Will surgery be enough???

As my time is winding down to my surgery date I am really starting to wonder if the RNY will be enough or if I should do the VSG and then get the RNY.
*I have been told by plenty of people that I need to get the DS but it is not covered by my insurance so it is NOT an option.

I do plan on exercising but I am wondering if my tool is really going to help do the trick when I have over 200 lbs to loose.

Would love to hear from some of you who have had the RNY and lost 200+ lbs?

Most of the people I see and who have had the RNY started out at 250 lbs (and all I can think is----uhm yeah---I'm trying to get to 250 first).
It can be heartbreaking at time to know that we can loose 100 lbs or 150 lbs and still have another 100 lbs to loose.

At first I was going to just answer the title, "Is surgery enough?"  NOPE.  But then I read what you were really asking, and will just tell you what my journey has been like.

First, I think VSG is a FABULOUS surgery, I wi**** would have been something for me to look at, but I already have a very efficient body - and STILL do... Sigh.  I had RNY almost one year ago, and I am working for every pound I see drop.  I have lost 160 pounds, and it wasn't easy.  I had three months NO exercise, so my "golden three month window" sort of blasted by with only 80 pounds lost.  Yeah, 80 sounds impressive, until you factor in how much I started at... Anyhow, I have consistently continues to lose, with a few plateaus, so of course I start asking myself if I can push further -- the answer: YUP!

I talked to my surgeon's nurse practitioner yesterday, that I realize I will NEVER be cured of obesity, that I will have to continue my fight for the rest of my life.  I signed on for a life change, not just to look cute in my swimsuit -- so I am ready to keep working at this, no matter how long it takes to be a "normal" size.

VSG may be enough for you, but you should discuss this with your primary doctor who knows you and your surgeon.  For me, I only have a bowel movement every other day, sometimes three days apart -- which just goes to show, I have a very efficient body.  Some days I feel like I should have gone for a more "drastic" approach, but I remind myself I did not gain this weight in a year, so it will take a LONG time to lose it - safely.  So, talk to your docs, see what they have to say, VSG may be enough for you - and if it isn't, you can always have it revised ;)

Hope that helps, even a little!
Brenda : )~

Do you think your insurance will cover a VSG and then a RNY? I dont recommend planning on 2 surgeries from the start.

Im not a good person to advocate for the RNY since i didnt want one for various reasons, but i can tell you that if you check out the VSG forums, people there are losing similar amounts of weight at similar rates as the VSG. There are several "heavy weights" who have done very well with the sleeve alone.

I have no doubts that I will reach my goal with my sleeve. I lost a substantial amount of weight pre-op so I went into surgery with the confidence knowing I could do this. I do not think about my ultimate goal very often - i take it 5 lbs at a time, one clothes size at a time. When I started, I never imagined being where I am now, but here I am, going strong. I got the whole "omg you are so big and your bmi is so high so you have to get a DS" BS drama before surgery, but soon enough, I'll be another good mark for the sleeve, much to some people's surprise.

Can you tell me more about the VSG----I have gone back and forth over the VSG and RNY and am still not sure...

Check out the VSG forum - they have links to all the medical info and stuff about VSG.

In simple terms, the VSG removes a large part of your stomach and leaves a small tube shape stomach in tact. The doc leaves the least stretchy part of the stomach. You need a good surgeon because it is is possible and does happen that surgeons can make the sleeve too big, too small, or screw up the shape of the stomach or other problems. There is always a risk (though its really low with a good vsg surgeon) of leaks at the staple line. Risks in general for this surgery are slightly lower than RNY/DS.

I chose to have this surgery because: (this is just my personal view - i have nothing against the RNY or anyone who determined that it was the right surgery for them - there is no one perfect WLS and depends on people's needs)

- the band was never ever an option ( too many complications, multiple surgeries, constant follow up, little to no weight loss)

- with the sleeve, the pyloric valve is left in tact. This regulates how food and liquids empty out of your stomach. You should read up about this little part of our stomach. With a RNY, you do not have a pyloric valve, but rather a stoma that is subject to stretching over time (as well as the pouch itself)

- with the sleeve there is a lower risk of ulcers. I can take NSAIDS with my sleeve unlike the RNY where it is an absolute no-no. If I ever get arthritis or any other medical condition that requires NSAIDs, I'll be able to take them. Im young, so i wanted to keep my options open.

- VSG is purely a restrictive surgery. RNY is restrictive and has a malabsorption component. However, that malabsorption is not permanent and wears off (from what I've heard) between 18mo-2 years. So then you have a restrictive only procedure after that time period (except vitamins, i believe you will always malabsorb those) (i am not an expert in RNY though - this is just what i recall when I did my homework a year ago).

- with RNY, because of the intestinal re-routing, you are at risk for bowel obstructions. I wasn't interested in having to worry about that.


If, say, I had any metabolic disorders or diabetes, I may have considered the RNY for resolution, but I had really no co-morbidities at the time of surgery, and I had a good track record for being able to lose weigh, i could just never keep it off, so i felt that for me, the VSG was the way to go.

To answer your main question, I have not lost 200 lbs with my RNY, YET, but I am on my way. So far 160 since March. Started at 480, now 320.

Yes, it can be done with a RNY. just as many people have lost the same amount with VSG.

However, more important than choosing the right surgery, find the right surgeon. When you find the surgeon you trust, talk with him/her and come to a decision together based on your needs and medical history.

I am still a pre-op so I cant answer your question just yet.  But i attend the support group meetings.  I am amazed at how many have lost 175 and 185 lbs with Rny.  It can be done.  I am having RNY because its what is covered under my policy.   

Good Luck

As you can see I had VSG, started with a BMI of over 70 and am not at my scale goal yet but healthwise doing fantastic at age 60. With the RNY you will lose more pounds quicker because of the malabsorbtive component. However the VSG patients have been compared and lose equally as well. With RNY the malabsorbtion of calories and fat diminishes as time goes on which might result in some re-gain. There is also the issue of the pylorus valve, which in RNY is by-passed (or removed?)  There have been some studies pointing to metabolic issues later on with that. You will have to search for those articles.

Also if you have to take NSAIDS, you might want to consider the VSG because with the RNY you can't.

Keep researching to make certain you have chosen the best for you.

 I had the RNY 12-15-10.  Coming up on my one year anniversary!  Super happy with my journey!  I have lost over 200 lbs post surgery.   My journey started 08-23-10 with my actually losing weight.  Pre surgery I lost 110 lbs.  In the first month, while in the hospital I had gained a bit of fluid weight.  I stuck with it and kept positive.  I had complications, but with my bleeding issues that I have dealt with in the last 10 yrs, I knew my risks before going in for surgery.  (so I do not count the weight I gained and lost in my surgery, the first month after surgery I spent taking that off)

Today I have weighed and actually now am 324 lbs.  I started at 654 lbs.   
To date my total weightloss is 330 lbs.    I know that this process has not been only a "surgery being enough" process for me.  For me my experience is that I am able to use this as an effective tool.  It is my new baby stomach and am fully focused on good habits to my second chance.   My body would hurt with incrediable pains if I did not eat and my body had a hard time even just getting to the bathroom.  There were many things I could not do for myself.  It has been a PROCESS and lots of patience.
REMEMBER THE WEIGHT DID NOT COME ON OVER NIGHT,  AND IT WILL NOT GO AWAY OVER NIGHT!   
BEST OF WISHES FOR YOU IN YOUR DECISIONS!!
NUTRITION, EXCERSIZE, AND LIFESTYLE CHANGE  WILL HAVE TO BE YOUR FULL FOCUS along with YOUR NEW TOOL (whatever WLS you choose)!!