DS for lightweights?

 Would anyone here recommend DS for a lightweight (BMI 38.1) with no co-morbid conditions?  I am 48, and have been overweight since childhood.   I am not a classic overeater or a binger.  I am definitely a grazer (which I know I will have to learn to control for success with any WLS), and have never had much of a sweet tooth.  I have about 80 or 90  lbs to lose.
I am currently scheduled for a sleeve with an excellent surgeon who does many of them.  He also does the DS, and is one of the recommended docs on dsfacts.com..  During my consultation, I mentioned in passing that I assumed that my insurer would not approve a DS for me with a BMI below 50 and no co-morbids.  (Altho my current BMI is 38.1 it is "officially" 40.1)  He said that my insurer would in fact approve it, and that if I had diabetes, that would be the surgery he would be recommending for me.  I did not discuss the possbility with him further because i was pretty much set on the sleeve.   I am wondering now if I should consider it.   I want this to be my one and only WLS and I want to reach goal, stay there and have my weight struggles behind me.   Revsising to a DS down the line should the sleeve disappoint is not a realistic option because i would have to regain every ounce i lost to get to a BMI high enough for insurance to re-qualify me. 

With a strong incidence of osteoporosis in my family, metabolic bone disease is what scares me the most about DS.  From what I've read, this can be a difficult to treat problem even for people who are diigent with their supplements.  But all the glowing testimonials on the boards from DSers are hard to ignore.  

By the way,  I was initially scheduled for an RNY on 9/12 with another doc who does neither the sleeve nor the DS.  It was a link posted by a DSer to a presentation by Dr. Roslin (http://vimeo.com/25570146) that convinced me to cancel that surgery and look for another doc.  So thank you to all the people who take the time to post!  ( I am cross-posting on DS and lightweights forum. )
 

There are lightweights who have DS here on the lightweight board (I'm not one of them).  They would be a good source of information.  I also suggest that you have a long talk with your surgeon about the risks and benefits of all of the surgeries.  For me, I have risks that make either a sleeve or a DS a poor choice, and my doc was against a DS for me.   But those are my risks. 

What you and your doctor need to do is to assess the risks of each surgery, and also the benefits of each, and choose the surgery that provides the best balance.

Welcome aboard! I was 36.8BMI to start with but had several comorbidities. You are just over the line that you may be able to get approved without severe comorbids. It's worth a try.

You may be able to discuss a longer common channel with Dr J to reduce the malabsorption issues. You still have to supplement a little more than RNY but not too much more and osteoporosis if you supplement correctly shouldn't be too much of a problem. I started out pre-op with osteopenia so when I lost weight, I lost some bone to put me in the osteoporosis range. If you lose weight, you're going to lose some bone, it's pretty much a given. We have to supplement to compensate.

If there's any thing I can try to answer for you, ask away.

--gina

I'm a light weight sleever.  I never considered the DS.  I am self pay. 

I have been very successful but just had the surgery in February 2011.  I don't have the long term success to advice you on your decision.  

That said, I know alot of grazers with sleeves, who have done amazing.   I have to graze to get in my calories.  Three meals a day for me is not an option.  Keep asking sleevers.  

Try asking at the sleeve maintence page to.  they are at:

www.obesityhelp.com/group/VSGM/discussion

Goodluck with your decision.
K   

I agree with Gina.  You sound like you would be a good candidate for the DS because you don't have a sweet tooth, which will sabotage any WLS.  The malabsorption will help you with maintenance.  The long term results of the sleeve are unknown.  You can always ask to have the surgery tailored to you specifically.  Maybe a little smaller sleeve and longer common channel to help with absorption.
Just stay on top of your labs and you are good to go.

For me, it came down to whether the risks of malabsorption were worth it and also did I need to take them on. I didn't think I did so I got a sleeve and I'm 3 years out, been at goal since forever, and am maintaining just fine without any struggle or constant dieting.

And I was a grazer and still am a grazer.

I think whether you go for the DS over the VSG has to do with how much weight you have to lose, how much "insurance"  you want to have (DS has the best weight loss stats overall-some people want that peace of mind), whether or not you have indications that you will have trouble losing even on a very low calorie diet, how much activity you have in your life or think you will post-op... and stuff like that. Then throw in the lifestyle factors...

