Question:
My surgeon will allow me any procedure as I answer to various criteria. My BMI is 40

Cannot decide between lap-band, sleeve or RnY. Please advise?!    — zimra (posted on July 28, 2008)


July 28, 2008
Personally, I highly recommend RNY. Lap-Band restricts food quantity, but not sugary foods. RNY goes much further than Lap-Band by preventing most people from eating sugary foods and greasy foods by making you feel sick if you do (this is a "tool" to help you not eat those things). RNY also restricts the amount you can eat + prevents the absorption of some of the fact and calories from the foods you eat, + reduces the production of a hunger-causing hormone called Ghrelin. RNY also cures, yes cures, Type 2 Diabetes in over 90% of people, many within days or weeks of having the surgery due to modifications made during surgery to the small intestine that cause Diabetes to reverse itself. Lap-Band does not do the things RNY does. I am not a Doctor, but personally I highly recommend RNY. I do not have info about the Sleeve procedure, I am sure others here will answer about that. Best wishes!!!!!!
   — Gina S.

July 28, 2008
Just as every person is different, so is every answer. If you need to lose lots of weight very quickly, then the Gastric Sleeve or RnY. If you are concerned about having a drastic surgery where your insides are cut, re-routed, stapled, and stitched, then the LapBand is your choice. Studies have shown that about 1 - 2 years out the weight loss is the same. It's just a matter of how fast you want to get there and what kind of surgery do you want.
   — Tammy M.

July 28, 2008
RNY has a very good success rate. Vitamins and calcium citrate needed on a dialy basis though post op. Pretty sure sleeve will require same vitamin regimin, perhaps higher amounts each day. Lap band has slower wt loss, and is designed for those who only need to lose under 100 pounds. If you desire a larger wt loss, then I'd consider options other than lap band. DAVE
   — Dave Chambers

July 28, 2008
I would say research research research...I spent about 4 months doing nothing but that. I had a total of 105 pounds to lose. I thought about lap-band but I had to make the decision, can I not eat surgar and fat without the "tool" of the RNY? I had to be honest with myself and the answer was no. I am a junkfood junkie, I am 5 weeks post op and there are days where I literally am mourning for food. I get depressed and withdraw from people. I feel like I lost a very good friend. But then I realize that any "friend" that made my butt this big cant possibly be a good friend back to me! The choice is up to you, only you know what you feel deep down inside. Do your homework, listen to that little voice in your head, you will make the right choice.
   — Kimberlin Katayama

July 28, 2008
I also had a choice a make. I chose the RNY. My BMI was 41. I am starting week 5 and even though I still have some left side pain, and have only lost 15 lbs scalewise, I have lost lots of inches. I was wearing 2 or 3x clothing and everything is huge on me. I was also taking 3 meds for diabetes, 2 blood pressure, and 1 cholesteral and am now taking nothing except for the vitamins. I definitely think I made the right choice. I highly recommend the RNY. Good luck to you...Magdalena
   — Magdalena52286

July 28, 2008
i am having the sleeve surgery on sept 2...you dont have the malabsorption of nutrients like RNY and some other benefits that you can read for yourself and make an informed decision... just click FORUMS at the top of this page and then choose Verticle Sleeve Gastrectomy..Im Excited!!
   — Rhonda C.

July 28, 2008
I've had Lap Band and have been very successful.....I also can not stretch my pouch out later and regain my weight like you can with other surgeries...also if I were to gain a bit I can get a fill and lose it.....I have had 3 friends that have had the sleeve and all three are dissapointed with the time frame of losing weight...they say it is very slow.....my niece had GBY and she is 8 years out....lost over 120 and had kept it off....but no matter which surgery you chose the surgery is on the stomach and not the head....so you are going to have to deal with what got you overweight in the first place......it does not take cravings away....you have to do that on your own. Pam / Ft Worth....bandster Bites Silverware [email protected]
   — pphillips4720aol.com

July 28, 2008
If you have failed at diets before as I did and you have any issues like High Bloood Pressure, High Colestroal, or Diabities then I recomend the RNY, as it cured all of these for me. I also did a lot of checking before my surgery and I found that more than 50% of the Lap Band patients failed to get fills regulary and therefore lost only about 1/2 their weight. RNY patients seem to come closer to their goal weights by far. I have to tell you however, that RNY will cause you to eat healthy and soon (6-8 months) you will not even think about food like you use to. I have no desire to eat bread, rice or pasta, as I found those were the biggest cause of meing getting fatter. Sugar is not even an option and I watch meats like pork or bacon that are high in fat as well as dairy fat. I never drank skim milk as I did not like it. Now, if I taste whole milk I just taste fat. I don't care for more than a small bit of ice cream, so this is a 180 turn arround for me. I have lost nearly 130 Lbs in 7 months and feel great. I got 45 more to go to my ideal BMI of 24.9. Best of success to you.
   — William (Bill) wmil

