Biggest decision ever.
all of the people you know in real life who had the sleeve are 30 to 50 pounds above goal after five years? all ? What about the people you know in real life who had RNY five+/- years ago? What are their statistics? surely they're not all at or below goal ? my own surgeon told me to the contrary at our first consultation.
Either way, there's been a study done showing that after some years post gastric bypass, the gastrojejunal stoma begins dilating, progressively... what this means is the food RNY patients take in, empties out of their pouch quicker and quicker (as the dilation gets worse) causing more and more hunger problems. here's a link to an article about it. http://agajournals.wordpress.com/2011/03/03/what-causes-weight-gain-after-gastric-bypass/
People do well on all surgeries, and people regain a bit on all surgeries. We're all human, and everyones results will directly reflect their own behaviors, genetics, activity level.
HW 383 SW 371 CW 234 
Back to the OP's topic, I had a RNY in part because the VSG was not available at the facility I chose, and the two options were RNY or lap-band. I chose the RNY because my BMI was in the 50's and I felt I had a greater chance of long term success with the RNY, plus I disliked the idea of hardware inside of me that required "filling" or adjustment of any kind.
With RNY, over time, the intestines do compensate for the malabsorption of nutrients by growing longer internal cilia, which do a better job of "catching" the good stuff. That being said, I am still very careful to take my supplements twice a day, to be on the safe side. After several years, my absorption of B-12 from regular foods was so good that I no longer needed to take a supplement, but I still take calcium citrate, a daily women's vitamin, and glucosamine-chondroitin (because I am a distance runner and like to give my joints as much help as possible!).
The main thing to remember is that the 1 1/2 to 2 years of VERY small stomach time that you get with the RNY is the best opportunity to examine your eating habits, add newer, healthier ones, and begin the daily work against the food demons that cause compulsive overeating. Dumping and reactive hypoglycemia can be avoided by eating well--fruits, veggies, naturally fiber-rich foods, lean protein--and curtailing super-sweet stuff, just like any other thin or fit person who "watches their weight."
The advantage of the VSG is simply that you retain your sphincter muscles! One of my colleagues has had it, and has had very good success. I don't know anyone with the DS, though I have read that they are more prone to rectal fissures due to the higher acidity of the resultant bowel movement. That's the only thing I've heard on that score, although by all accounts DS folks can still eat like linebackers and not gain weight.
The RNY is a tool to help you use up your stored energy (fat) and learn to enjoy the kind of diet that is more like that which our ancestors evolved and thrived on. I lost 162 pounds post-RNY and have kept it off for almost 6 years by doing the mental and emotional work, sometimes even going back to keeping a diet journal when I feel myself "cycling" back into unhealthy mindsets and overeating, and adding exercise to my life! I am very happy with the results--my absorption, labs, body fat percentage, and overall health and fitness are excellent.
Good luck on your journey, J!
"Fall down 7 times--STAND UP 8!"
