I have PCOS as well, am insulin-resistant and have thyroid issues. I take medication for both plus HBP meds. I am 44. I wear a size 22/24. I have been going to monthly support groups since the Summer of 2014 and going through all the insurance requirement visits with my last nutritionist appointment just last week. I am struggling so much with which surgery to go through. My surgeon said RNY is best for anyone with sugar issues. I am not diabetic--yet! I do, however, take Metformin every single day since TTC 12+ years ago (have two children now). I don't want to end up with diabetes--this is my biggest fear. But my sister had RNY in November 2014 and has been in the hospital three separate times for dehydration. I'm really struggling. At the support groups, it seems like all the newbies have gotten or are getting the sleeve. It seems so much easier to deal with after the surgery to have the sleeve. Also, I believe if you get the sleeve, you do have the option to later 'upgrade' to the RNY if needed, but who wants to count on that?? But I believe there is more risk of putting weight back on later with the sleeve and my nutritionist said I would lose more weight with RNY. Uggh. It is so tough. You talk to almost anyone who has gone through with RNY, all say they would do it again in a heartbeat--even my sister I think! This is just so hard. I am really struggling. But then wonder if my worries are just another excuse which all of us who struggle with weightloss are so very good at--making excuses. Problem I am experiencing is that I don't really think these bariatric surgeons truly understand PCOS. I no longer see a reproductive endocrinologist for my PCOS because I am no longer TTC, but I do see a regular endocrinologist. I wish I could see a study of PCOS patients who have undergone the surgery and really see their long-term results--like over one to two years out? I will be mortified if I get this surgery and then stretch out the sleeve or pouch only to get fat again.