July 28, 2008
I HIGHLY suggest that you research for yourself and NOT rely on ANYONE on the boards for advice since MANY have an EMOTIONAL stake in their own choice. There are SOME people on the boards that are giving some very BAD advice to newbies and they are calling themselves "Experts." They are no more "Experts" than I am, since all they ARE is a PATIENT that has done some RESEARCH on weight loss surgery! By THAT standard, ANYONE can become an "EXPERT." Give someone a DEGREE in LAW or SCIENCE and a COMPUTER, and they can become an "EXPERT" on ANYTHING! Having said this, I HAVE done some research on weight loss surgeries and you can use MY research as a FOUNDATION for your OWN. You can find MY research at my profile page at: http://www.obesityhelp.com/member/hubarlow/ . If you don't find it on the main profile page, look for it in the March Archives under the title "Surgical Comparisons." To boil it down into simple language, I have discovered that most people do not do well with the Lap Band. About 50 to 60% of the people who get this procedure actually achieve their goal in 3 to 5 years. This procedure also has the highest incidence of complications. While these complications happen less than 1% of the time, What happens if YOU are the 1 in 100 person that it HAPPENS to? The Gastric Bypass is the most COMMON Weight Loss Surgery. Many people think this is because it is the BEST. I think this is a false presumption. There are a number of side effects from the Gastric Bypass that make it LESS desirable than some other options. If you WANT those side effects, there are OTHER options that can do the job BETTER. The main reason that this surgery is so POPULAR with SURGEONS that I can see, is that the INSURANCE companies will PAY for it without too much of a FIGHT. Many insurance companies will NOT pay for these OTHER options because they have not been performed in the UNITED STATES for more than 5 years and they do not have the endorsement of the AMERICAN MEDICAL ASSOCIATION and the FDA. These other options HAVE been successfully performed in Central and South America and in Europe for some time now quite successfully, but the American Medical establishment will NOT use the data from these countries as a basis for research to see if these procedures are effective since they do not consider these places as "Reliable Sources" of information, as if the UNITED STATES was a "Reliable Source!" We have ALL seen how the medical industry can manipulate data to suit whatever outcome they desire in an effort to get a drug on the market. The number of "Recalled" drug products is evidence of this type of activity. The Gastric Bypass takes your stomach and divides it, as I am sure you know. The rest of the operation involves bypassing a section of the intestine and attaching it to the side of the upper half of the stomach and re attaching the lower half of the stomach with a portion of the intestine further down the in the intestinal tract. This procedure requires that you take supplements for the rest of your life because the bypassed intestine causes you to not be able to absorb all of the nutrients in your food. The Vertical Sleeve Gastrectomy is quite a different procedure. In the VSG, the doctor essentially just removes about 85% of the patient's stomach and turns what is left over into a tube or "Sleeve." The results are SIMILAR to those of the Gastric Bypass in that you lose about the same amount of weight in the same amount of TIME, but there are some major DIFFERENCES in the way this goal is met. With the VSG, there is NO malabsorption issue. Since your intestines are not rerouted, you do not have to take SPECIAL supplements for the rest of your life. You MAY need to take REGULAR VITAMINS to supplement your diet ONLY BECAUSE you are not EATING as much as you would OTHERWISE eat WITHOUT the surgery. Once you reach your weight loss goal, and you adjust your caloric INTAKE, you MAY be able to drop the vitamins altogether if you find that you are eating a balanced diet and no longer NEED them. This is NOT true of the Gastric Bypass. Another difference you may find is that you will likely be able to eat every food and take EVERY MEDICATION you were able to eat and take BEFORE the surgery with the Vertical Sleeve Gastrectomy. Some people report food sensitivities immediately after surgery, I personally have experienced NONE that I did not have BEFORE the surgery. I suspect that after a while, some of those that DO experience sensitivities find that they lessen with time as the stomach heals. I would not know from experience, since I did not suffer from this. Some people LIKE the idea of being sensitive to certain foods. They find that it helps them AVOID things like SWEETS and FATS that were some of the CAUSES of their obesity to BEGIN WITH. The PROBLEM with going INTO surgery with the HOPE that the procedure will CAUSE this condition is that you do not KNOW what the outcome will BE before you go IN. You MAY be hoping for an aversion to SWEETS and come out with a sensitivity to FATS. You may go in hoping for an aversion to FATS and come out with a sensitivity to SWEETS. You may go in hoping for BOTH and get NOTHING or you may go in hoping to come out with NO sensitivities and come out with sensitivities to BOTH! This type of thing is like a crap shoot.The doctors have no influence on the outcome in this regard. The procedure is fairly complicated and WITH that comes more opportunity for COMPLICATIONS. The vertical Sleeve Gastrectomy is quite SIMPLE. They just cut the stomach out. When they DO that, they remove most of the cells that produce the hormone called grehlin. Grehlin is one of the hormones responsible for creating the feeling of HUNGER. I don't feel very hungry any more. For quite some time I did not feel hungry AT ALL. What HUNGER I DO feel is easily ignored. The LAST procedure I would like to tell you about is a procedure that you have not mentioned. It is kind of a combination of the Gastric Bypass and the Vertical Sleeve Gastrectomy. Should you decide that you LIKE the malabsorptive factor of the Gastric Bypass, I suggest that you look into the Duodenal Switch. The DS has a SLEEVE like the VSG but it also has a bypass like the Gastric Bypass. It has better results than BOTH the VSG AND the GASTRIC BYPASS! You will have to take the same types of supplements as the folks that have the Gastric Bypass but you will have a much better chance of success with the DS than with the Gastric Bypass. If you are not quite sure what you want to do, Perhaps you can get the VSG and later, get a revision to the DS if you find that it is not working for you. I think you will be pleased with the results of the VSG, however. I had MINE done on March 1, 2008 and I have lost 90 pounds since then! It has been less than 5 months and I have only about 50 pounds to go to get to goal. I hope this helps answer your question
   — hubarlow

