40 BMI - should I consider DS?

For those of you who have had DS, would you recommend it as a first time surgery for someone with a 40 BMI?  Perhaps no surgeon would perform it on someone with a 40 BMI.  I am debating between RNY and VSG.

I am also very curious to ask you DS'ers -- if I weren't a good candidate for DS, would you recommend RNY or VSG, from what you have seen?

If you qualify for WLS, you qualify for the DS.

The ONLY other procedure I would recommend to ANYONE is the VSG. The crapbands should be made illegal today, and I consider the RNY to be senseless butchery.

I just attended the funeral yesterday of a friend who never recovered from RNY complications that started with a leak in the first 48 hours postop. That was over ten years ago, and OMG the tortures she suffered. Another woman had surgery the same day she did--they went to NYC together for their procedures--and while she had a picture perfect surgical procedure and recovery and lost an amazing amount of weight, she regained upwards of a hundred pounds and all her comorbidities.

Those are just two of the people I've watched with RNY over the years. I've seen a few do very well, but not many. Complications and regain abound.

There are some, including surgeons, who believe that the DS should only be performed on those with BMIs of 50 or greater.  I respectfully disagree.  While my BMI was over 50, it was the lifestyle after the DS that influenced my decision.  With my arthritis, I wanted to use NSAIDs.  I didn't think I could regiment myself to tiny bites chewed to mush on a rigid schedule.  Well, the tiny bites thing I could have mastered, but the the no drinking 30 minutes prior to and after meals bothered me.  I don't always have the luxury of scheduling my meals with such precise timing.

I have friends who have been successful with the RNY, yet it wasn't for me.  The sleeve probably would not have been enough for me; I wanted malabsorption, too.  You really need to look at what you are willing to do after surgery.  Both the RNY and DS require close lab monitoring and supplements.  I think I made the best choice for me.  Best wishes in your quest to figure out what will be best for you.

this can only be answered by you, what are you willing to do, how much "help" do you need, age, gender, physical limitations, health status, etc.  BMI of 40 should not be your only deciding factor.  personally I would never get RNY, I don't ever see a reason to get RNY over VSG actually, the problems and regain are too severe for me.   I prefer the lab band over RNY, so that tells you a lot.  You have to make a decision are you ready for the responsibilities of DS, bloodwork and vit/min for the rest of your life everyday? If you are not willing, then your answer is VSG.   For me the 2 best surgeries are VSG and DS.  My first WLS was 9 yrs ago, and 10 months ago I revised to DS, 4th WLS with a bmi of 32 at that time.  This question can only be answered by you, get all your research done, then ask youself what are you willing to do and not do, what do you ultimately want?  to lose and get healthy?  to get to a normal bmi?  to maintain for a long time?   once you make a list you will come up with the perfect decision for you.....wishing you luck with your choice.....

I had the DS and my BMI was 42 if I recall. Take a look at your lifestyle, how and why you eat... then consider what you want your post op lifestyle to be. For me I didn't want to feel like I was on a diet the rest of my life. While I believe the DS is the best surgery, I don't think it's for everyone. You need to self advocate and be viligant about your labs and vitamins. I love my DS! Read everything... good luck!

My husband has the sleeve and loves it! I would do a sleeve over RNY any day!!!

 Quick aside, you say 'first time surgery', I feel it is faulty thinking to go into ANY weightloss surgery with a sequential frame of mind.  One surgery, one time.  

Now to the point of your post, I had a BMI of 40.  I had no comorbidities at the time but a family history that promised a slew if something wasn't done.  I view it as making a pre-emptive strike for my health.

If I had been forced to settle for something other than a DS, it would have been a VSG.  

I feel exactly the same as Ragamuffin. I also had my DS at a BMI of 40. Most DS surgeons will do it for "lightweights," but I've heard that a couple of them might still require you to have a higher BMI. VSG would have been my second choice. Definitely not RNY or band.

Karen

Rags is right. Get it right the first and hopefully only time. We're seeing so many people who have failed with lap band or RNY these days, it's very sad. Weight regain is the dirty little secret of RNY. Sleeve? Longterm results are not yet known. Initial results seem about the same as RNY, and unless the sleeve is made very narrow, weight regain begins at about 4-5 years out. So, many surgeons are now making the sleeves more narrow, but no one knows if this will prevent weight regain or just postpone it. My guess is postpone, as sleeves stretch out with time.
     The DS combines moderate restriction with moderate malabsorption and has the best longterm statistics of any wls presently available for percentage excess weight loss, MAINTAINENCE of that weight loss, and resolution of almost all comorbidities. Morbid obesity is a chronic health problem, not an acute illness. You need a treatment that will work for you for the rest of your life, not something that only works for 18 months, like RNY - an honest RNY surgeon will tell you that after that, it all depends on behavioral changes and not on the operation. If you think you can sustain the necessary low fat, low carb, low calorie diet and exercise for the rest of your life, fine, but many people find this impossible despite the best attitude in the world.

Larra

I have a 42 BMI and I plan to get the DS.

When I started looking into WLS I found the lap-band. I thought non-ivasive and looks pretty simple! That was just the nice fluffy version.... I found pt's and forums with not so happy things to say about the lap-band. So I a big no on the lap-band!

Looked into RNY after that, and just reading what they did to your upper stomach! All those problems and not truley being able to eat like a normal person for the rest of your life?! I am here because I have a metabolic problem, not an eating problem. So when I saw the RNY limited you to 'dieting' for the rest of your life..... I was blown away by this being the most comman used procedure! This?! It had to be better than this? Then someone mentioned the DS..... now all is history.

I will never do any other WLS besides the DS or maybe the VSG. Since I am a metabolic disorder pt the VSG would not work for me, I need the malabsorbtion. I hope enough people convince you to make the best decision for yourself. But if it were me RNY and lap-band would never make my list of WLS!