What WLS is the best for PCOS?

My eyes are crossing with all of the options out there.  I thought I wanted the Lap band 2 years ago.. but no money and hubs wasn't behind any weight loss surgery.  Had fertility treatments for a year (where I was diagnosed with PCOS), lost 25 pounds on a vegan diet, then got preggers.  Gained 40 pounds from pregnancy (and maybe 5 more after pregnancy?) and here I am 9 monthes later and the weight hasn't budged.  Top it off 3 weeks ago when I went back to my fertility doctor she diagnosed me with hypertension.  I turn 32 on Saturday. Now I thought I was going to be on the road to try to have another baby this year.. since clock is ticking, but am realizing my health is a more pertinent issue.  I have been overweight since 9 years old, have done the dieting rollercoaster all my life and nothing is sticking!! Now I am realizing that PCOS makes it even that much harder to lose weight. So..  I have been researching and decided the lap band isn't for me.  I thought I had decided the Sleeve might be a better deal, since I wouldn't have to worry about malabsorption, taking pills in the long term, how it would effect my quality of life down the road, etc.. but am worried that it really won't do that great and I might have to go back to a revision later..  I don't want to do that! I would like to get it done in one fell swoop if at all possible!  So, with all of that, is maybe the RNY or DS a better choice?  Please 'weigh' in with your thoughts!

it kinda depends on whats right for you, rny is harder in some ways but with the DS you have bathroom issues alot... theres plus's and minuses with all of them I think for PCO either of them would be great, DS is alot harder to get, but youd have a more "normal" quality of life after so the DS people claim... I know people that have both of them and as I said they each have their plus's sometimes I wish I had gotten the DS but I have never dumped with any foods yet (only on medications for some reason)  read all the facts go with your instinct.  no one can tell you one is better than the other because its all about the person having the surgery, DS takes 5+ hours on the table (my friend took 8 hours in surgery) so its much riskier I know people that just got the Sleave and are happy with that... but the only person I know that has PCO besides me also got the RNY and we are both doing great, shes almost at goal ive lost 53 pounds in 2.5 months so its definately working

I had RNY... but I also didn't really have anyone in my area for DS... I also wanted to go to a place where all they did was weight loss surgery instead of the local hospital... So, I got RNY...

at 6 months my blood work looks great... and I am about 90 pounds down... but you need to research what is in your area... what your insurance will cover, and what is right for you... also most docs say to wait TWO years after any weight loss surgery before trying to get pregnant... I will be turning 35 when I can try again... but I know I will have a healthier pregnancy...

I am so glad you posted this, I have similar questions. Forgive me for not knowing, but what does DS mean? And am I correct in thinking that the lapband won't really help someone with PCOS, because you still have the insulin/carb issues?

Oh dear... you sound alot like me.

5 yrs off bcps and ended up on diet pills and out of the blue after losing 30 lbs got pregnant... surprise!!!   then gained and sat around 220-230 for years.... did 4 yrs of fertility treatments and then decided I'm not spending anymore money there, if I wasn't getting pregnant I'm getting skinny.. SO....

I knew lapband wasn't for me, my lifestyle doesn't support the mainteance it requires..... I started down the road for RNY not really looking forwad to gas, dumping and extra nutrients....

THEN i learned about the sleeve (or VSG).... in the end I went with that and hit my goal at 9 months out and have maintained pretty much effortlessly for 4 months now.  Waiting for the end of summer to start trying to get pregnant again.

Good luck wtih your choice/research!  I thought I would lose slow, but if you follow the rules it actually goes very fast.  I have not head any bloodwork or anything done to see if my PCOS symptoms are still there; but the physical ones I already notice are gone.

I'll throw another surgery in the mix.  I have lapband and the reason i feel that it's best for me with PCOS is that with RNY you will lose weight due to the surgery for at least 2 years even if you eat those sweets you most likely can take in 6 months out, my best friend had RNY, and is now petrified of regain because she has been eating things she knows she's not supposed to be is still within her two year window where the surgery is still doing it for her for the most part...she also works out like crazy so it's hard work too, not saying that it's not. Now I have to eat right, and exercise every day or the scale will not be happy.  the band will restrict how much food i can take in and yes cheating is an option, but if i make bad choices it will catch up with me.  the reason it was the best choice for me is that it makes me accountable from day one and is still there in ten years if i need an adjustment.  Yes there are complications with both surgeries, honestly it's just what you are the most comfortable with.

Some interesting replies here. What I am really wondering about is whether there is research showing that a certain procedure benefits the PCOS patient in terms of their metabolic condition. We may all have our preference of which surgery we're more comfortable with (and I'm fine with this) but preferring a certain surgery for lifestyle reasons isn't the same as figuring out which surgery is most effective at resolving PCOS symptoms. I have seen an article that talked about PCOS in effect going into "remission" in RNY patients. And the 60 Minutes piece a month ago talked about diabetes going into remission only days after surgery (before the patients lost significant amounts of weight--thus they think re-arranging the intestines had something to do with it). I've heard similar things about DS. The LapBand had lesser results with resolving diabetes--it can do so but like the weight loss, the resolution happens over time as weight is lost. I am guessing that a Band wouldn't be as effective in combating the metabolic aspects of PCOS and insulin resistance because there is no significant physiological change or change absorption, ghrelin levels. As for VSG--this is the one I really wonder about. I know that the ghrelin levels change--this is a big deal. But if mal-absorption, and not just restriction, is a main player in resolving PCOS, I do wonder how effective VSG would be long term for resolving PCOS, particularly as compared with RNY and DS. I really don't have any answers, but I'm getting a second opinion tomorrow from a different surgeon...