If a doctor tries to steer someone in the direction of RNY, why not just quote statistics and disadvantages, etc...
I'm a disabled vet from '91 Gulf War and the VA has offered/suggested twice now that I have it done and they cover it. I think it's done in West Virginia but I don't recall. LIke other surgeries, they won't do it at a VA facility, it's contracted I suppose. For example, if I ever had to have heart surgery I would go to Vanderbilt.
They (VA docs) were doing bypass, but recently I was told they opted to go with Lap Banding because of the advantages and fewer complications compared to bypass. I don't have any other health issues, and they are doing tests over the next few weeks (psych, blood, ECG, ultrasound of abdomen) and I have to go to 12 weekly meetings on diet & exercise.
But if I were having it done and a doctor tried to steer me to a bypass and I didn't want it, I would just remind them of statistics between the 2 methods. That and maybe check another doctor lol.