Question:
RNY or VSG?

I thought I would go RNY because I consider myself such a food addict. The VSG concerns me because they throw away most of your stomach and there are no studies out past 3 years. How did you decide which surgery to have? I need to lose 150 pounds or so. Thanks for any input!    — GlitterGal (posted on March 16, 2008)

March 15, 2008

   — SameButDifferent

March 16, 2008
RNY and DS are both good surgeries but you can get similar results with VSG without having the bypass and not have to worry about the taking extra vitamins and dumping. If you feel like you are not able to lose enough weight you can always go back in and have the intestines bypassed at a later date. But if you lose the weight you won't have to and you keep your intestines intact.
   — [Deactivated Member]

March 16, 2008
I had VSG in 1995 and went from 370 to 239 pounds. I slowly gained weight back up to 305. VSG doesn't do enough to stop someone from eating soft foods or sweets. I t was easy for me to eat ice cream, chocolate reese's peanut butter cups, cookies and cake with the VSG. I had revision surgery last month, over to a RNY because it restricts sweets. I am happy I had the RNY and can not recommend VSG. Studies have shown that over a 10 year period, people who had VSG gain back more weight than those who had RNY. If you don't like sweets you might be ok with VSG. I am not sure, but I have been told DS is moreso for people who need to lose alot of weight - like people who weight 400 pounds and up.
   — Gina S.

March 16, 2008
This is for Gina. Please don't be fooled into thinking that RNY restricts sweets, because I eat them at least once a week. In moderation of course. However, I'm almost four years out having had the RNY and can eat anything that I want (in much smaller portions of course). I'm 5'6 and weigh 121 pounds and have been there for over two years and have been eating sweets practically ever since the surgery. I'm not condoning eating the sweets, but I just don't want newbies thinking that just because you have the RNY that your sweet intake will be restricted.
   — Belle

March 16, 2008
After much thought and discussion with my importanat people, I've decided on VSG over RNY for a number of reasons. First and main reason, I like the idea of leaving the valve out of the stomach intact and avoiding the stoma problems (ulcers and strictures, things getting stuck or dumping) I've read about here. I started researching for surgeries that would do that and came across the BPD/DS. That sounds like an excellent procedure, especially for heavier people (I have 235 pounds to lose). Apparently the DS can be done as a 2 stage procedure. The first stage is the VSG. The VSG is safer (fewer post op issues) than most of the other procedures currently going. While there isn't research more than 3-5 years out there, those 3-5 years are encouraging. Results tend to be better than the LapBand and equal to or a little behind the RNY (depending on the study). And since it is part of the BPD/DS, I can always go back later for the DS part if I need to. Then again, it may not be necessary. I am motivated and do pretty well eating properly when I don't feel starved/constantly hungry. (I know, because Atkins was a Godsend for me for 2 years, until the Dr. told me to add more fruit to my diet and the glucose spikes and drops started again!) Since the VSG cuts grehlin (sp?) production and decreases the feeling of hunger, at the same time that I'll need to be eating higer protein and lower carbs because my stomach capacity is diminished...that may just be enough for me. Another consideration is price. I am self-pay and the price of VSG (Dr. Curry in Cincinnatti) is $14,900 including 2 years of followup. The DS seems to run between $30-35,000. My hope is that I either won't need the 2nd stage, or will have insurance or other money that will cover it by then. If nothing else, I would be much smaller by then and have a much lower complication rate! To be honest with you, though, if I had insurance that would pay for the RNY but not the VSG or DS, I'd probably choose the RNY. It has more 'trouble' associated with it, but it is effective and definitely doable. Good luck on finding what is going to work for you! April
   — abeeba

March 17, 2008
I chose the RNY because I'm a food addict. Since I was never able to STEP AWAY from sugars and fat pre-op, I wanted a radical, permanent solution that would FORCE me to comply with a healthy lifestyle. I'm 7 weeks out now. Down 43 pounds, 72 more to go. I've had a stricture, which requires 4 EGD procedures to fix. I'm dealing with a lot of "head hunger" -- that is, I'm thinking about foods I *used* to eat and love that are "off the list" for now ('cause I'm still on soft foods, and know that I can only have 1 or 2 bites of something sugary without dumping). But despite all that -- RNY was the very best choice for me. For exactly the reason listed above. The only way I was going to be able to eat reasonable amounts of reasonable foods was to have something done that FORCES me to do it. I'm having discomfort now, but in return, I don't have to wear my CPAP for sleep apnea anymore; my cholesterol is WAY down; my pre-diabetes is almost completely cured; it's easier to get in and out of my car, and I'm beginning to remember what it was like to have a feminine shape! All of this points to a longer, healthier, HAPPIER life! I'm going to have to adjust living as a post-food-addicted person, because my BRAIN still has addictive tendencies, but that will come in time. Anyway, this is my story. I sure hope it helps. :)
   — crydecker

March 17, 2008
Oh gosh, and I should have mentioned -- I *ALSO* chose VSG, before I changed my mind and went with the RNY. I originally chose the VSG because it had benefits, but none of the risks of RNY. Eventually I decided that, if I was gonna do this, I was gonna go ALL THE WAY. RNY has the highest risks and restrictions post-op, but I decided that was what I was going to have to do in order to be successful. I mean, if you're going to pay so much, and have SURGERY, I really wanted it to work the FIRST time. Again, this is just my experience. I hope it helps.
   — crydecker

March 18, 2008
Hi Kim, I too am a real food addict. I chose the lapband surgery over RNY or duodenal switch because to me the lapband seemed like a more restrictive way to go. I have a family member who had the RNY and my surgeon said that with the RNY you are much more likely to overeat and stretch the pouch but with the lapband, if you overeat you can damage the stomach and/or esophagus and/or get sick from trying to overeat. My family member never got sick from eating sugar. Not everyone experiences dumping. I am six weeks out from LB and I have chosen to avoid sugar and flour which are the real things that keep me craving food. If I want something sweet, I have a sugar free popsicle or sf jello. My health is more important than any sugar at this point. I do experience head hunger where I will stand in the store and look at food knowing that I can't have it. The 5 year study of LB vs RNY shows the same amount of weight loss over time. Best wishes on what you decide. : )
   — Bigwyfan1964

March 19, 2008
First, you got great advice about the DS. Although I am a big advocate of the RNY, I recognize that for many of us, the DS might have been a better choice. Over time, as the surgical technique has improved, many of the side effects have been minimized. Secondly, the majority of people who have the RNY will dump-- if you can commit to restricting sugar, then you will continue to dump years after your surgery (I am out over 5 years, I avoid foods with added sugar and I still dump if I unwittingly eat something that has sugar). Dumping isn't caused by the stoma, rather it's caused by the small size of the pouch, the relatively small amount of gastric acid in it and the fact that food passes into the intestine. Although everyone doesn't dump, it is an intended (and hoped for) side effect. Lastly, whether you overeat wtih a band or after an RNY, you can cause damage to your esophogus and can harm your stomach. With the band, you could always decide against going for more fills--- with the RNY, you can't lessen or increase the size of the pouch. Of course, that also means that you can't easily get a "fill" that will give you added restricted when you need it. The key is to evaluate the path you took to your morbid obesity and evaluate which of the bariatric surgeries will most likely address those causes. Then evaluate the follow-up protocol and long-term side effects from the method you've chosen to see if it would be a good fit for you. dd
   — SteveColarossi

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