This is a great pre-op question! Each individual has to choose for him or herself, of course. Here was how I ultimately arrived at bypass for my choice.
After learning about each procedure, I originally decided that I would have gastric sleeve. I have arthritis in my knee from an old sports injury and I was taking an NSAID for it—which you cannot take with bypass due to the high likelihood of ulcers. I also wanted a lower likelihood of dumping syndrome. After talking with my PCP, however, I changed my choice to bypass for a few reasons.
First, after losing over 100 pounds to date pre-op I have been able to manage my arthritis with over-the-counter medications. Second, thinking of surgery as one tool in the weight loss toolbox, bypass is likely to result in a higher percentage of weight loss than sleeve. Last but not least, I want surgery to work as a tool to help me sustain my weight loss when I hit my goal weight. My PCP has had many patients who received sleeves require dilation and, in some cases, extension of their sleeves to bypasses. She also shared that the dumping syndrome that comes with bypass serves as a good long-term deterrent to overeating.
I am having bypass surgery on Monday, February 24th. I plan to continue to post both pre- and post-surgery, so more to come!