And you should get your answers.

For me, I knew I'd get active after I lost some weight because I'd been active in the past. I knew I could lose weight just fine with calorie restriction only because I always lost weight whenever I went on a diet. (Maybe I couldn't stay on the diet every time and I always gained it back but those are not metabolic issues.) I also didn't want to worry about eating certain types of foods (i.e., carbs) and having bad consequences. Or have to eat a lot of fat (I don't like greasy food and already eat a higher fat diet than some).

So I didn't see any upside to taking on the risks of malabsorption that come with a DS. But I can see other people that I want to smack upside the head and say "Get the DS, damn it and stop being so afraid of malabsorption." They are in a different place than me though.

 I had a BMI of 37 and change when I had my DS.  However, I did have several co-morbids.  Good luck to you on your weight loss journey.

Well I was in your shoes up till last week Fri 9/16.  I had everything all figured out and was a bmi of 38.  Type 2 diabetic with sleep apnea and Osteopenia, begining of high blood pressure.

So after all my research I wanted to go with the DS, Since all WLS is a tool I wanted what was in my mind the best tool for me whi*****luded the malabsorbtion which would help to keep me on track if I was to later on start to eat some foods which I should due to the reprocussions.

So with that being said thats what I went in for.  However I woke up with a sleeve LOL  Once they got inside they found to much dense fat which no one antisipated since I was a light weight and they were not able to complete the DS so a Sleeve it is.

Like yourself I also checked with my insurance this week and if it was not completed due to complications it is covered 100 percent if I go back in before by bmi drops below 35.

So now im left with another decision to make.  So back to the books all week reading everything I can find in the different groups here

So with that being said, So far I am losing 1lb a day every day. I know it will slow down but right now I have gone from 256 before surgery, went on my 2 week diet for surgery, got to 241lbs for that and today I was 234lbs.

From everything I have read, I think im going to be perfectly happy with my sleeve and just have to come to terms that either I do this right or im going to gain the weight back. So doing things wrong is not an option for me.

Its a tough decision, but it is your decision and once your on the table its not in your hands anymore either.  You have lots of valid thoughts, If I could of had the DS I would of be very happy, Getting the sleeve I am still happy, reading up from everyone with a sleeve im still happy.

 Thanks, everyone for your thoughtful responses, and good luck, Tony with your decision about whether to revise.  I saw your post a few days back about going in for a DS and waking up with a sleeve, and wondered why you chose DS a a lightweight without a ton to lose.  The co-morbids explain it.  I appreciate hearing from and about the grazers who have done well with the sleeve, and also about the ways in which my surgeon could "personalize" the DS for my needs.  I have heard from DSers who maintain their good health by taking supplements 4 - 6 times a day, and feel that is a recipe for failure for me because I have never come near to that level of compliance with any medication or supplement.  Then again, with fairly robust health all of my life (knock wood) I've never had a life or death reason to be that  compliant.   MacMadame -- I do think exercise, particularly weight training,  will be a big part of my life after WLS.  My last few diets were abject failures -- scale didn't budge a bit despite going low cal and low carb, which makes me wonder if all the yo-yo dieting over the years made me metabolically resistant.  

I will be reading up some more on the supplementation needs of DS and will be honest with myself about whether I could make it a part of my life.  

Welcome to the board.

I am also a lightweight DS'er...(married to cbramsey5898) and going into the WLS process, I weighed in at a 35.2 BMI . I think I come close to being the smallest BMI to begin with in the process of getting a DS.

My reason for getting a DS was two-fold, I needed to take NSAIDS for my arthritis and I did not want reactive hypoglycemia (I already had it within my insulin dependent diabetes). My comorbid's were diabetes, high cholesterol, and sleep apnea. My diabetes is now controlled thru my diet alone. Prior to surgery I was on an insulin pump and metformin.

My common channel is 175. Normal length is 100, but my doctor and I decided a longer one, while slowing me down some, would also keep me from going too small.

Glad you joined the board.

Liz