Question:
Why Would People Choose The RNY over the DS?
I just read that with the DS procedure you can eat anything not experience dumping and still lose wieght. I am going to have lap RNY and now question why more people don't have the DS. There must be a reason.. does anyone know why more people chosse RNY vs DS? — kumuat (posted on June 19, 2003)
June 19, 2003
My #1 reason was that my insurance will not pay for the DS. I also felt
that the RNY would provide me with sufficient weight loss (and with 181
pounds lost in 11 months, I'd say that is sufficient) without the
significant malaborption issues that the DS causes....JR
— John Rushton
June 19, 2003
As John pointed out, I too didn't want to deal with the major amount of
malabsorption. I am or rather WAS a volume eater (God forbid I should ever
return to those huge amounts of food again!) and really enjoyed sugary
products. With the RNY my food consumption is dramatically lowered and for
the most part I don't feel deprived. Unfortunately I don't dump on sugar -
just on starchy carbs and once in a while too much fat...but I still don't
choose to eat it. There's so little room, when I want something sinful I
have rich good foods instead of sweet ones (prefer steamed broccoli with
cheese sauce to sugar/chocolate now). Don't get me wrong, I still eat what
I want - I just don't necessarily WANT the crap I'd eaten pre-op.
— [Deactivated Member]
June 19, 2003
Oh and I should point out that to be honost I did want the DS originally,
but my insurance wasn't covering it then. So here I am :>)
— [Deactivated Member]
June 19, 2003
Why Would People Choose The RNY over the DS? Well- because the insurance
company said yes to RNY and no to DS otherwise I would have!
— Karen R.
June 19, 2003
I didn't WANT to be able to eat junk for the rest of my life. There's more
to health than being thin, and since I'm not one to make good nutritious
choices if I don't have to, the RNY keeps me honest ;) I was also worried
about the more prevalent malabsorption issues. As you increase in success
rates, you also increase in risk, and the RNY was the best compromise for
me personally.
— mom2jtx3
June 19, 2003
I never seriously considered the DS because I was a lightweight (42 BMI),
and didn't feel I needed the more aggressive malabsorption of the DS
procedure to succeed. Also, I examined why my prior diet efforts had
failed; I wanted to pick a surgery that addressed my particular brand of
diet failures. In my case, I'd sabotaged previous diet and exercise
programs with binge eating (with the restriction of the RNY would help
control). I didn't want the band because I didn't like the idea of the
port and the plastic tube thingie around the stomach (an emotional
reaction, I know, but I just didn't cotton to the idea). That took me to
either the RNY or the DS. I knew I had something to "bring to the
table" by way of dedication to better eating and exercise, because I'd
done it successfully in the past, for months at a time before, but I needed
a "backup" from when I fell off the wagon and wanted to re-binge
my way back up -- which I thought the pouch would help me with. Also, I
didn't want to keep on eating the crummy foods I had been eating as a
pre-op, which the DS would've allowed me to do (or at least, that was my
perception). Having said that, I know many folks clean up their acts,
foodwise and exercisewise, with the DS -- but for me, if I'd had the notion
I could "get away" without making and keeping necessary healthy
lifestyle changes, I was afraid I'd do it, and I didn't want that (didn't
believe it could actually be healthy for me anyway). And, somewhere, I saw
a cartoon of the DS surgery depicting a tube running from the mouth
straight out the other end, which I realize isn't a fair depiction at all,
but it made me think, Am I really so unable to eat and exercise properly
that I need something that extreme to save me? I thought the answer was
no, so I went with the RNY. I'm sure dieters could make similar criticisms
of my choice over yet another diet (and they could say it's the "easy
way out" -- I don't really care, since so far, it's been the way
that's finally working, and I still have to exercise and eat right to make
it work). BTW, am one of the 30 percent or so of RNYers who don't dump
(never did). I'm glad I didn't have the DS because I feel I'm already
doing enough supplementation to correct for the RNY malabsorption (and I'm
only a proximal -- 75 cm. bypassed), and wouldn't want to have had more
malabsorbtion issues, personally.
— Suzy C.
