I chose the bypass because my lack of weight loss prior to surgery was determined to be caused by metabolic issues. Bypass corrects those issues, where as the sleeve and bypass do not. Also your weight plays a factor I went into this program weighing 364, for my age and body type I should be 155, so I went into this needin to lose 209lbs. Through research and support groups the only patients I found who lot jay much weight were bypass patients. I do not regret my decision for bypass I am 2 weeks out from surgery and lost 22 lbs post op and it took me 4 months pre op to lose 40lbs. So now my total weight loss is 62lbs.....my doc told me I have already lost 27% of the weight I needed to lose and I am only two weeks in.....so with all that said I say if you have a lot to lose or metabolic issues, go with the bypass.