My first initial visit

My BMI was over 70 when I started the process to have WLS.

My surgeon gave me the choice between the RNY and the VSG.  I was always reluctant to have the RNY.  When I heard about the VSG, it sounded like the perfect choice for me.  I'm a quantity/emotional eater and although I've lost a significant amount of weight, I haven't reached my personal goal.  Plus I've found that the emotional triggers that brought me to SSMO don't go away unless you deal with them, which I'm still working on.

My surgeon said that the weight loss difference for patients who have had the RNY vs the VSG are statistically similar at the two year point.  The RNY gives you an extra benefit with the malabsorption component.  The VSG removes the portion of your stomach that generates ghrelin, the hunger hormone.

It's a very personal decision.  You can ask the surgeon for his recommendation, but in the end, go with the type of surgery that you feel most comfortable with.  You're going to be living in that body for a long time and the decision should ultimately be yours.

Good luck on your journey.  It was the very best thing I ever did for myself 

Thank you ladies so much especially you JOLLY for the break down of your visits...I was just filled with curiosity but now that I have some idea of what the first visit may be like I'm even more excited.. Just thank you all for taking the time to comment!!!

My starting BMI on the day of surgery was 78.7 - today it's 58.3, and I've lost 111.5 pounds since June 1st.  I went from 430 to 319 pounds.  I'm 5'1" and have done really well.  So, the VSG is very effective.  The DS is effective.  The RNY is effective.  Any of them

So, the VSG is very effective.  The DS is effective.  The RNY is effective.  Any of them are effective if you follow the rules. 

Now, for higher BMIs the outcomes tend to be better for the DS that is true.  I think that is a combination of behavior and metabolic differences.  The malabsorption is very good with the DS, and it also has much stronger metabolic changes, though we aren't sure of all the details why.  The VSG also alters metabolic regulation too, though these mechanisms are also poorly understood.  We've only known about ghrelin since 1995 or so, so much of this science is new.

My point I guess, is that any surgery works if you work it.  You have to use the sleeve as a tool and not rely on it - you still have to rely on your choices and judgment.

As for sleeve vs. RNY, that's a conversation to have with your doctor.  The outcomes are more on par with each other, though some studies show the RNY has slightly better results.  I did not choose it because I was concerned about having a blind and unscopable stomach.  I also wanted something I knew was completely permanent.  I wanted the option to take NSAIDs in a pinch, if temporarily.  I also knew I might have to revise to the DS one day, though I've had really good results in just six months, at any rate.  We'll see how things look after a year.

Thank you for responding and I would like to ask you one question why would you have to revise to the DS? Is that something that's mandatory when you get the sleeve done? I've heard a few ppl comment about having to revise to the DS.. 

It's not mandatory.  A lot of people at very high weights do well with just the VSG - it became a stand alone procedure when individuals had it first and then did not do the DS.  Everyone's metabolism and habits are different.  It is also true that many of us struggle with eating, and the DS has a metabolic benefit in that you can eat more and not gain as easily.  

I might need it simply because of statistics; my highest weight was over 700 pounds.  I got down to 430 on my own and that was my weight June 1st.  I was 400 on surgery day, on the 22nd.  Statistics simply are that I am at risk of regain than the average WLS patient.  I intend to avoid it with good habits, though, as I really don't care for the vitamin regimen of the DS.  Even so, I also know I have eating issues I work on via counseling.

There are many reasons that the DS is still regarded as the best surgery for very high BMI patients, though, due to the results being far ahead of the other surgeries.  Having said that, there are also DS patients that have significant regain, too.  No surgery will work if you rely on it instead of on changing your habits.

Oh ok thank you so much for that explanation.. 

It's nice to finally find a few people here that are/were around my height/weight!  I'm 5'2 and was 431.2 when I started my journey in May, but my first appointment with the bariatric clinic wasn't until 2 days ago.  During the 6.5 month wait for my appointment I decided to get a head start on things and began using MyFitnessPal to track everything I ate and had a goal of 1500-1600 calories.  This worked wonders for me and am now I'm down to 362!  

When I went to my appointment they were so impressed with my progress and knowledge of the process that they fast-tracked me in the program and scheduled me to meet the surgeon on Jan.13th.  I'm determined to get the sleeve, as I don't want my intestines re-routed and have to deal with malabsorbtion the rest of my life.  I'll still have many months of appointments before I can be scheduled for surgery, but it's so great knowing that all my hard work and research is paying off!

If you haven't already, I highly recommend starting a food journal and doing all the research you can on both surgeries and what you can expect before/after.  The more you know going into your appointment, the more prepared and comfortable you'll feel with your decisions! 

Best of luck!

Thank you so much for your response.. I'm doing a lot of research, it's to the point that it's all I have to talk about lol... I want be very educated and making sure I make the right decision on which surgery to have and the more research I do the more I'm deciding on the sleeve... what you said about the intestines I had the very same thought.. 

Congrats and good luck on your journey!!!!

Do you have GERD?  If so, you will probably be told by your surgeon that you need a RNY.

By all means research the DS. It has the best long-term, maintained weight-loss stats for patients of any size, but especially so for those with a BMI greater than 50. It also has the best stats for resolving or preventing co-morbs like diabetes and high cholesterol.

The DS has a Sleeved stomach, plus nan intestinal bypass similar to, but more aggressive than, that of the RNY. With the DS, you'll always and forever malabsorb calories, as well as certain vitamins and minerals. (With the RNY, the malabsorption of certain vitamins and minerals is permanent, but the malabsorption of calories is not. If you need malabsorption, you're going to need it forever.)