Pre-op BMI

One more thing....
Most of what I have seen is that insurance usually easily approves a DS with a bmi of 40. And if insurance companies actually agree with that, that says a lot!    Make sure you let your research dictate your choice of procedures, THEN find your doctor. Do not do the reverse!  A doctor will only sell you what they have to sell.   Read up on people's real life experiences.....read the threads on this site....there are over a year's worth of comments!  Then you can take out any individual doctor's own bias. 

Thanks for the information. I'm willing to adopt whatever lifestyle changes are needed. I need to do this for the diabetes. Take vitamins and supplements every day or eventually  shoot up with Insulin every day. The diabetes is not really bad now... easily controlled by diet IF I stick to a very strict low carb diet. My anatomy always wins out though. Hit the carbs just a little too much once and the spiral of carb craving/hyperinsulinemia strikes and I'm derailed again.

I'm actually a Nurse Practitioner (Psychiatric) and I've scoured the medical literature. It seems RNY is the gold standard because more surgeons are capable of performing it... not because it offers tremendous advantages in terms of complications, etc. Furthermore, my health really isn't bad. I can do an hour of cardio at target heart rate, lift, run, etc. If not for the metabolic disadvantage I could really be fit. I Say I'm a 400 lb man in a 250 lb body. I work to keep that 250lbs. The average guy doing what I do would probably weight 160lbs. Hell, I was 195 in the Army, running 5 miles every other day, marching another 5 every day (and no thyroid disorder or anything). I'm hoping that I can unlock a metabolic advantage and put in the work to become really fit.

Anyone really into fitness after a DS? Have you had problems with hydration, etc with really intense exercise?

A lot of DS vets are at the site in my siggy. BTW, psych nurse here...saving the world one Haldol at a time.