but I think I will cruise the boards and get some feedback. Being so young, I want children as well, so the vitamin deficiency is a concern for me as well. The reason I didn't mention the VSG is because my insurance will only cover the three I did mention. I have done some reading on the VSG as well, but since it isn't covered for me, I didn't get too into it. Well, thank you for all your advice. God bless you!

I believe that some doctors wont do a LAP band on higher BMI's. have you talked to your surgeon about the options you have?

Personally I would lean towards the RnY, DS or Sleeve. The Sleeve and Lap Band may both provide a slower weight loss. And at the age of 25, if you want children, both of those options may be better for you. Although pregancy after the RnY is an option as well. But you don't have the malabsorption with the sleeve or Lap Band.

It really is what you feel most comfortable with! And excess skin could be a problem with any of the four surgery options. I would investigate more into the other options and show your mom what you find. Hopefully she will be supportive no matter what your choice is.

Thank you for your feedback! I haven't had my consultation with my surgeon yet. I kind of hope that they say that the LAP band won't be effective because I really don't want to go that route. I promised my mom I would keep an open mind but that's not what I want. My mom is great though. She will be supportive no matter what I do. She just wants me to be happy and healthy. I can't have the Sleeve because my insurance won't pay for it. I know I'm gonna have excess skin no matter what, she is just thinking that it would be a lot less with a slower weight loss. I have seen pictures of people that look like they have just melted like a candle due to the excess skin and I'm afraid of looking like that. Oh well, guess it's just a risk I'm going to have to take because the skin is definitely better than the fat. Well, God bless you!

Hi Gayla,

I don't mean so sound mean, but if you are 380# and lose weight you are going to have excess skin no matter what.  I started out at 344# and 5'2", I have lost just over 150# so far, and I do have excess skin.  My upper arms are very droopy, I have an area just above my belly button that sort of bulges, then my pannus is droopy, my thighs are loose as well, by boobs look like grapefruits in tubesocks.  I don't want to scare you, but it is like a melted candle, however on that note, I would still do it all over again.  I have so much more energy... I look so much better in clothes, I can do so much more.  Even though the skin is gross at times, I still think it is better than the life I had just a year ago.

As for which surgery, I am of course partial to the RNY.  I think the DS is a great surgery too, I would probably stay away from the lap band.  I had researched the lap band as well, but found that the potential complications (band slippage, erosion, slow wt loss) were just not worth it.  I wanted something more permanent, and something that I knew would help me get the wt off.

Hope this helps... feel free to ask me anything you want.  Good luck in YOUR decision, you are the only one who can choose what is right for YOU!!!

Caroline

Hi Caroline. Thanks for responding. I do know that I am going to have excess skin no matter what. I'm prepared for that. It does scare me a bit but I am still prepared and think that I will be much happier even with the skin. My mom is just wanting me to do the LAP band because she is thinking that with the LAP band, the weight loss won't be as rapid and my skin will have more time to bounce back. I'm pretty sure I'm not going that route though. Anyway, thank you for all of your information and congratulations on your success. God bless you! Gayla

The way I look at it now is that I currently have excess skin anyway - its just filled up with other excess stuff :P  Slower weight loss will give your body a chance to retain some elasticity in skin - mainly, I"m told from the vitamin absorption that you won't get on RNY with DS.  The malabsorption is harder on the skin from all that I have read.  I'm looking at either the band or the sleeve.  I'm leaning more toward the band just because I really don't want a change to my anatomy - and if I do have a change, I certainly don't want that extra stomach just kinda hanging out in me haha.  I really don't like the idea of the malabsorption just due to hair loss and other issues that i have - its not that I can't have it, but I'm already taking so many medications for a completely unrelated condition that I don't want to add more to it, or risk not being able to continue these meds.

The loose skin will happen trust me it far less an issue as being as big as we get. I have it adn it sucks but I wear a compression shirt and all is good. Your younger so it should be less of an issue adn working out will help some it BUT that really should be the reason to choose one option over the other, NEITHER should your mom.
Do this for you adn be clear what YOU want this all about YOU and no one else, unless you have kids then its all about them and their future. this will help you learn more about all the options...

http://www.obesityaction.org/weightlossoptions/bariatricsurg ery.php

**UPDATE**UPDATE**UPDATE**UPDATE

Thank you all for responding. I just wanted to let you all know that I DID make a decision after cruising all of the boards and talking with my surgeon. I am definitely having the Duodenal Switch. I think it is the best surgery for me and my body. Thank you all for your support! Continued good lucks to you all on each of your journeys and God bless you!