Bypass vs. Sleeve

[kaitlynm 335]

I originally had planned on doing the bypass, but my Doc pointed out a lot of good things about the sleeve. I ended up with the sleeve and am very happy so far. I'm 5 months post op and have lost 83 pounds since this journey began. I must admit that one of my key decision makers was the thought of never having a piece of cake or other sweets again. I was afraid of the dumping. My Doc also told me that at the 2 year mark the results were about the same for sleeve and bypass, so I thought why risk it. I also have pernicious anemia and he thought that might cause a problem with the bypass because I couldn't get any B-12 from the oral Vitamins. So far I haven't found any foods that I can't eat, but I don't think that is true for everyone. Good luck!

[caligirltt 60]

@@Celeste 45 I hope you start to feel better. A leak would probably be deadly for me most likely.

[dbender603 12]

I picked the bypass because I only wanted to do it once, you can if you want have the bypass done after the sleeve but not visa versa. I just had surgery on the 2nd so not much to report yet but I know it was the right thing. It's a win win you really can't go wrong with either good luck

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[leebick 448]

I am also unsure as to which procedure would be the best for me. I have made a list of pros and cons for both bypass and sleeve and still cannot decide. One of the biggest things that has me leaning towards the sleeve is my fear of dumping. I had my gall bladder out in 1995 (age 39) and had no problems with any foods until about 5 years ago. Now I find that if I eat certain foods (pizza, Chinese food), I am in the bathroom within 30 minutes, having terrible diarrhea. It's really awful! The thought of having dumping most of the time for the rest of my life is horrifying to me! Another thing that concerns me with bypass is the malabsorption. I understand that this is intended and is part of the reason bypass is so successful, and also that with careful eating and supplementation, malnutrition does NOT have to occur. However... I worry about my age, and aging. I will be 60 next summer, and while I still feel young and have no physical ailments, I see what friends are going through as they age. What happens if I've had bypass and then have a major medical crisis, like developing cancer, for example? How do bypass patients fare through chemotherapy? Is the malabsorption a problem for them? (There IS a fair amount of cancer in my family, so this isn't a far-fetched thought.) And what about aging, in general? Will having gastric bypass mean it'll be more difficult to maintain health as I become elderly- so would the sleeve be a better choice? Then there's the weight loss itself. My NUT tells me that sleeve patients generally lose less weight, all told, than do bypass patients. Will I not be as successful meeting my goals, or will my 'expected' loss be less than I'd like because of having the sleeve?

On the other hand... bypass is the gold standard, weight loss is faster, and usually more weight is lost. There isn't as much data on sleeve surgery success rates because it's a newer procedure. I just read an article that says it seems that sleeve patients actually have a higher regain-rate than bypass patients, so there's that to consider and makes me think perhaps bypass is the better choice. But... am I going to regret bypass at times, like when I cannot toast my daughter's marriage with champagne, or have a slice of her wedding cake, without spending the next half-hour in the bathroom... for the rest of my life?

I know most of these questions are actually unanswerable, because we are all different physiologically and anatomically. It's really hard to decide, though, especially as I have no co-morbidities at all, and am not "addicted" to sugar or high-glycemic carbs (we've had 6 packages of Girl Scout Cookies in the cabinet for a week and I haven't touched them- not even tempted). I know it's good to not have any issues, but this also means I don't have any factors that would guide me toward one surgery or the other. I have to decide soon- I have a final weigh-in next week but have met all the pre-surgery goals (meetings, weight loss, etc) and will meet with the surgeons soon after that weigh-in to schedule surgery. It's just so hard to decide.

[Spiceyfrog 269]

What made you think you would have never been able to have a piece of cake again? I am a firm believer that if you want something have it, but within reason. If I want cake, I have 2-3 bites, not 2-3 pieces like I did in the past! You can eat whatever you want.

I originally had planned on doing the bypass, but my Doc pointed out a lot of good things about the sleeve. I ended up with the sleeve and am very happy so far. I'm 5 months post op and have lost 83 pounds since this journey began. I must admit that one of my key decision makers was the thought of never having a piece of cake or other sweets again. I was afraid of the dumping. My Doc also told me that at the 2 year mark the results were about the same for sleeve and bypass, so I thought why risk it. I also have pernicious anemia and he thought that might cause a problem with the bypass because I couldn't get any B-12 from the oral Vitamins. So far I haven't found any foods that I can't eat, but I don't think that is true for everyone. Good luck!

[CowgirlJane 14,259]

In 2001 when I was banded, that surgeon was experimenting with"band over bypass" - yes, just what it sounds like. Failed with bypass, so lets toss a lap band on. I can't imagine it.

I mention this because you can fail or succeed with any WLS. While the choice is very important, never lose sight of the fact that long term results have alot to do with the person too.

