RNY vs VSG

Hello - first time posting here and I could really use some help. I have 90% decided on RNY because I am 62 years old and after a lifetime of yo-yo weight issues I don't have the time to fool around AGAIN with losing and eventually regaining weight. It seems that RNY is the most restrictive with less chance of regain which is why I chose it. But I follow so many Instagram WLS people and almost all of them had the sleeve surgery. Why? I am beginning to second-guess my choice and the surgeon's office is probably going to call me this week to set up a surgery date. When I started all the classes and research 6 months ago I didn't realize that the final choice was really going to be up to me. I thought there would be clear cut reasons for either choice but there doesnt seem to be for my health issues (high BP, sleep apnea, high cholesterol, pre-diabetic) I feel fine with no GERD. Any thoughts would be greatly appreciated. :)

Many people with no previous GERD develop it after VSG. Then they do RNY to correct it. If you were 40 years younger, you might take the chance on two surgeries. At 62, I would advise you to go staight for the RNY.

Thank you for your response!

RNY is not "more restrictive" than VSG, but it does have the addition of malabsorption which should make initial weight loss easier and faster. I had VSG and it was very successful (was 56 when I had the surgery). I never had GERD issues, and still don't nearly 3 years post-surgery. However, ANY surgery you have is only as good as your dedication to new eating habits. If you cruise through the honeymoon period of easy weight loss with the "when I'm done losing I can eat what I want" mentality, as many do, then you will regain, no matter which surgery you choose. RNY has a longer honeymoon period due to the malabsorption, but it doesn't last forever. Once it stops, you're left with the same as VSG...a small stomach. If you eat the wrong foods, eat too much and stretch your RNY pouch, or eat around RNY or VSG by consuming high calorie slider foods, you'll gain weight.

If, however, you really change your eating habits, embrace the new way of eating, learn to exercise and never get back into your bad habits, you will keep the weight off. I'm thrilled with my VSG and wouldn't change my decision for the world. It's the hardest weight loss work I've ever done, but the easiest to keep off since I maintain good eating habits.

Best of luck whatever you choose.

P.S. I have a best friend who opted for RNY 6 months after my surgery. It took her nearly 2 years to lose 100 pounds, more than twice as long as it did for me, because she never stopped eating all the wrong foods. She still hasn't and I worry a lot that she will regain. Only time will tell.

Thank you so much for your reply! I completely understand what you're saying and it is scary. 4 months ago in preparation for WLS I started WW (formerly Weifh****chers) and have done amazingly well at changing my eating habits (down 35 pounds) AND my mindset. I am trying to not put such an emphasis on food anymore - more of eating to live instead of living to eat. I realize rhat WLS is a radical step and am ready (I think...LOL).

Some surgeons tend to push VSG over RNY because it takes less time to perform the procedure, therefore they make more money doing it. That's probably part of why you see so many sleeve patients on social media.

If you are pre-diabetic, RNY is probably the best choices. RNY is known to cause almost immediate remission of diabetes, whereas VSG does not have any such effect.

Regarding regain, I think both surgeries have similar rates. Regain happens when you start making bad choices, which is possible no matter what your stomach looks like!

Remember, your body and your medical situation are unique; this is YOUR choice and folks on social media shouldn't influence it. Your doctor knows your situation best and that's generally a good reason to trust their guidance.

I had thought that the cost factor might play into it and I did have one pre-op person in my class state they were going to choose VSG because it was less invasive. I did research on that and from what I can find, the pain level and recovery time is about the same so that doesn't appear to really matter. Thank you for your remarks- I really appreciate your time.

VSG is not less invasive. They remove a big portion of your stomach. However RNY they only rearrange and leave your stomach in tack. Hence if you have problems down the line you can be reattached with the VSG there is no going back.

Makes sense. Thanks!

Sparklekitty, I have to respectfully disagree. I know you're the science person, but from my own personal experience, I was cured (my surgeon's word, not mine) of Type 2 diabetes after having VSG. I was officially diagnosed with T2 in summer 2014, and by spring of 2016 was on metformin. Under my surgeon's orders, i stopped the metformin 2 weeks prior to surgery when I started my clear liquid diet. I never took it again, and within 3 months I had normal BG, which now stays 80-85 and my A1C is consistently around 5.0.