New to board-DS or VSG?
I think it comes down to whether or not you need the malabsorption that the DS adds to the VSG. If you don't need it, you are taking on extra risk without getting extra benefit.
For myself, I never had trouble losing weight (if I stayed on the diet) so I didn't need malabsorption to lose weight. Some people have metabolic issues that mean they'll have trouble losing weight with just restriction.
I also had periods when I was pretty active so I figured that I'd be active again when I lost the weight. So I worried I'd have to eat too much. As it turned out, I got even more active than I ever dreamed of and there are periods where I am training rather heavily and I have trouble getting all my calories in. So, if I had a DS, that would be even more an issue. OTOH, some people have physical restrictions that keep them from exercising and can't be as active as they need to be to keep their weight off without malabsorption to help them.
I also had no metabolic comorbidities. Though on that one, the 'cure' rate for diabetes for VSG is very good. If you haven't had it long and aren't on massive quantities of insulin, then most likely you'll be fine. But people who have had diabetes for decades and are on several diabetes drugs may not be able to get off all their drugs, particularly if they don't lose all their excess weight, without some sort of intestinal bypass.
I think as lightweights we are in a good position because statistically we are much more likely to lose all our excess weight and keep it off with minimal bounce back. So that means we aren't in a position where picking too light a surgery could mean that we won't succeed. There are plenty of people who are afraid of malabsorption to the point where they'd never get a DS no matter what but are SMO and so they get a VSG or a lapband never lose to the point where they are not obese.
This is not our situation. Most of us will end up in the normal or overweight BMI category no matter what surgery we pick.
I think the main thing is to pick your surgery based on the facts and not based on myths. I read all the time stuff about both the DS and the VSG that isn't true. Some examples:
VSG:
-If you get a VSG, you will be on a diet for the rest of your life.
Pffft. Most VSGers aren't constantly dieting. Our appetite matches our activity level so we are satisfied with the quantity of foods we eat and we can treat ourselves occasionally too just like non-WLS people without weight problems.
-VSGers don't have to worry about vitamins
All WLS types need to worry about supplements and labs. Sure, VSGers are statistically less likely to have malnutrition issues but we still have them as we can maldigest certain nutrients (that is they don't get broken down enough in our tiny stomachs)
-Your stomach will stretch out and you'll be as hungry as before
The sleeve does get bigger over time but most people I know who are 2-5 years out stil have great restriction and can't eat as much as before. And they aren't as hungry as they were pre-op even though most people do eventually get hungrier than they were early out. I can't eat any more than I could at 1 year out unless I break the rules, as an example, and I'm 3.5 years out.
-A VSG is a restriction-only surgery
The VSG is very metabolically active. It's more metabolically active than RnY and only the DS is more metabolically active. It's just that its metabolic "oomph" comes from changing the hormones involved in digestion and not from malabsorption.
DS:
-You'll have bathroom problems
Obviously, if you malabsorb food, it has to go somewhere. So you'll poop more than before. And simple carbs can cause noxious gas. So it's not like you get a free lunch with malabsorption. But these problems are rarely as bad as the naysayers make out. It's up to you to decide if you want to deal with them or if they are deal breakers.
-You'll eat unhealthy
Some people don't get that if you malabsorb 80% of your fat that eating 10 slices of bacon is like eating 2 slices and they think the DS diet is unhealthy because it's high fat.
-You'll be sick all the time from malnutrtion
If you don't keep up with your labs and your supplementing, then yeah, this can be a problem. But most DSers are willing to do what it takes to be healthy and most of them don't have big issues with malnutrition.
-You'll lose all/most of your excess weight and you'll never have regain
Absolutely, the DS has the best weight loss stats hands-down. But not everyone with a DS loses the average or better and people with DS absolutely have to deal with regain. You can regain with ANY of the WLS t ypes -- there are no magic wands.
In the end, I think the best thing to do is to lurk on the DS and VSG board, especiall the VSG Maintenance group, and see what life is like for the long-term DSers and VSGers. See if the things they are dealing with and the way they live their lives matches up with how you want your future to be.
For myself, I never had trouble losing weight (if I stayed on the diet) so I didn't need malabsorption to lose weight. Some people have metabolic issues that mean they'll have trouble losing weight with just restriction.
I also had periods when I was pretty active so I figured that I'd be active again when I lost the weight. So I worried I'd have to eat too much. As it turned out, I got even more active than I ever dreamed of and there are periods where I am training rather heavily and I have trouble getting all my calories in. So, if I had a DS, that would be even more an issue. OTOH, some people have physical restrictions that keep them from exercising and can't be as active as they need to be to keep their weight off without malabsorption to help them.
