Bypass vs sleeve?

[saltykisses 27]

I'm torn between the surgeries. My surgeon said I qualify for both and it's my choice. I've seen friends have great results with both surgeries.

I'm 41, low BMI of 35 with comorbidities of very high BP, high cholesterol, pre diabetic , weight 205.

If anyone has any recommendations or insight please share. Anyone In the same situation please share your thoughts or choice of surgery and why. I originally was thinking sleeve but now wondering if long term bypass would be best....

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[Waler 330]

The best I can tell you is they both come with pros and cons. With the bypass you will have some Vitamin absorption issues and you can get dumping syndrome if you do not behave on your diet, but the long term weight loss is higher. I personally when with the sleeve do to less issues with absorption, but you will not lose as much weight long term. Do you research and talk with you doctor, this decision is totally up to you and each person has a different view on it. It is your journey make it what you want it to be

[Berry78 4,261]

Sleeve will work well for you (you don't have GERD, do you?)

[CrissCriss 97]

I would lean towards the gastric sleeve.

[DropWt4Life 957]

I think that the sleeve would work just fine for you since you probably only have 60-70 pounds to lose to place you into the normal range. If you already have acid reflux issues or Gerd, those issues can be agitated or worsened by getting sleeved, however, and many people undergo a 2nd surgery to convert to GB because of this. If that is the case, you might be better off with GB instead.

Other than that, see below:

Gastric Sleeve vs Gastric Bypass

Comparison of the Bariatric Surgery Procedures

Comparing the various methods of weight loss surgery can help you determine which surgical approach is the best option for you. As weight loss surgery is only a tool to assist with weight loss, what works best for one individual is not necessarily what will work best for another individual.

The following chart is a side-by-side comparison of laparoscopic sleeve gastrectomy (LSG), also called gastric sleeve surgery, and Roux-en-Y gastric bypass surgery. The information is intended as a general overview of these two types of weight loss surgery to help you quickly compare the similarities and differences of these procedures.

Weight Loss Procedure	Gastric Sleeve	Roux-en-Y Gastric Bypass
Approach to Weight Loss	Restriction Limits food ingestion Controls hunger sensations	Restriction & Malabsorption Limits food ingestion Reduces food absorption
Changes to Stomach	Stomach size reduced 75-80% of the stomach is cut away along the greater curvature and removed from the body	Stomach size reduced and new stomach outlet (stoma) created Stomach is separated into two and stoma is created in the smaller upper pouch; lower remaining portion of the stomach is bypassed
Changes to Small Intestine	Kept intact	Cut and rerouted Small intestine is cut in the middle; upper section is bypassed and lower section is attached to the stoma
Changes to Pyloric Valve	Kept intact	Bypassed
Average Operating Time	1 to 3 hours	2 hours
Average Hospital Stay	2 to 3 days	2 to 3 days
Average Time off Work	2 weeks	2 to 3 weeks
Average Recovery Time	3 weeks	3 months
Surgery Advantages	Safer and less complex procedure Limits food ingestion Reduces hunger sensations by removing the portion of the stomach that produces Ghrelin, the hunger hormone Digestion occurs naturally and does not cause nutritional deficiencies resulting from intestinal bypass Does not cause Dumping syndrome as the pyloric valve is kept intact Few problematic foods Option for high-risk patients (very high BMI or medical issues such as anemia, Crohn?s disease, anti-inflammatory drug use, or extensive prior surgery)	Greatly controls amount of food that can be eaten Malabsorption assists with weight loss Dumping syndrome prevents intake of sweets Considered gold standard for bariatric surgery based on long-term use and results
Surgery Disadvantages	General surgical risks including infection, bleeding, and blood clots Leakage along the stomach sutured/stapled edge Not reversible Lack of long-term data Considered investigational and not covered by some insurance companies	General surgical risks including infection, bleeding, and blood clots Complex operation Leakage along the staple line of the stomach Stoma obstruction Nutritional deficiencies Gallstones, ulcers, reflux, and bowel obstruction Dumping syndrome
Causes Dumping Syndrome	No	Yes
Dietary Guidelines	600-800 calories per day, during weight loss period 1000-1200 calories per day for weight maintenance Meals should consist of high-protein, low-carbohydrate and low-fat foods Drink 6-8 cups of Water or other low-calorie liquids per day	800 calories per day during weight loss period 1000-1200 calories per day for weight maintenance Meals should focus on protein-rich foods and nutrient-rich fruits and vegetables Drink 6-8 cups of water or other low-calorie liquids per day Chew foods thoroughly into a pureed consistency
Eating Habits	Eat five small healthy meals each day Do not eat and drink at same time Do not overeat, skip meals, or snack between meals	Eat three small protein-rich meals each day Do not eat and drink at same time Chew foods into a pureed consistency Do not overeat, skip meals, or snack between meals
Problematic Foods	Not many problematic food as the stomach continues to function normally, but high-calorie and high-fat foods and drinks must be avoided and daily calories limited for weight loss to occur	Foods that are dry, sticky, or fibrous can cause discomfort or blockage, including tough meat, bread, Pasta, rice, raw vegetables, nuts, popcorn, and skins of fruits and vegetables, and chewing gum Sweets can cause Dumping syndrome Carbonated beverages can cause bloating High-calorie, high-sugar, high-fat foods and beverages will ruin weight loss efforts
Nutritional Supplements	Multivitamin Calcium Vitamin B12	Multivitamin Calcium Vitamin B12 Iron
Average Weight Loss	Studies show greater than 60% excess weight loss at 12 months after surgery and a maintained excess weight loss of 53-69% at 5 year follow-up.(1)	Rapid weight loss during first 6 months Weight loss settles 18 to 24 months after surgery 70% excess weight loss at 1 year 60% excess weight loss at 5 years