People have at times unrealistic expectations and come back years later with regain because the procedure they chose didn't stop them from making poor lifestyle/food/activity decisions. To the best of my knowledge - my experience and exposure to other people, NONE of the procedures really keep you slim over the years unless the person is able to keep "working it"

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[aelovelady 243]

I am 16 months post op from RNY, I eat whatever I want. Small portions.

[aelovelady 243]

I completely agree wil Cowgirl Jane, it takes work! The WLS, is just a tool and is very helpful, but you still have to be committed to the process!

[Djmohr 6,965]

I am 18 months post op from bypass. I have been able to eat whatever I want without dumping. I very occasionally treat myself to sweets.

It is all about how how much of something you eat. If I have a small piece of cake, cheesecake, pie, scoop of ice cream, I don't get sick. I have only made the mistake once of eating just a little too much and it left me feeling crappy but I don't get sick. Now, I have had too many carbs and they can stall you so just because I can eat whatever I want, doesn't mean I should.

Also, anything overly sweet just simply doesn't taste good to me. I try to choose a dessert that isn't overly sweet tasting. My favorite is cheesecake! I have a couple of bites and I am satisfied.

Of course I never even attempted trying sweets until I was post op 6 months. I still have not tried alcohol but that is because I am on pain medication. I also don't do carbinated anything mostly because I didn't drink soda before and I don't need to start now.

Life after bypass is pretty darn good. My only side effect that I truly complain about is Constipation. My doctor recently put me on Linzess and it is working fantastic.

[QueenLoser 20]

I am also unsure as to which procedure would be the best for me. I have made a list of pros and cons for both bypass and sleeve and still cannot decide. One of the biggest things that has me leaning towards the sleeve is my fear of dumping. I had my gall bladder out in 1995 (age 39) and had no problems with any foods until about 5 years ago. Now I find that if I eat certain foods (pizza, Chinese food), I am in the bathroom within 30 minutes, having terrible diarrhea. It's really awful! The thought of having dumping most of the time for the rest of my life is horrifying to me! Another thing that concerns me with bypass is the malabsorption. I understand that this is intended and is part of the reason bypass is so successful, and also that with careful eating and supplementation, malnutrition does NOT have to occur. However... I worry about my age, and aging. I will be 60 next summer, and while I still feel young and have no physical ailments, I see what friends are going through as they age. What happens if I've had bypass and then have a major medical crisis, like developing cancer, for example? How do bypass patients fare through chemotherapy? Is the malabsorption a problem for them? (There IS a fair amount of cancer in my family, so this isn't a far-fetched thought.) And what about aging, in general? Will having gastric bypass mean it'll be more difficult to maintain health as I become elderly- so would the sleeve be a better choice? Then there's the weight loss itself. My NUT tells me that sleeve patients generally lose less weight, all told, than do bypass patients. Will I not be as successful meeting my goals, or will my 'expected' loss be less than I'd like because of having the sleeve?

On the other hand... bypass is the gold standard, weight loss is faster, and usually more weight is lost. There isn't as much data on sleeve surgery success rates because it's a newer procedure. I just read an article that says it seems that sleeve patients actually have a higher regain-rate than bypass patients, so there's that to consider and makes me think perhaps bypass is the better choice. But... am I going to regret bypass at times, like when I cannot toast my daughter's marriage with champagne, or have a slice of her wedding cake, without spending the next half-hour in the bathroom... for the rest of my life?

I know most of these questions are actually unanswerable, because we are all different physiologically and anatomically. It's really hard to decide, though, especially as I have no co-morbidities at all, and am not "addicted" to sugar or high-glycemic carbs (we've had 6 packages of Girl Scout Cookies in the cabinet for a week and I haven't touched them- not even tempted). I know it's good to not have any issues, but this also means I don't have any factors that would guide me toward one surgery or the other. I have to decide soon- I have a final weigh-in next week but have met all the pre-surgery goals (meetings, weight loss, etc) and will meet with the surgeons soon after that weigh-in to schedule surgery. It's just so hard to decide.

Very well said Leebick. All the concerns you have and everything that's gone through your head is similar to my thoughts. Although I'm still pretty young, I was also concerned with the future given my family's medical history. Although I've chosen to just go with the sleeve, I still question myself every day, and I won't really know the full scope of my decision until many years after my procedure. As you said...there's really no way you can know how you will react to any of the procedures as an individual. That's why...as interesting and beneficial as it is to hear other people's experiences, it's not going to be yours or mine. Some people experience dumping syndrome with bypass while others never..and some end up experiencing it with the sleeve. For me personally, I wouldn't be surprised if I experienced it with the sleeve due to the fact that I already have a sensitive stomach. It seems like with all the procedures, most people are able to eat most things within reason given some time.

