Lapband Vs Sleeve Vs Bypass Surgery

[hayleylamas 74]

Hello to all,

I am in the early stages of starting my wls journey and jut when I think I know which surgery I will opt for, I read some of your threads and it completely makes me question which one to go with.... Pleeeease share your own weight loss journey and which surgery you chose, why you did so.....and if you could change it would you?! Please can you tell me how long it's been and your current weight loss total? Thanks for any advice, experiences and wisdom shared!

[Sydney Susan 333]

Hi Hayley. Well no doubt you will get a huge number of responses on this newly integrated site. And we'll have opinions that don't align tidily, so I bet you still are confused at the end! But it seems I get to go first...

I have sleeve, which seems to be done very similarly in Australia to the US, although perhaps with slightly longer stays in hospital. We also have a very different private insurance scheme to the US, and insurance company approval is not an issue - it's entirely between you and your dr, and your health insurance either covers bariatric surgeries or it doesn't. Also, for me at least there was no difference in the cost - my dr offered all options and all were the same price.

I understand that satisfying insurance requirements and cost is a big issue for many... And influences the decisions of some. But as I said, not me.

Why not the band? I don't like the thought of a foreign object inside me (I'm a near-miss cancer survivor, which may be a factor in the absolute repulsion I have about that), and I'd also heard terrible stories of bands eroding through stomachs etc. I also didn't want to worry about bands slipping, regular visits to Dr to increase or decrease the band etc.

Why not the gastric bypass or duodenal switch? My BMI was just over 36 so I was never really a candidate for those, although I had a lot of co-morbidities. I didn't feel I needed something that drastic and I didn't want malabsorption. I wasn't sure I could live with that long term.

Why the gastric sleeve? I wanted something permanent - I've had problems with hunger and portion size all my life although my weight really only got out of control after the cancer, which took an enormous toll on my body. I wanted Portion Control and hunger reduction and sleeve does both of these. After the first 6 weeks, sleeve complication rates are lower than the band, and that appealed too.

How long and how much? 6.5 months and 26kg. The amount is less than predicted but my thyroid packed up early in month 3, and is only just now recovering. Weight loss was 22kg by 9 weeks and 4 kg since... But I haven't exercised a great deal as I've felt so awful (from the thyroid). I'm just picking up again now.

Problems? Reflux is sometimes better and sometimes worse than pre-sleeve.

Would I do it again? Yes! I eat normally now though avoid carbs (by choice). Nothing I can't eat. Have a glass of wine occasionally. Feel very much in control of portion size, which is tremendous. People who don't know me think im a small portion size, slow eater - that's all. Slower weight loss means I've had no trouble with hair loss and my skin is in pretty good shape.

What else you should know...

1. I'm 53. If I was a lot younger I may not be as keen on a permanent solution. Don't know, as my eating habits feel very natural now.

2. I had a very good surgery and recovery but not everyone is so lucky - go in with your eyes wide open! It's not a small surgery.

3. I had an easy adjustment to the sleeve - I was begging for restriction and never once regretted it. Again, not everyone is the same. But I really didn't feel physically better and able to eat and do a little more each day. I took on your new foods very slowly, so my stomach was well healed before I tried each one.

4. (So far) I've never vomited or had dumping syndrome.

Good luck with your decision.

[☠carolinagirl☠ 18,721]

i was super morbid obese...it was either seek/get help or be cut out of my house one day..my dr wanted me to do the bypass (and my ins did not cover the sleeve or the ds).....and even though the dr tried to get me to do the bypass (due to my starting bmi of 62) i held fast to the band......he then told me of the plication but stressed it is new so he couldnt tell me alot of it.....i had to sign a waiver for this and he did it for free w/the band.........

he told me something i never forgot......he said no matter what WLS i got.....the bypass, the sleeve, the ds, the band, the plication or whatever.......that unless i changed what i ate....begin to exercise, no WLS would help me...

choose what works for you.....following the doctors instructions on how to use is for the best results.....sometimes things with any WLS happens (good and bad)....and this is a risk we all take.....no one surgery is better than the other....patient compliance in ALL areas is a must....

i went from hardly being able to wipe my butt and barely walking.. to now doing step aerobics classes on a 4 inch step bench 4 to 5 days a week and back to strutting in my 5 inch heels (because i can now).....in 17 months...for me i made the best decision for ME

up to you...all the best

[DELETE THIS ACCOUNT! 12,703]

I chose the Lap Band and it was the best decision I could've ever made for myself.