July 28, 2008
3 yrs post op RNY here. If you cannot decide, then you need to keep researching or spending your time on here and weight out the pros and cons of each. You have to fully understand the impact of each and see what works best for YOUR mind and body. This is a lifestyle change - FOR LIFE. Keep asking questions, keep reading, keep looking - you'll know whats right once you have all the answers. Good luck on your endeavor and remember to ASK away.
   — C-There

July 28, 2008
First of all, you have to always remember that any of these surgeries are tools to help in your weight loss, they are not a cure to anything and that your choice is yours - not anyone elses. You know your mind set and body the best. With that said, let me share my experience with you. I'm a lap band patient 14 weeks out and would highly recommend the lap band procedure to any one. My experience with it has been wonderful and it so less invasive than the RNY. The only thing I have been frustrated with is people not knowing exactly how the lap band works and assuming that you can eat anything. I watch every bite that I eat - do I have a sugary snack or a glass of wine? Yes I do, but I account for it and you can be sure I work a bit harder at the gym to account for it. In fact, last night I went for ice cream and I got a "kiddie cone" - - it was a one ounce serving. It was just enough to satisfy my desire for ice cream. I know that I no longer need the double dip of ice cream. My mind set has changed in regards to food - it is no longer my life, there are other things to enjoy in life. As of today, I am down 45 pounds and my doctors are thrilled with my progress. I have gone from a size 22W to a 16 misses. My surgery was on April 29 and when I was discharged from the hospital on April 30, I was taken off my fluid pill and diabetes medication - so the lap band is as effective as RNY in helping alleviate diabetes. I am also being taken of my blood pressure meds and my cholesterol meds. With this said - the decision becomes yours and no one elses. The best to you in your new journey in life.
   — Monte57

August 2, 2008
Wow -- look at that long-winded old HuBar, who HATE HATE HATES the DSers, and me in particular, for promoting a surgery he didn't chose -- and yet, despite himself, has to give it the props it is due: "The DS has a SLEEVE like the VSG but it also has a bypass like the Gastric Bypass. It has better results than BOTH the VSG AND the GASTRIC BYPASS! You will have to take the same types of supplements as the folks that have the Gastric Bypass but you will have a much better chance of success with the DS than with the Gastric Bypass." I hope you do check out the DS -- it not only has the best results of any WLS, it is also by far and away the easiest to live with -- come to the Dark Side -- we have -- and can eat! -- cookies!
   — [Deactivated Member]




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