My Doctor is Trying to Talk Me Into RNY Instead of the Sleeve

There are plenty of people who love their sleeve. You surgeon is probably just giving you his opinion based on his personal experience. Although what he says does happen, his 2% figure is certainly an exaggeration. Plenty of people also love their RNY, and I know it was the right choice for me. It has resolved all of the heartburn and upset stomach issues that I used to deal with on a regular basis. I always had a sensitive stomach before surgery. Among other things, I could never drink coffee because it upset my stomach so much. Since surgery, I have developed a love for coffee! My advice is to do lots of research to determine what is best for you. This is something that you are going to have to get used to anyway if you intend to go through with surgery.

Same here with the coffee bothering me before WLS but not after.  Was it on your NUT's list of "to be avoided?"  It was on mine, so I consider coffee my transfer addiction.  I don't stop, in part, because many of this forum say coffee is okay.  Do you try to limit your coffee consumption? 

LOL, I could have written this post!  (I don't try to limit my consumption though)

My NUT doesn't have a problem with coffee. She just says to avoid it until you are getting enough water. I don't believe there is anything unhealthy about coffee unless you consume it in excess or add calories laden sweeteners to it. Most articles I have read define excess as a pot a day. However I choose not to drink more than two cups a day simply because I don't want my caffeine dependence to be that high. But that is already higher than I have ever allowed it to get before so I'm not sure what I am going to do now. I just hate letting a substance have that kind of power over me. I was trying to keep my caffeine to 100 mg a day, but those delicious cold brew Starbucks iced coffees have pushed me to closer to 200 mg a day.

If he has had such a bad experience with the sleeve, I think that speaks more to him than the sleeve. What are his support groups and post surgical diets like? Is that why his patients aren't successful? No surgeon has 100% success, patients do what they want. He was incrediblt negative though. Part of my decision for RNY was because I had a lot to lose, and at this point in my life even when I was restricting my diet I wasn't losing anything significant. I was concerned that restriction alone wasn't going to be enough and I needed that 'head start' malabsorption provides to get the weight off. Good Luck.

Jami1371,

I went through this and it shocked me when it happened.  My PCP had already told me he would only approve the sleeve. I had to wait a couple of years for my insurance to cover the sleeve.  I wanted the sleeve so how could it not be the right choice for me?

My surgeon explained the amounts of weight loss expected along with additional concerns in my case.  I am type 2 diabetic, and a heart patient.  I have a bevy of complications to add to the mix.  He explained not only the amount of weight loss to expect per procedure, but also the rate of losing my diabetes, and numerous other medical conditions.  The RNY had the best rate of success of getting off my medications, and become healthier.  LIVING healthier and longer is my main goal.

Yes.  I'm fully aware that many lose to goal weight with the other procedures, but we all have differences.

I went back to my PCP thinking he would protest.  He immediately told me he no longer would approve the sleeve in my case.  He would only approve the RNY.  Again I was surprised.  I've had my PCP for almost 20 years, and he knows everything about my health.  I had not gotten a referral from him, so I wasn't sure if he had heard from the surgeon.  I didn't tell him I had an appointment.  So what changed?  

As time passed he had educated himself to the different procedures.  He studied their effects on diabetes, as well as other complications and disabilities.  He also went over my disabilities, medications, and chances for long term success.  I did a lot of soul searching to make my decision, and took my time to research and mull things over.  I just had my RNY surgery, and I have my 1st follow up appointment tomorrow.  Luckily it was covered by my insurance 100%.  I think the decision I made for myself is the right one for me.  

You have to choose in the end what are your goals and expectations.  Are there reasons other than weight loss that has brought you to consider any of these procedures?  If there is other reasons does the type of procedure have any effect on your choices?  Take your time to research all your options.  Good luck in your decision. 

Thank you for taking the time to respond to my post.  I do have two medical issues that I am hoping will clear up by having the surgery and losing weight.  Maybe that has a lot to do with his suggestion, and he just didn't communicate that to me.  I will look into that further.

Good luck to you!

I would say go for the RNY. I had the sleeve approximately four years ago, only lost about 57 pounds and then began to regain the weight. I developed aweful GERD, and two ulcers from the Gerd, and now have been approved for my second weight loss surgery which is the RNY.

I just served on a panel (CA Technology Assessment Forum) that compared a bunch of weight loss methods... here's what the report said about it...

"Head-to-Head Evidence Comparing Variants of Bariatric Surgery * Total of 24 good- and fair-quality studies comparing bariatric surgical procedures * Meta-analysis of BMI change only feasible for RYGB vs. VSG * No statistically-significant differences in BMI change between these two procedures in any individual study or overall"

If that helps. 

Thank you!