Originally, I was actually scheduled for Gastric Bypass. The surgeon at the time told me that with my BMI being a whopping 72 and weighing over 400 pounds, it was the only option for me. He told me I'd never lose enough weight with the Lap Band.

I canceled the surgery at the last minute. Logically, I just couldn't justify re-routing my digestive system permanently. I also couldn't agree to the Sleeve because I wasn't about to have 80% of my healthy stomach hacked out. I didn't want to deal with dumping or malabsorbtion issues for a lifetime, either.

So, I found a new surgeon who believed in my ability to be successful with the Lap Band despite my massive starting size.

In about 20 months time, I have lost over 230 pounds. I can not begin to tell you drastically my life has changed for the better. Honestly, the Lap Band saved my life. I used to have high blood pressure- now it's about 100/70. I used to be borderline Diabetic- now my blood sugar is about 85. I used to have a sleep apnea- now not only do I no longer have a sleep apnea but I don't snore at all anymore. I used to need a cane just to get around my house and a motor scooter to grocery shop- now I walk over 2 miles a day with ease and unaided.

That's my story and why I chose the Lap Band. My best advice to you is to do your research. Learn the actual facts and base your decision on them not anecdotal evidence you may read here. Educating yourself and finding a good baritric surgeon are so crucial. And remember that regardless of which surgery you choose they're all just tools not magic cures for fat. The work will always be ours to do and require lifestyle changes that last forever.

Best wishes on whatever you decide.

[Terry Poperszky 2,784]

I chose LB for a variety of reasons, first off it was the least invasive. WLS is something that I swore I never would have to do, so when I finally came around to do it, I chose the WLS with the lowest complication rate and the possibility of it being reversible (It also has the slowest loss of the three current surgeries). Don't get me wrong, I have nothing against the other surgeries, in fact if for whatever reason I lost my band, I would probably revise to a sleeve. BUT, I could never have gone there in the first place, it was just too radical a choice for me.

Now 10 months later, I wish I had made the decision years before, I have dropped 60 pounds and am wearing a size 36" waist, something that I couldn't do as a freshman in high school. I am an avid Road biker, and just picked up my first Mountain bike. I have another 40 to lose, but I'm in no hurry, it will happen if I listen to my band. But if I don't lose another pound, my band has been a success based on the increased quality of life that I enjoy now.

As you make your decision, focus on the facts, not just our stories and choose the surgery that you are comfortable with and no matter which one you choose, it is still going to be a heck of a lot of work to be a success.

[Fluffnomore 1,235]

This is a great question, and you'll probably have a lot of different answers.

I chose the sleeve. There are several reasons for me. I actually came into the surgery process at a high 39 BMI and the surgeon first recommended the lap-band. I didn't like it for several reasons. I didn't want the maintenance of a band, for one. I have been involved in a CrossFit gym, and a lot of the exercises focus around crunches, pull ups, etc…I didn't like the idea that I might feel the port every time I worked out. I know several people who'd had the band and been unsuccessful (although frankly that would be less of a concern to me now), and I did a lot of research about success and failure rates and was worried about the studies that showed a large failure rate, reoperation, etc. for the band. I am also a singer and didn't like the idea of anything in my abdomen while I was singing. That is the silliest of my objections, probably, but it is true.

Sometimes I hear banders say that they can't imagine cutting out their stomachs. I guess for me, what it came down to was this. I have been on WW (3 or 4 times), Jenny Craig (twice), Optifast, a doctor-supervised Zone + pills diet (twice) and any number of non-institutionalized weight loss programs. I'm 44 years old. I have a lot of skinny friends and most of them eat very little, and exercise a lot. Instead of being afraid of cutting my stomach capacity permanently I welcomed it. I'm looking for a permanent solution here, and while most of the work will come from inside of me, I think this is one of those tools that can be a game changer. I don't have any interest in eating around my sleeve, or going back to a different option if this doesn't work. I will make this work.

