Gastric bypass versus sleeve for the 300+

[SamBwaR3 62]

I am up in the high 300 range as well and have been asking this very question.

I am going to talk to my Dr. and surgeon about bypass instead of sleeve.

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[Pinkgirl1234 761]

Funny my friend who had the sleeve is looking to revise to RNY....years later...I wonder why?Gold Standard ...I know this because after 13 years of lapband misery...I can say my revision to bypass 2 months ago is the best thing ever!38 pounds down and...much more to go!!!

[SamBwaR3 62]

Yeah, I only want to do this one time. May as well do it right the first time.

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[Chrystee 838]

I finally had my first visit and the surgeon is recommending that I get the bypass while I was already heavily in the sleeve camp. He said he's not trying to talk me into it but that the bypass would be better for me since my biggest problem is eating the wrong foods.

I am 57 years old and weigh well past 300.

Can you give me your opinion on this topic? I'm assuming most of you will go with what you chose but if you can be objective for someone in my situation what would you advise?

The other difference is that I am a cash pay patient so I believe the difference is going to be an additional 4k out of pocket to get the bypass. I keep reading good things about the sleeve but also read the bypass is the gold standard and that you lose more weight with the bypass.

Is that still true?

Thank you to everyone that responds.

RNY SHOULD keep you restricted longer.. but after a year or two, a lot of bypass patients can eat anything as well. Some don't dump. Some do. You want to work on changing your behaviors the most.

[jane13 2,256]

I think whatever you decide you have to be comfortable with, my choice was and still is the sleeve. I had the choice of all 3. Band, sleeve or bypass. I was over 120lbs over weight. I didn't have a lot of the issues others have pre-op but I was headed towards diabetes and that scared me the most. I probably would be at goal by now with the bypass aka the "gold standard" but I didn't like the re-routing of my intestines and malabsorption issue.

My "gold standard" is my sleeve

[jmg79 10]

I finally had my first visit and the surgeon is recommending that I get the bypass while I was already heavily in the sleeve camp. He said he's not trying to talk me into it but that the bypass would be better for me since my biggest problem is eating the wrong foods.

I am 57 years old and weigh well past 300.

Can you give me your opinion on this topic? I'm assuming most of you will go with what you chose but if you can be objective for someone in my situation what would you advise?

The other difference is that I am a cash pay patient so I believe the difference is going to be an additional 4k out of pocket to get the bypass. I keep reading good things about the sleeve but also read the bypass is the gold standard and that you lose more weight with the bypass.

Is that still true?

Thank you to everyone that responds.

My husband didn't have a ton of weight to lose but he was told bypass for his diabetes, and now his diabetes has gone almost in full remission (he had it done Feb. 23rd). I think it depends on your age, your comorbidities, etc. Everyone is just a little different. I started the process around 300lbs and my Dr recommended the sleeve because of my age (36). The bypass is supposed to be a more complicated procedure but my husband has healed a lot better and progressed farther than I have with my sleeve (I'm a little jealous!). Good luck to you and I'm sure you will make the best of whatever procedure you decide on.

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[nyseness 76]

My husband didn't have a ton of weight to lose but he was told bypass for his diabetes, and now his diabetes has gone almost in full remission (he had it done Feb. 23rd). I think it depends on your age, your comorbidities, etc. Everyone is just a little different. I started the process around 300lbs and my Dr recommended the sleeve because of my age (36). The bypass is supposed to be a more complicated procedure but my husband has healed a lot better and progressed farther than I have with my sleeve (I'm a little jealous!). Good luck to you and I'm sure you will make the best of whatever procedure you decide on.

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I was thinking the same thing b/c I'm only 38. I initially started my journey w/ the Sleeve in mind and recently changed it to the Bypass. I even got approved by my ins last week for the Bypass but since then I cannot seem to wrap my head around it. My surgeon said both procedures would be great for me, but of course RNY would lose more weight. I'm 279 now and my goal is lose at least 100 lbs. I think I can do it w/ the Sleeve my problem is snickers and lays potato chips. I literally eat a snicker and snack size chips every night, but otherwise I can control my portions. It's the occasional snacking but is that enough reason to do the bypass? I even thought about putting the whole ordeal on hold until I feel completely comfortable with my decision. The Bypass scares me and I want a "normal" life.

[JamieLogical 8,708]

@@nyseness The sleeve won't keep you from eating chips and Snickers. At least once you are healed. The bypass may not either, though. Not everyone who has bypass experiences dumping. I would never recommend bypass over sleeve for the SOLE purpose of having dumping syndrome, since there are no guarantees there. Also, long term, you can lose just as much weight with sleeve as with bypass, it may just not be as quick.

[Ruin's Angel 6]

I first posted in this topic back in January. I had my first appointment with the surgeon on February 11 and he asked me which surgery I wanted. I told him the gastric bypass then he proceeded to tell me that he wouldn't do the bypass on me and would only do the sleeve because my BMI of 64 (weight was 399) at the time was too high and it was too risky then he told me to lift up my shirt and show him my belly, then said again I was too big. I was dumbfounded! Most doctors prefer the bypass for the heavier patients so I don't understand this at all. Then his dietician came in and said I had to lose 30 lbs before surgery but on my next appointment with her I saw paperwork that said 40 lbs. I'm waiting on my 3rd appointment on May 4 to clarify this but I'm down 21 lbs so far. I'm extremely frustrated because I've been going through this process for exactly a year now because their office keeps rescheduling my appointments. The day after my first appointment I had my endoscopy and it showed that I had several ulcers. I was put on Omeprazole and I think they are healed, but if I am prone to ulcers, isn't this yet another reason to do the bypass over the sleeve? I've had lots of time to mull this over while on my pre-op diet and I am convinced that I will fail with the sleeve and I know my body and I feel the bypass is what I need. I haven't seen the surgeon again since the first appointment so I'm hoping having had the ulcers will change his mind, but I am seriously contemplating looking into changing doctors if he still insists on only doing the sleeve. He tried to tell me I could do the sleeve then revise to the bypass, but why would I want to go through surgery twice if I don't have to? Also, my insurance is covering this 100% so I really doubt they will cover it a second time. My surgeon's office is a Center of Excellence and he has even appeared on TV a couple of times advertising his surgeries on a news show. Any thoughts on all this?

