Question:
What's the difference? Which is better for long term success?

I keep seeing these two terms used and wondered what is the difference between them and which is better for long-term success? Is it something you choose or your surgeon? Any help would be appreciated.    — San (posted on May 9, 2002)

May 8, 2002
Hi...It refers to the amount of small intestines that are bypassed. Proximal, meaning close, and Distal, meaning far. If you have a proximal, it means the portion of the small intestines is not very long. Distal is usually reserved for heavier patients because they have more to lose. The more that is bypassed, the less you can absorb calorie, fat, and nutritionally.
   — lily1968

May 9, 2002
Hi Sandi - I rencently read that the amount of intestine bypassed has little to do with long term loss or sucess. I think it is a good idea to bypass as little as possible so that nutrition is less of an issue.
   — crishsapig

May 9, 2002
Some docs customize to fit, as mine do here. Some docs issue a one-size-fits-all model. I'm 8 yrs distal, VERY distal. Naturally I think mine is "the best" because it works for me. There are people who should NEVER consider a distal, because they're not going to follow the same guidelines I do, which is a LOT of supplementaion. Now, *I* would not do well with a proximal. I can put things IN my face, but keeping them out was a problem for me. I need all the mechanical help I can get, BUT I'm willing to pay the price for it.
   — vitalady

May 9, 2002
Hi! I just thought I would share with you that I have the Fobi Pouch. It is a Vertical Transected Pouch with a Silastic band. If your interested in finding out about the fobi pouch the websit is www.cstobesity.com. They have a questions and answers page that explains the differences between different types of surgery. There is over 100 questions and answers with pictures. Pretty cool site. Good luck and God Bless!
   — Yvonne C.

May 9, 2002
Even though I started out super obese (407 lbs.), my doctor decided to give me a proximal RNY to avoid potential malnutrition problems. Looking back at it, 13.5 months later, I am SOOOO glad about this. I have been very successful in my weight loss, and all my labs are perfect. Regarding distal vs. proximal, I think like Michelle Curran said, that it really depends on the patient. If you're the type who can be totally rigid about your supplementation, distal may be the answer for you. For me, I wanted an easy-sneezy supplementation plan that I could carry out for the rest of my life without too much effort. These days I take a multi-vitamin and calcium supplementation. That's about it. It works for me.
   — Terissa R.