Why did you choose bypass?

[NewAngela 60]

I choose bypass because my gastroenterologist suggested it due to a combination of hiatal hernia and previous lap band. The weight loss is slightly better on average, and I like that it would make eating sweet foods harder. The biggest reason was the increased pressure in the esophagus that the sleeve has versus the bypass. I didn't want to feel that pressure I had with the band. I am pretty happy with my decision, but I have no idea what the sleeve would have been like. Type 2 diabetes and gastric reflux and excellent reasons to choose RNY. A sweet tooth also pushed me towards RNY. I definitely can't overindulge on sweets, but I can still enjoy the occasional small servings.

My practice also seems to push the sleeve, so I figured the bypass might be a better choice (I was annoyed they didn't even suggest RNY at the initial appointment.) Sleeve is the new, hot thing. It hasn't been time tested the same way, are though all indications show it is comparable to the bypass in weight loss. I would just rather have the most studied surgery, and my surgeon was top tier so I didn't really face any additional surgical complication risk with bypass.

Oh, the chance of me getting a revision with RNY is less. That is a big reason I went with RNY. This is my 3rd and hopefully last wls.

As far as actual experience, my weight loss wasn't very fast, about 62 pounds at 5 months, from 282 to 219. I am on target, but it isn't as fast as some people. I am a woman and my metabolism has started to slow. I definitely think I would have lost weight quicker when I was younger. I have had minimal restriction issues for the past month. Sometimes I doubt they even did RNY and mistakenly did the sleeve (jk) except that I have mild dumping syndrome with sweets. Mostly just a little dizziness and sweating, enough to earn me, but not enough to compromise my function. My Vitamin levels/bloodwork were all fine. I take a lot of pills without any issues, although I only take chewable Vitamins. Vitamin pills made me feel sick pre surgery, so I am not going to risk it. I even take ibuprofen a few times a month, although I have to take it with nexium. I am able to eat most foods now, including pizza occasionally. I do tend to pick bypass friendly foods on a daily basis. It is just nice to know I can eat out socially without too much planning, although I did have mild dumping after Thai food yesterday. I think they used a coconut cream product for a Soup that had sugar.

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Edited August 11, 2016 by NewAngela

[jdk524 12]

I'm going to copy and paste something I wrote a couple weeks ago explaining my reasons for choosing the RNY over the sleeve. Hope my perspective helps in some way.

I did consider sleeve and would have happily gotten one if my surgeon had had some reason for me not to do the rny. But rny seemed like a better option for me based on a lot of different things.

- There is much more long-term data on it.

- It's considered the "gold standard" of wls.

- My bmi was very high at the beginning of the program... about 67. From everything I've observed/researched and learned in the surgeon's seminars, those with higher bmis tend to lose more during the honeymoon phase and continue to lose more/easier in the maintenance phase. I had a looong way to go to get to my goal.

- I wanted the accountability of the rny. Many sleevers I talked to simply didn't have dumping, or were able to tolerate slider foods even in the weight-loss phase. I wanted the most strict accountability either surgery could offer, and that meant the rny.

- Many sleevers I talked to years out that had started very heavy as I did were not really happy with the larger amount they were able to eat, how easy it was to eat bad foods they should not eat, etc. The rny offers more restriction. True, I can stretch out my pouch just like a sleever can stretch out their sleeve but it seemed to me (and statistics back this up) that rny-ers had more restriction farther out than sleevers, and I wanted that.

- I also knew a lot of sleevers who, for whatever reason, wanted revisions years later and couldn't get them because of insurance, etc. I could mess up my rny too, of course, but I wanted the smallest chance possible, and the biggest bang for my buck.

- I saw many sleevers, particularly ones with high bmis, entering maintenance with 50, 60, 80 pounds left to lose to reach goal. Of course, this wonderful tool will help you reach goal after maintenance has started with enough work and dedication regardless of the type of wls, but since I had such a long way to go and I wanted to lose weight as quickly as possible to give me a good head start on my life-long road to health, the rny seemed a better option. As it is, I'm not yet in maintenance and I'm about 45 pounds away from my goal. Chipping away.

