Question for you VSG'ers

I am scheduled for a RnY next month, and just had my first appointment with my Surgeon. He asked why i wasnt considering a verticlal sleeve. I started looking into it and i get why he would recommend it but im worried i wont lose enough weight without the malabsorbtion portion of the surgury. So my question for you VSG'ers who are getting a revision. What happened to cause the revision? What do you wish someone would have told you about the differences between the gastric bypass and the verticle sleeve. I guess just any advice you all have would be great. thank you so much!!!

Most VSG'ers I see getting revision (not huge numbers, by the way) are due to insufficient weight loss.

First, let me say I love my sleeve and believe it was the right decision for me. But it's NOT the right decision for everyone.

VSG is not an ideal surgery for those with huge amounts to lose (say BMI well over 50). There are a couple of people with really high BMI numbers who have done well on VSG (guy over there has lost 330 lbs, several others over 200) but it's not the norm. 

It's also not the best surgery for those who have a metabolic problem that would interfere with weight loss. Can you lose now on a properly followed 1200 calorie or so diet? Someone who eats those calories and can't lose may have a metabolic problem. I have a slow metabolism due to being post-menopausal, but I can lose on 1200 calories so I knew I'd be OK on this regard.

Please read carefully the revision rates for RNY, which are higher than for the sleeve. This is because you lose the malabsorption of calories to an extent as your body adapts AND can develop reactive hypoglycemia which leads to weight gain. It doesn't happen to everyone, but it's not uncommon either.

My advice: hold onto your pyloric valve. This means either a VSG or a DS (duodenal switch - not a huge number of surgeons do this one). If you have a BMI below 50 and no metabolic problems, I'd go with the sleeve. But if you really think you need malabsorption, I'd seriously investigate a DS even if it means changing surgeons.

I don't regret having a sleeve rather than a DS, but I'd have a DS before I'd ever consider an RNY.

yeah the more i look into the sleeve the more i think its right for me, at this point i am 225 (+/- a few) and my bmi is 41 so to be my "happy" weight i need to lose 75, to be my "outfricken standing!!" weight id need to lose 85.