[wendilin 29]

@@Ruin's Angel, you are in a tough spot. If it were me, I would get a second opinion, you are in charge of your health and if you aren't getting the information you need with your current team, shop around! I'm early in the process and have my mind made up on the sleeve and all my care team agree. Hope you get answers!

Wendilin

[KristenLe 5,979]

You are under anesthesia longer with bypass and that may be his concern @Ruin's_Angel. Alot of High BMI patients get the sleeve. I don't think ulcers are any more of an issue with sleeve vs bypass.

[Sajijoma 1,324]

I first posted in this topic back in January. I had my first appointment with the surgeon on February 11 and he asked me which surgery I wanted. I told him the gastric bypass then he proceeded to tell me that he wouldn't do the bypass on me and would only do the sleeve because my BMI of 64 (weight was 399) at the time was too high and it was too risky then he told me to lift up my shirt and show him my belly, then said again I was too big. I was dumbfounded! Most doctors prefer the bypass for the heavier patients so I don't understand this at all. Then his dietician came in and said I had to lose 30 lbs before surgery but on my next appointment with her I saw paperwork that said 40 lbs. I'm waiting on my 3rd appointment on May 4 to clarify this but I'm down 21 lbs so far. I'm extremely frustrated because I've been going through this process for exactly a year now because their office keeps rescheduling my appointments. The day after my first appointment I had my endoscopy and it showed that I had several ulcers. I was put on Omeprazole and I think they are healed, but if I am prone to ulcers, isn't this yet another reason to do the bypass over the sleeve? I've had lots of time to mull this over while on my pre-op diet and I am convinced that I will fail with the sleeve and I know my body and I feel the bypass is what I need. I haven't seen the surgeon again since the first appointment so I'm hoping having had the ulcers will change his mind, but I am seriously contemplating looking into changing doctors if he still insists on only doing the sleeve. He tried to tell me I could do the sleeve then revise to the bypass, but why would I want to go through surgery twice if I don't have to? Also, my insurance is covering this 100% so I really doubt they will cover it a second time. My surgeon's office is a Center of Excellence and he has even appeared on TV a couple of times advertising his surgeries on a news show. Any thoughts on all this?

if I were you, I'd find a different surgeon. I was 429 when I met my surgeon and we sat down and talked about options and he said either rny or sleeve would be good, but rny would probably offer more weightloss. I was 386 on the day of surgery. I wasn't required to lose anything, but I tried so hard because I know losing weight does make it easier to do the operation, but seriously, unless you are like 4'9 or something and it's just inaccessible due to anatomy, it really should be gastric bypass IMO. I don't regret my rny at all and it would be better to get her done right the first time instead of suffering through a second surgery if it doesn't work out.

[Pinkgirl1234 761]

I first posted in this topic back in January. I had my first appointment with the surgeon on February 11 and he asked me which surgery I wanted. I told him the gastric bypass then he proceeded to tell me that he wouldn't do the bypass on me and would only do the sleeve because my BMI of 64 (weight was 399) at the time was too high and it was too risky then he told me to lift up my shirt and show him my belly, then said again I was too big. I was dumbfounded! Most doctors prefer the bypass for the heavier patients so I don't understand this at all. Then his dietician came in and said I had to lose 30 lbs before surgery but on my next appointment with her I saw paperwork that said 40 lbs. I'm waiting on my 3rd appointment on May 4 to clarify this but I'm down 21 lbs so far. I'm extremely frustrated because I've been going through this process for exactly a year now because their office keeps rescheduling my appointments. The day after my first appointment I had my endoscopy and it showed that I had several ulcers. I was put on Omeprazole and I think they are healed, but if I am prone to ulcers, isn't this yet another reason to do the bypass over the sleeve? I've had lots of time to mull this over while on my pre-op diet and I am convinced that I will fail with the sleeve and I know my body and I feel the bypass is what I need. I haven't seen the surgeon again since the first appointment so I'm hoping having had the ulcers will change his mind, but I am seriously contemplating looking into changing doctors if he still insists on only doing the sleeve. He tried to tell me I could do the sleeve then revise to the bypass, but why would I want to go through surgery twice if I don't have to? Also, my insurance is covering this 100% so I really doubt they will cover it a second time. My surgeon's office is a Center of Excellence and he has even appeared on TV a couple of times advertising his surgeries on a news show. Any thoughts on all this?

I had a revision to bypass and I am so damn happy about it!!!

[Pinkgirl1234 761]

Get rid of the Doctor...I demanded the bypass .I have to much weight to lose to screw around!!Best thing I ever did!

[Pinkgirl1234 761]

Why would a doctor say "you can do the sleeve then revise to bypass"Your body and your health is not a joke.He may think it's great to cram in surgeries and make money off performing multiple surgeries but believe me you want to have one surgery.The best that works for you.Lose that surgeon.Find one that listens to you....not the other way around....