- The only arguments people had against the rny did not really matter to me at all. I have to take Vitamins for the rest of my life? Okay, no problem, most people probably should be anyway. There's a slightly higher risk with the rny? Okay, it's really a tiny extra risk, and with all the added benefits, entirely worth it. It didn't scare me at all. I may deal with malabsorption and other complications? Well yes... but so may the sleeve. The different percentages of risk were so close anyway, it didn't worry me at all to take that leap for what I perceived to be my best chance at getting the best head start I could, which would not only greatly improve my health (it has!) and greatly improve my self-esteem (it has!) but also greatly reduce the difficulties of everyday life (it has!!) as soon as I possibly could. I'm 24 and I left college two years ago because I was so sick. I've been sitting here fixing my body and essentially saving my life, and I really don't want to and can't wait another second to start my life. I'm enrolled and going back to school in about 3 weeks, and I look and feel pretty much normal now. I've had no complications, and I've lost 172 pounds since the day of surgery less than a year ago. This was my dream, and it felt like a silly and ridiculous fantasy before. But here I am, and everything I could have possibly wished for has come true for me. AND BONUS! It only gets better from here!

For all these reasons and many more that are more personal and harder to explain, I would choose the rny all over again, and again, and again...

Thank you so much! Exactly the kind of information I was hoping to get from someone!

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[dhrguru 1,238]

I chose bypass cause with the amount of weight I had to lose- I wanted the double effect of malabsorption and restriction. A large part of why I did not want VSG was because of the large possibility of reflux. It was never an issue for me before and I didn't want to come out Of surgery with new issues. I've lost 137# so far, zero complications . I'm happy with my choice.

That's awesome! Congrats! Would you mind sharing SW & CW?

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High weight 337

SW 315

CW 200

[bhappychic 0]

I had an RNY in April. I started at 209 and am now at 154. I had done a dr. supervised diet over a 1 year diet that started with liquid nutrition only and then added foods in over the year. This helped determine how many calories I could consume without gaining. 900 calories is it!!!!! I knew I couldn't keep that up forever thus my RNY. I am very happy so far!

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[DeletedMember 715]

I think you are seeing a bit of a pattern as to why people chose RNY, and I am really no different:

1) I wanted the restriction and malabsorption to help with the quickest weight loss possible. I wanted to lose at least 150lbs.

HW: 333lbs (2/9/2016)

SW: 287lbs (3/21/2016)

CW: 194lbs (this morning)

Total Loss: 139lbs in 6 months and 6 days

2) I had been suffering from GERD for a few years, definitely didn't want it to get worse, and hoped it might cure it!

I can't comment on this yet as to rather it's "cured", as my doctor prescribed a PPI during the initial healing phase and I just received permission to begin phasing off of it last week. But I've not had an symptoms with the PPI (although I would not expect any given previous experience).

3) It's been around a very long time. For many years I put off having this surgery, and part of the reason was I was just not confident what would happen over the long term.

4) Technically, it's reversible. While this is probably a dumb reason to select the surgery, it gave me some comfort knowing if things went horribly wrong there was a chance I could revert back to something close to my original state.

My surgeon said I was definitely a candidates for RNY and Sleeve and he would support either, but said he tended to agree with me that RNY might be the better options.

Honestly, the only reason I really considered the sleeve was due to my use of NSAIDs. I was a chronic daily user (800mg, 3 times a day) that needs to have both knees replaced and one hip replaced. I'm happy to report that I have not used an NSAID in over 5 months and am functioning fine. In fact, while I still experience pain, I have less pain now without NSAIDs than I had before with NSAIDs.

It's not easy, and everyday I still struggle a bit with food (some days food goes down well, some days it doesn't). And I still obsess about everything I eat (maybe I always will?). BUT, man does it feel good to be down 140lbs. I am no longer "obese", just "overweight", but in today's society, that makes me VERY normal sized. Life is so much easier in every way that doesn't involve eating!!

After reading thousands upon thousands of articles and posts, I am sure whatever you end up choosing will be right for you. If you follow the plan, you will be successful.

[Hagengirl3 65]

Chose bypass because I did not want to risk having Acid reflux. Only had it when pregnant but knew I never wanted to have to deal with that again. I am super happy with my choice. I have never had any dumping or other issues although I have never actually tried anything with sugar yet. Haven't had bread, Pasta or rice either but assume they would not bother me. I just don't feel a need to have them.