June 19, 2003
Each surgery comes with its own unique profile of benefits, risks, and side
effects. The DS is a more "powerful" surgery than the proximal
RNY, and it does have some attractive features (no dumping, fewer food
restrictions, no "pouch" side effects), but it also has some
drawbacks. First and foremost, it's a more technically demanding and
extensive surgery (approximately six times as much cutting &
stapling/suturing as with the proximal RNY). It takes longer to perform,
and that (theoretically) can put you at higher surgical risk with the DS.
After surgery, the heavy-duty malabsorption of the DS puts you at higher
risk for long-term complications such as malnutrition (5-7% chance of
nutritional problems with the DS, vs. 1-2% with the proximal RNY and 10-12%
with the distal RNY) or ongoing problems with gas, diarrhea, etc. Now, the
vast majority of DSers are very healthy and happy and experience few
problems (just like the vast majority of RNYers), but each patient has to
look at the relative risks and pick the surgery that best suits their own
needs and goals. And not just your current needs, but what about ten or
twenty or thirty years from now? What if you develop cancer or AIDS at some
point and you start to need all of the absorption capacity you can get?
Hard questions, to be sure. But it does make sense to choose the *least*
powerful and invasive surgery that will still get the job done. Then there
are the insurance and availability issues. The DS is a newer, more
technically demanding procedure, and many surgeons don't want to perform a
surgery that requires such careful follow-up and patient compliance (with
supplements, protein, etc.). If a DS patient doesn't take vitamin
supplements, he or she WILL get very sick eventually. That's a big
responsibility for a surgeon to take on, and I understand why many of them
aren't jumping to do it. All that said, I was a "lightweight"
(BMI of 41 at the time of surgery) and still chose the DS, even going
out-of-state and self-paying to get it. The bottom line for me is that the
DS had better long-term weight-loss stats than the proximal RNY, and I was
afraid of going through surgery and then still finding myself struggling
and gaining weight 3-5 years later. I had yo-yo'd up and down the scale so
many times -- I just couldn't bear the thought of going through that again.
And I knew I was already eating pretty healthy foods; I wasn't binging on
sweets or junk, and I wasn't eating thousands of calories a day. In my
case, I was pretty sure that a restrictive procedure wouldn't be enough to
really solve my problem. I wanted the surgery that would give me the best
chance of *permanent* success, and I was willing to accept a little extra
risk to get it. I'm very happy I did. I feel wonderful, I have virtually no
side effects, I can eat freely, and my blood work is spot-on perfect. But I
realize I have been very lucky. I took a carefully calculated risk, and so
far it's paying off just the way I hoped. And that's what we all do --
calculate our own personal risks and then make the best "bet" we
can. After that, it's up to us to make the most of whatever procedure we've
chosen. The DS is a good surgery and so is the RNY. You can be a success
either way. Good luck!
— Tally
June 20, 2003
I think I probably *would* have chosen DS except for the facts that: 1) I
was a teensy bit scared of the malabsorption risks, 2) my insurance
wouldn't approve it, and 3) even if they would've approved it, at that
time, there was no DS surgeon near me or in-network for me. So, it just
didn't even seem to be an option in my case.
— Laurie A.
June 20, 2003
I chose proximal RNY for several reasons- I wanted the dumping (sugar and
high fat foods were what made me obese), I wanted normal bowels after
surgery, and I wanted the least malabsorption to try to ensure the best
chance of long term health. I never checked to see if my insurance company
would cover it - they would not cover lap band which I was intitially
considering. I'm happy with the results. I've read posts from DS'ers that
talk alot about having several bowel movements a day, more stink if they
eat too much fiber or other foods, and some have diahrea issues that are
hard to control. I didn't want to run that risk either. It is definitely
a personal choice which surgery to have and everyone has to make their own
decisions-there are happy and unhappy post-ops with all the types of
surgerys.
— Cindy R.
June 20, 2003
I wanted DS but am getting RNY. It comes down to insurance approval and
finding a dr who performs DS
— Leica R.
June 24, 2003
fear of malnutrition due to malabsorption. fear of dumping will keep me
honest. and right or wrong, I felt that ds was just too drastic for me
personally with the amount of weight I had to loose. I am EXTREMELY
satisfied with RNY decision.
— **willow**
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