Question for lightweights about RNY

I asked this in the RNY section but I thought it more appropriate here.

Because we are lightweights, do the surgeons make out pouches bigger or bypass less or make the stoma bigger so we will lose less?  Anyone heard of this? 

I've heard that some do, but mine didn't. His medical opinion is that if a person needs the surgery, they need the most researched/vetted procedure.

So far it's worked for me - I definitely surpassed his expectations!

Ask your surgeon and see what he says, and, more importantly, WHY. If it's so you lose less, I'd really consider switching surgeons. You can increase fat content (good fats... nuts, etc.) easily if you go too low, but it would seem that it's easier to not lose enough than to lose too much.

If I remember correctly, my surgeon did change the length of the channel depending on how much you had to lose.   Being a LW mine was 100c bypassed.  But NO, not the stoma,.  The bigger the stoma, the more you can eat.  Think of your stoma as the open end of a funnel.  The bigger it is, the faster it empties.  If he were to do that, that would just be counterproductive.  Otherwise why wouldn't he just make you a bigger pouch and keep the stoma the same?  Same results, except long term your stoma could stretch even more and then you have one, very long stomach, and you won't feel fullness... ever.  Ok - that's drastic, but can happen.

Yes, some Dr's make pouches bigger - that's something you need to ask your Dr about.  Ask him the size of the pouch and how much he bypasses and if it differs according to how much weight you have to lose.

Get yourself armed with info - you can't go wrong!!

Good luck!

I don't think mine makes any difference on whether you are a lightweight or not.  Like Jody said, I would ask your surgeon because they all do things differently.
I personally would not want a bigger stoma, but that is just my opinion.
Linda

My surgeon does discuss which surgery may be more appropriate for lightweights and for specific co-morbidities, but I did not get the impression that he'd do them differently for specific patients.  

Thanks for your replies.  I jsut read something on RNY that suggested that.  I lose hard enough as it is.  I dont meet again with the surgeon for a couple months and just wanted to know if that was the usual practice which it sounds like it is not.

 Mine did choose to make modifications in the usual procedure .   

i think what matters most  are the modifications U make Urself  post op .... by EATING   especially the  first 8 weeks post .  

If U indulge in buffets expect not to lose as much .    If U weigh Ur food   and act as if Ur on a permanent diet ...  U MIGHT have to get Ur stoma stretched out .   Happiness lies somewhere between the two .. listening to Ur body ..helping to get the digestive motor  jump started again post op  ..and feeding its regular fuel to poop daily etc ....

If my surgoen did anything different because I was a light weight, he didn't tell me, before or after.

Personally I'd run far away from a surgeon *****gularly gave lightweights a lesser version of any of the surgeries. It means they don't really understand how these surgeries work for one thing!

The thing is, a lightweight may have less weight to lose, but the weight loss portion of this journey is such a short moment in time. The real issue is maintenance -- how many calories you can eat a day and not gain weight.

That's why the only reason I can see to give someone a bigger pouch or less intestinal bypass is if they are going to need more calories than average to survive once they've lost all their weight. And that has nothing to do with what weight you start at and everything to do with how fast your metabolism is and how active you are.

So I can see giving a 6' young guy who used to play sports competitively and wants to get back to it a bigger pouch or sleeve if they are concerned about keeping their weight in a good place post-op and aren't sure they can eat 2000-4000 calories a day with a smaller one. But I can't see giving a short middle-aged lady who doesn't work out much a bigger stomach and/or less bypass.

A lot of WLS patients are in that category and they often end up being needing to eat 1200 calories or less to maintain and that''s going to be tough, tough, tough, if your pouch and stoma are big or your sleeve is big and you only feel satisfied on a volume of food that would typically be 1400-1600 calories. It means you have to watch every morsel that goes in your mouth and eat mostly rabbit food and diet food and who wants to have to do that for the rest of their lives if they can avoid it? Not me!

I don't have a clue what my Surgeon did but at 3 years out it's still working!