[graham99 6]

My doctor told me the gastric bypass was the best option for me because of how much weight I needed to lose, and health problems. Such as heartburn and acid reflex.

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[yncse8 23]

I chose the bypass because the percentage of weight loss was higher. Also I needed the threat of dumping syndrome if I eat sugar, bad fats and carbs to help keep.me on track. I've had no complications and absolutely have no regrets except waiting so long.

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[gina171 626]

@ .... What an incredibly swift weight loss!! To what do you attribute your success? How did you lose so much so quickly?

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[DeletedMember 715]

@ .... What an incredibly swift weight loss!! To what do you attribute your success? How did you lose so much so quickly?

I don't think it was anything in particular. Partly I had a high starting BMI (50). I'm also male, which tends to help. And then I just followed the program. I get my required 60g of Protein and 64oz of fluids daily and have since pretty much the day I got home from the hospital. I eat exactly what I'm supposed to.

I also started walking pretty much every day and make an effort to workout a few times a week (I am not consistent with this).

But a lot of people do what I do and don't lose as fast. Part of it is just genetics. My surgeon has said the single best indicator of how well you will do in your initial weight loss is if you have an immediate family member who has had the surgery and has done well. He refers to me as a "super responder". He says my loss is in the top 10% of his patients, so it is definitely not typical.

That being said, from everything I've read, if you follow the program the weight will come off.

[shelbys mom 70]

a few reasons - I wanted the malabsorption (I also started at 300+ lbs), I had moderate GERD pre-surgery and did not want to risk it getting any worse (it completely went away with surgery), and I liked the fact the bypass has been around for a long time and there's a lot of research on it - so they know what they're doing.

I've been very happy with it. Other than two strictures early out (which are an easy fix), I've had no problems with it.

Catwoman7: Im new, in the process, can you explain what you mean when you say, " you wanted the malabsorption? Confused

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[catwoman7 11,212]

with the bypass, part of your small intestine is bypassed, so you don't absorb all the calories you eat (for example, and I'm just pulling these numbers completely out of the blue, so don't quote me - you may eat 800 calories, but your system is only absorbing 600 of them). At least this happens for the first year or two. After that, you start absorbing them all again, because your system gradually adapts to the new layout :-( But having this malabsorption for the first year or two gives you a jumpstart on weight loss, which is why....at first....bypass patients tend to lose faster than sleeve patients (by the end of the second year, though, they've pretty much caught up)

[Sumaire 75]

I chose RnY because it seems to be the "gold standard" for GBS, and I want to be able to take advantage of the restrictions it will place on me. I'm about 284 right now, and all the women on my mom's side of the family tend to run large. My knees, hips, and spine all show signs of arthritis, I walk with a cane, and I use an electric scooter for what would otherwise be long walks through stores and places like Disneyland.

I can't let this go on any longer.

I've got GERD, so the sleeve isn't in the cards for me, as well as a hiatal hernia.

I'm hoping I can have my surgery scheduled for sometime in the next eight weeks. It's pretty much in the hands of my insurance medical group at this point.

Once it's done, I will have a good tool for helping me get my life back to a place where I am in charge, and not medical issues.

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[shelbys mom 70]

with the bypass, part of your small intestine is bypassed, so you don't absorb all the calories you eat (for example, and I'm just pulling these numbers completely out of the blue, so don't quote me - you may eat 800 calories, but your system is only absorbing 600 of them). At least this happens for the first year or two. After that, you start absorbing them all again, because your system gradually adapts to the new layout :-( But having this malabsorption for the first year or two gives you a jumpstart on weight loss, which is why....at first....bypass patients tend to lose faster than sleeve patients (by the end of the second year, though, they've pretty much caught up)

Ohhhh I,see. That makes sense. Thank you for clarifying.????

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[Teejay1958 7]

I am looking for personal experiences. What did you choose bypass over sleeve and are you happy with your choice?

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I didn't choose bypass specifically. For my issues, my surgeon thought that RNY would be better for me; and the more I read, the more I believe so too. I will let you know if I have issues and how everything goes. But yes, as of now, I am happy with my decision.