Other points: I'm in great health generally, but I was what my doctors and I called a ticking time bomb. I knew that unless I found a permanent solution to my weight problem, I would be diagnosed with diabetes or heart disease sometime in the next 10-15 years. I was starting to have knee and ankle trouble; I had metabolic syndrome; I am hypothyroid. None of these were life-altering, but they did make "regular" weight loss difficult. So here's the thing: I feel like I have a much better chance of living the life I want to by nipping it in the bud now, than waiting until I packed another 30-50 pounds on and seeing what developed health wise.

As far as the dangers go, I was really less concerned about that. I didn't enter into the surgery lightly, but I felt based on what I could read beforehand, that this option was the LEAST likely to cause complications in me. Now, you will see stories with all of the WLS options of complications that are horrible and are not the fault of the person who underwent the surgery. And you have to know that it could happen to any of us. I guess I believe it won't happen to the vast majority of us.

I'm happy with my decision to do the sleeve; it is working exactly as it should and I am eager to see where I am in another year.

[Bandista 7,466]

Hi Hayley and welcome -- so glad you found this site! I started my LB process in June and am newly-banded. This is such a great place for information and support. I learned far more here than in the materials provided by the hospital or my office visits, etc. There are some very knowledgable people willing to share their individual experiences.

I was not able to consider a permanent surgery to my stomach -- that was too drastic for me. I like the idea that all my organs are still intact and should it ever become necessary the band can be removed easily. I like it that the band is adjustable, that the tightness can be increased and decreased to find just the right place for my optimal weight loss. I will be seeing my surgeon weekly to assess whether I need a fill, and although that is a little time-consuming I like it that I have this partnership. The accountability. I believe that many hospitals and surgeons prefer other surgeries because this followup time with the surgeon is reduced, and thus the expense. I'm so happy my surgeon is in this not just for performing surgery but my for my long-term weight loss.

I am 52 and have struggled with weight issues for 22+ years. I have been hovering in the 240s for a long time and had to hit 250 to qualify for the surgery (a BMI of 40 was my insurance company's only requirement and even though I have high BP and sleep apnea they would not consider co-morbidities). The day of surgery I was 243 (lost some on a pre-op diet) and this morning I am 232. I expect it is going to take quite a bit of time to get down to my goal weight but I am committed to a healthy weight loss.

When I started my process I began a journal. First I listed all the things I want to be able to do -- all my reasons for getting surgery. It's been helpful for me to have one place to record office visit info, my own thoughts, research tidbits, guidelines, etc. Also I got a therapist. Over the summer it was helpful to meet with some one to talk over the process and help me make sure I was ready. Even though I've done so much work around my food issues and dieting, self-image, etc., I got a lot out of this because the emphasis was different. I was ready to let go of personal failure. Being unsuccessful at so many attempts to lose weight over the years is so disheartening. I feel like the band is just the aid I need to fight off the hunger and help me get back in sync with my body.

Wishing you the very best. What's important is that you have decided to take charge of your health and your future. You are choosing yourself.

[GoingforGoal 1,734]

Hello Hayley and congrats on your decision to pursue WLS.

I've been banded for 4 years, lost over 100 lbs and am now at goal/maintaining.

To undergo surgery is a serious decision and sometimes our reasons to choose one procedure over another can be arbitrary. Examples include: Are you insured? If so, what does your provider cover? What kind of lifestyle can you most relate to, comply with and see yourself living? Do you thinking monthly checkups for the first 6 months than annually is asking too much? Which potential risks are present and what is the back up plan if those risks arise? etc. It really comes down to personal preference and which surgery you think will best suit your circumstances and goals.

I chose the band because it was the least invasive. It's a laproscopic procedure so the recovery is quicker. Working full-time and having children made this appealing. The rules were not too burdening and there's only a few of them. I had a healthy fear of bypass because my friend's daughter passed away from bypass complications, she was in her 30's. The only thought I had was what was the backup plan- there isn't one sometimes. I wanted options and the more steps it took to get to that point was ideal. It felt safer to me.

