RNY or DS?

I had VSG 4 years ago and lost about 40 pounds, but have gained back almost all of it. I feel like I can eat way more than I should, and I'm always hungry! I'm pretty certain I want a revision but can't decide between DS or RNY. I would prefer DS, but I am a lightweight and have been told that DS is too drastic. I will be going to mexico for my surgery. I have looked at docs already and still haven't decided between a list of 3. Ideally I would like to lose 60 pounds. What would you do?

First it would be in your best interest to figure out why you haven't been able to lose and keep off weight.  Have an endoscopy - find out if there's something wrong with your sleeve.  Track everything and see what you're eating and how that might need to change.  

I was a so-called lightweight also. I initially lost about 70 pounds, and gained 25 back. I opted for a DS, even though the Mexicali intake folks suggested I have a SADI-s for fear I would "lose too much weight". Now, I know that ain't never gonna happen. I said I wanted the DS, and that's what I had, with Dr. Ungson. My surgery was 2 weeks ago. I think it was a very good decision. Good luck to you!

Chances are the sleeve stretched and/or the simple carbs are dominating your diet.  An upper GI can confirm that.  As far as which revision to have, DS has better long term results, but some are concerned with the excess malabsorption.  RNY is better understood, but the revision results aren't as good and it has its own issues.

Don't let anyone tell you what's best for you.  That's only for you to decide. There are lots of posts on these topics and an on both surgeries.  Once you've read them, I think an answer will come to you. The only unsolicited advice I will offer is to think it through carefully.  Once you've revised to RNY, it is extremely difficult (if not impossible) to undo. Chances are that will be it. DS is a bit easier (except the sleeve, of course) but, even that, wouldn't be much fun.

As far as looking at what you eat, well, of course.  But if you had total control over your eating you wouldn't be here.  Neither would anybody else on these boards. They only have control if the tool is good. If your tool is broken, don't beat yourself up. I'm sure you've done that enough and you don't deserve any more.

I wish for you everything you wish for yourself.

MM

The DS is no more 'drastic' than the RNY.

Both surgeries cause you to FOREVER malabsorb certain vitamins and minerals, require you to take vitamins and supplements daily, and get regular labs drawn to ensure you're taking what YOUR body needs. I have a DS; I know RNYers who take more vitamins than I do, and I know other DSers who take less than I do. Each person who gets a malabsorptive surgery has to rely on their own, individual labs to stay healthy. And my DS allows me to take the NSAIDs my arthritis requires.

Both the RNY and the DS also cause malabsorption of calories. For the RNY, this lasts for about 18-24 months; this is the reason that at five years post-op, the VSG and the RNY have nearly identical maintained weight-loss stats. For the DS, the malabsorption of calories is PERMANENT. Needless to say, the DS has the best long-term, maintained weight-loss stats.

I know several light-weights who chose the DS for a variety of reasons. Besides the best stats for maintained weight-loss, it's also the best for resolving or preventing co-morbs like diabetes, high cholesterol, insulin resistance, PCOS, and metabolic syndrome.