Just one little tidbit... for a long time I really wanted to do the bypass because you lose more weight. However, a couple of things that finally made me make up my mind is 1) after the 2 year mark... people tend to catch up to the gastric bypass people. After some thought, I decided that's not so bad for me. 2) As some mentioned, how much you lose total is really up to the individual.I kept doing the math in my head, and thinking... well, if I do the bypass I'll lose 80% of the extra weight, versus 70% from the sleeve (according to the hospital who's doing my procedure anyway, these numbers seem to change with every source I look at) and I was stuck on that. The fact that these numbers constantly change from website to website is also an indicator that this is not an exact science. Finally I was like...wait a minute, I want to lose 100% of my excess weight, so either way it's going to be on me whether or not I achieve my ultimate goal. I think of it the same way as far as the regain.... none of the these procedures are going to keep me from regaining. It's up to me. That's why I laugh when people say WLS is cheating. There's absolutely no cheating because there's a lot of work to be done. I'm having my surgery in Mexico which doesn't require any of the usual stuff they require here in the U.S...but I was still adamant about doing the work: joining support groups, finding a psychologists to address personal issues, getting tests done, and so on because I don't want to treat this like the thing that's going to solve all my problems. I think if you look at it from that point of view, the decision will be less stressful. Both the gastric bypass and the sleeve are great options and at the end of the day you'll just be happy cause you were proactive about getting control of your life. I think anyone who decides to do WLS are strong people for acknowledging needing help and taking action.

[Pinkgirl1234 761]

I had bypass...no dumping ,gerd or vomiting whatsoever.

[MinaT 669]

I was sleeved in 2012. At my highest weight I was 330. When I started the sleeve journey I was 299. I went down to 168 pounds. Prior to surgery I had severe reflux and took two omeprazoles a day. I was able to quit them. Eventually I needed to go back on them.

The reflux came back pretty severely. I went to the hospital in January 2015 thinking I was having a heart attack. All my tests came back negative. I saw a pulmonologist, I then had an endoscope done, I had many other tests done too, including barium swallows and other tests that tested my swallowing function etc. The acid reflux came when I drank Water, I was constantly choking on my food. I ended up with severe esophageal spasms.

I stopped eating most meat and eat mashed potatoes, oatmeal, I eat a lot of Soups. I went from 168-205 pounds due to not being able to follow the high Protein diet.

I am having revision to bypass on March 21st.

This is not something that happens to everyone, but I do highly suggest that if you suffer from severe GERD prior to surgery that you explore the other option. Having surgery twice is not easy. It's also a horrible feeling having the spasms, and it's extremely depressing to feel like you have failed, when you felt like you were on top of the world at one time.

Had I known that the acid reflux would start wearing away my esophagus and I would constantly feel like crap I would have gone straight to the bypass the first time.

I spent a year researching everything I could on revision surgery and there is a huge amount of people that are being revised from sleeve to bypass due to this issue, moreso than people needing to have a second surgery to lose more weight.

I have a feeling that Insurance Companies are going to eventually request more testing on GERD prior to sleeve surgeries in the future due to not wanting to pay out for an eventual revision surgery.

Everyone needs to make their own personal choice, but as someone that went through this, if you have serious issues with GERD, talk to your doctor about your choices of sleeve vs. bypass. I wish I did. Best of luck.

[catinaadams 6]

Mina it's not just the sleeve...I had the bypass in 2009 and I too am having all the issues you are having. I've gained back 67lbs of the 242 I lost and after 8 EGD's, the discovery of an ulcer in my new stomach and unable to keep ANYTHING down including Water (I eat to survive now) I'm having my revision on the 28th of this month after my battle w the insurance company. Good luck to you and hope you stay in touch on your progress as I will do the same.

[MinaT 669]

Catina, are you saying you are having another gastric bypass to redo the pouch? Since your pouch does not have the ability to produce acid the problem you are having is an ulcer in the pouch. What you have sounds so painful. The issues we are having are both painful but different. Ulcers could be caused by many factors including stress, cigarettes, coffee and alcohol or other reasons, but the GERD I am having is partly because the esophageal spasms make food get stuck in my esophagus so since I was sleeved, I still have acid produced in my stomach which then forces it's way up trying to digest the food that is stuck in my throat because of the spasms. The spasms are due to the acid. Of course, I could always end up with an ulcer in the pouch, but my pouch will not produce acid which will stop the GERD which hopefully will stop the esophageal spasms.

Even with the sleeves we aren't suppose to drink coffee and I sometimes do drink coffee and have wine occasionally. Thanks for input. I am prone to stress so I hope that I can do whatever I can to avoid an ulcer, but I know sometimes they aren't avoidable.

[catinaadams 6]

I developed an ulcer do to miscommunication from the dr that performed my first bypass. It was discovered approx 3 months after my bypass when I switched dr's at this time it was addressed and was treated w medication however it continued to get worse as time went by. For the past 6 months I've been vomiting so I avoided foods I thought to be causing it only to get to where I am now where it doesn't matter what I eat or drink nothing is staying but the calories (not losing weight at all). My dr tells me since my first procedure was done they have learned new ways to cut the stomach to avoid stretching he also talks of a hormone they now remove to makes you hungry. Whatever works thou as I'm tired of being in pain not knowing which hurts worse the hiatal hernia or the ulcer.