I am not here to push on surgery over the other. But please recognize a few things while you do your research: 1) Most wls patients are not on these forums sharing their stories so you will only get a small insight into what 'most' patients have experienced on this forum, 2) for every good story, you can find a bad one (in all 3 types of surgery). I want to emphasize listening to personal stories of success/failure and not someone's opinion based on things they heard- it's simply inappropriate, 3) Also understand that complications can arise spontaneously, but many of them arise due to patient noncompliance. Those stats shouldn't reflect on a procedure's capabilities. Recognize that if you are noncompliant you can sabotage your wl efforts no matter what procedure you undertake.

Living with the band, for me, has been easy. I adopted the rules readily, I have learned to adopt a mentality of eating in moderation and am maintaining without deprivation, I am very vigilent with keeping my band at it's optimal restriction and respect the band so that it remains a safe tool. I don't regret my decision at all and fully endorse the band for those who feel it's right for them.

Best of luck with your decision and your wl journey.

[Ladybandito 516]

I originally was scheduled for gastric bypass, and canceled before surgery. My BMI was on the lower side, with co-morbids, but I just really was afraid to re-route anything in my body. I was unhealthy, but besides weight related issues, my body has been good very good to me.

I did nothing after that for about a year, (except try new diet programs), and then made a consult to discuss band/sleeve options. I liked the band's short surgery time, the recovery time, and the "adjustability" of the band. Even though my surgeon has had good success with the sleeve, too, I was really concerned that it may not work for me (common thought) and then what? With the band, I can get adjustments as needed, which I see as a positive.

Lots of people have been successful and happy with all WLS. And all WLS have their unique risks and complications. Do as much research as you can and find the one that "feels right" to you.

[hayleylamas 74]

Hello Hayley and congrats on your decision to pursue WLS. I've been banded for 4 years, lost over 100 lbs and am now at goal/maintaining. To undergo surgery is a serious decision and sometimes our reasons to choose one procedure over another can be arbitrary. Examples include: Are you insured? If so, what does your provider cover? What kind of lifestyle can you most relate to, comply with and see yourself living? Do you thinking monthly checkups for the first 6 months than annually is asking too much? Which potential risks are present and what is the back up plan if those risks arise? etc. It really comes down to personal preference and which surgery you think will best suit your circumstances and goals. I chose the band because it was the least invasive. It's a laproscopic procedure so the recovery is quicker. Working full-time and having children made this appealing. The rules were not too burdening and there's only a few of them. I had a healthy fear of bypass because my friend's daughter passed away from bypass complications, she was in her 30's. The only thought I had was what was the backup plan- there isn't one sometimes. I wanted options and the more steps it took to get to that point was ideal. It felt safer to me. I am not here to push on surgery over the other. But please recognize a few things while you do your research: 1) Most wls patients are not on these forums sharing their stories so you will only get a small insight into what 'most' patients have experienced on this forum, 2) for every good story, you can find a bad one (in all 3 types of surgery). I want to emphasize listening to personal stories of success/failure and not someone's opinion based on things they heard- it's simply inappropriate, 3) Also understand that complications can arise spontaneously, but many of them arise due to patient noncompliance. Those stats shouldn't reflect on a procedure's capabilities. Recognize that if you are noncompliant you can sabotage your wl efforts no matter what procedure you undertake. Living with the band, for me, has been easy. I adopted the rules readily, I have learned to adopt a mentality of eating in moderation and am maintaining without deprivation, I am very vigilent with keeping my band at it's optimal restriction and respect the band so that it remains a safe tool. I don't regret my decision at all and fully endorse the band for those who feel it's right for them. Best of luck with your decision and your wl journey.

Hazelsbliss, I love the way you put this and thank you for sharing your experience! Thank you! I have kaiser and my insurance covers all three, I've been always leaning towards the LapBand, I do have a question, you said you have been banded for 4 years, when someone who is banded reaches their goal weight, do they take the ban out ever? Or is that a different procedure not included?

[marywithoutsound 148]

Hi .

I had a sleeve 6 weeks ago and have lost 42 pounds so far.

I came to the decision to have a sleeve with my surgeon. My bmi was 44 when I started my journey. I knew I didn't want a band as I had seen research with regards to slippage and erosion, and didn't want to deal with those as well as fills and defills to find the right restriction. I also wasn't comfortable with having a foreign item in my body. I didn't want a bypass as I am only 23 so didn't like the idea of having something which was so drastic and would change the way my body worked.