I also had no metabolic comorbidities. Though on that one, the 'cure' rate for diabetes for VSG is very good. If you haven't had it long and aren't on massive quantities of insulin, then most likely you'll be fine. But people who have had diabetes for decades and are on several diabetes drugs may not be able to get off all their drugs, particularly if they don't lose all their excess weight, without some sort of intestinal bypass.
I think as lightweights we are in a good position because statistically we are much more likely to lose all our excess weight and keep it off with minimal bounce back. So that means we aren't in a position where picking too light a surgery could mean that we won't succeed. There are plenty of people who are afraid of malabsorption to the point where they'd never get a DS no matter what but are SMO and so they get a VSG or a lapband never lose to the point where they are not obese.
This is not our situation. Most of us will end up in the normal or overweight BMI category no matter what surgery we pick.
I think the main thing is to pick your surgery based on the facts and not based on myths. I read all the time stuff about both the DS and the VSG that isn't true. Some examples:
VSG:
-If you get a VSG, you will be on a diet for the rest of your life.
Pffft. Most VSGers aren't constantly dieting. Our appetite matches our activity level so we are satisfied with the quantity of foods we eat and we can treat ourselves occasionally too just like non-WLS people without weight problems.
-VSGers don't have to worry about vitamins
All WLS types need to worry about supplements and labs. Sure, VSGers are statistically less likely to have malnutrition issues but we still have them as we can maldigest certain nutrients (that is they don't get broken down enough in our tiny stomachs)
-Your stomach will stretch out and you'll be as hungry as before
The sleeve does get bigger over time but most people I know who are 2-5 years out stil have great restriction and can't eat as much as before. And they aren't as hungry as they were pre-op even though most people do eventually get hungrier than they were early out. I can't eat any more than I could at 1 year out unless I break the rules, as an example, and I'm 3.5 years out.
-A VSG is a restriction-only surgery
The VSG is very metabolically active. It's more metabolically active than RnY and only the DS is more metabolically active. It's just that its metabolic "oomph" comes from changing the hormones involved in digestion and not from malabsorption.
DS:
-You'll have bathroom problems
Obviously, if you malabsorb food, it has to go somewhere. So you'll poop more than before. And simple carbs can cause noxious gas. So it's not like you get a free lunch with malabsorption. But these problems are rarely as bad as the naysayers make out. It's up to you to decide if you want to deal with them or if they are deal breakers.
-You'll eat unhealthy
Some people don't get that if you malabsorb 80% of your fat that eating 10 slices of bacon is like eating 2 slices and they think the DS diet is unhealthy because it's high fat.
-You'll be sick all the time from malnutrtion
If you don't keep up with your labs and your supplementing, then yeah, this can be a problem. But most DSers are willing to do what it takes to be healthy and most of them don't have big issues with malnutrition.
-You'll lose all/most of your excess weight and you'll never have regain
Absolutely, the DS has the best weight loss stats hands-down. But not everyone with a DS loses the average or better and people with DS absolutely have to deal with regain. You can regain with ANY of the WLS t ypes -- there are no magic wands.
In the end, I think the best thing to do is to lurk on the DS and VSG board, especiall the VSG Maintenance group, and see what life is like for the long-term DSers and VSGers. See if the things they are dealing with and the way they live their lives matches up with how you want your future to be.
HW - 225 SW - 191 GW - 132 CW - 122
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I just wanted to put my 0.02 cents in. I am not diabetic, but my stats are similar to yours. My highest weight was 223.8, about 211 day of surgery and now am at 143.8 seven months out yesterday!!! My height at Weigh****chers (I'm going there for long term maintenance - reached goal there this weekend) was 5'3 1/2", surgeon's office 5' 2 1/2". I have reached every goal I have set for myself with the sleeve. My first goal was in the 160's, now 140's. I really don't know where I will eventually end up, but I have no doubt I can be at 135 if I choose to.
I love my sleeve. I don't have any experience with DS procedure, but as others have stated educate yourself and see what feels right to you. I had checked into surgery one year prior to when I had surgery and just could not feel comfortable with RNY (my insurance didn't cover sleeve until 2011), so I waited. I am so glad I did.
Best of luck to you!
Lynn
I love my sleeve. I don't have any experience with DS procedure, but as others have stated educate yourself and see what feels right to you. I had checked into surgery one year prior to when I had surgery and just could not feel comfortable with RNY (my insurance didn't cover sleeve until 2011), so I waited. I am so glad I did.
Best of luck to you!
Lynn
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