For me, the sleeve was the perfect compromise. My body still works the same way it always did, just on a smaller scale. I know having a sleeve can cause issues with Vitamin B12 deficiencies but I was already deficient before my surgery and had to have the injections anyway. Also, it can cause issues with heartburn and acid reflux, but my surgeon said this tends to happen mostly with people who already have issues with it. These are things to bear in mind.

All surgeries have their positives and negatives, and I appreciate I am not far out at all, but so far I feel like being sleeved is the best decision I ever made.

[GoingforGoal 1,734]

Hazelsbliss, I love the way you put this and thank you for sharing your experience! Thank you! I have kaiser and my insurance covers all three, I've been always leaning towards the LapBand, I do have a question, you said you have been banded for 4 years, when someone who is banded reaches their goal weight, do they take the ban out ever? Or is that a different procedure not included?

Hello again,

The band is designed to stay with you for life. I know logically it sounds like once it's done it's job that it's no longer needed. However, what the band is really designed to do is help with the maintenance phase of your loss. Many of us can go on diets and lose (maybe not all of it, but with a little effort we can knock of 10, 20, 30+) but we are all quite terrible when it comes to maintaining that loss. The trick with the band is that not only will it help with your wl maintenance, but I can share personal stories as to how it helped me through some difficult times when diet was simply not the priority (examples: pregnancy, accident resulting in dehabilitating pain/rehab etc) in which I gained zero pounds despite not eating optimally.

Additionally, no matter what surgery you pursue, one thing is for certain. To have your brain catch up to your new way of life/eating takes time and reinforcement with good practices. I am 4 years out and just getting to a place where I feel I have finally understood how to eat and balance through moderation. I dare say it'll take years of practice to truly drive those principles and practices home. I would be putting myself at great risk for regain if I elected to take the band out before I had full confidence I could maintain on my own. Like I said, the band helps with maintenance, so it still helps with things like hunger and Portion Control.

I have heard of other successful bandsters electively taking it out. I know some regain stories, but I surely don't know the statistics (does anyone have a resource w/ this info???) for success rates with elective band removal. But I think what most people do is instead of removing the band, they remove the Fluid. This is a great trial and error as well. Take the Fluid out for one year .If you can maintain on your own, voile, perhaps removal may be appropriate for you. I would highly encourage this route before just taking it out completely without a trial.

Hope this helps

[2muchfun 8,927]

Short answer: I prefer to keep my current stomach but I'd opt for the sleeve if my band didn't work out. So, for me, starting with the band was the logical choice. Starting with any other WLS was permanent, the band, not so much.

[Butterthebean 8,146]

Short answer: I prefer to keep my current stomach but I'd opt for the sleeve if my band didn't work out. So, for me, starting with the band was the logical choice. Starting with any other WLS was permanent, the band, not so much.

Question. As a sleever I've heard many lapbanders say that the band is removable and not permanent....and that this is an advantage. Obviously this is an opinion based on your point of view...but my question is why is this an advantage to you? Is it because of worst case complications? Or is there some other reason?

This is a serious question. I'm not picking, just curious about this.

[5.0junkie 770]

Question. As a sleever I've heard many lapbanders say that the band is removable and not permanent....and that this is an advantage. Obviously this is an opinion based on your point of view...but my question is why is this an advantage to you? Is it because of worst case complications? Or is there some other reason?

This is a serious question. I'm not picking, just curious about this.

Butter Ill give you my answer. I think the whole debate between all the surgeries is one that should be in our own hearts and not on a public forum as to which is better or why to choose one over another. I will say this though, I couldn't stand the thought of living with staples in me my whole life and knowing that the sleeve or bypass was forever. I liked the fact that the band was removable. Unlike many, I do understand the difference between removable and reversible. The band can leave scar tissue and many other things behind once its removed. I just felt more comfortable knowing I had options should I ever have any problems with the band and need it removed. I just didn't feel there were any options with the other surgeries. I may be totally wrong in that but its just what I believe. I had many try to sell me on everything but the band but its where I felt the most comfortable and I don't mind that the band is a chore to maintain. I felt that would keep me motivated in my head as time went on.