[CrissCriss 97]

16 minutes ago, DropWt4Life said:

I think that the sleeve would work just fine for you since you probably only have 60-70 pounds to lose to place you into the normal range. If you already have acid reflux issues or Gerd, those issues can be agitated or worsened by getting sleeved, however, and many people undergo a 2nd surgery to convert to GB because of this. If that is the case, you might be better off with GB instead.

Other than that, see below:

Gastric Sleeve vs Gastric Bypass

Comparison of the Bariatric Surgery Procedures

Comparing the various methods of weight loss surgery can help you determine which surgical approach is the best option for you. As weight loss surgery is only a tool to assist with weight loss, what works best for one individual is not necessarily what will work best for another individual.

The following chart is a side-by-side comparison of laparoscopic sleeve gastrectomy (LSG), also called gastric sleeve surgery, and Roux-en-Y gastric bypass surgery. The information is intended as a general overview of these two types of weight loss surgery to help you quickly compare the similarities and differences of these procedures.

Weight Loss Procedure	Gastric Sleeve	Roux-en-Y Gastric Bypass
Approach to Weight Loss	Restriction Limits food ingestion Controls hunger sensations	Restriction & Malabsorption Limits food ingestion Reduces food absorption
Changes to Stomach	Stomach size reduced 75-80% of the stomach is cut away along the greater curvature and removed from the body	Stomach size reduced and new stomach outlet (stoma) created Stomach is separated into two and stoma is created in the smaller upper pouch; lower remaining portion of the stomach is bypassed
Changes to Small Intestine	Kept intact	Cut and rerouted Small intestine is cut in the middle; upper section is bypassed and lower section is attached to the stoma
Changes to Pyloric Valve	Kept intact	Bypassed
Average Operating Time	1 to 3 hours	2 hours
Average Hospital Stay	2 to 3 days	2 to 3 days
Average Time off Work	2 weeks	2 to 3 weeks
Average Recovery Time	3 weeks	3 months
Surgery Advantages	Safer and less complex procedure Limits food ingestion Reduces hunger sensations by removing the portion of the stomach that produces Ghrelin, the hunger hormone Digestion occurs naturally and does not cause nutritional deficiencies resulting from intestinal bypass Does not cause Dumping syndrome as the pyloric valve is kept intact Few problematic foods Option for high-risk patients (very high BMI or medical issues such as anemia, Crohn?s disease, anti-inflammatory drug use, or extensive prior surgery)	Greatly controls amount of food that can be eaten Malabsorption assists with weight loss Dumping syndrome prevents intake of sweets Considered gold standard for bariatric surgery based on long-term use and results
Surgery Disadvantages	General surgical risks including infection, bleeding, and blood clots Leakage along the stomach sutured/stapled edge Not reversible Lack of long-term data Considered investigational and not covered by some insurance companies	General surgical risks including infection, bleeding, and blood clots Complex operation Leakage along the staple line of the stomach Stoma obstruction Nutritional deficiencies Gallstones, ulcers, reflux, and bowel obstruction Dumping syndrome
Causes Dumping Syndrome	No	Yes
Dietary Guidelines	600-800 calories per day, during weight loss period 1000-1200 calories per day for weight maintenance Meals should consist of high-protein, low-carbohydrate and low-fat foods Drink 6-8 cups of Water or other low-calorie liquids per day	800 calories per day during weight loss period 1000-1200 calories per day for weight maintenance Meals should focus on protein-rich foods and nutrient-rich fruits and vegetables Drink 6-8 cups of Water or other low-calorie liquids per day Chew foods thoroughly into a pureed consistency
Eating Habits	Eat five small healthy meals each day Do not eat and drink at same time Do not overeat, skip meals, or snack between meals	Eat three small protein-rich meals each day Do not eat and drink at same time Chew foods into a pureed consistency Do not overeat, skip meals, or snack between meals
Problematic Foods	Not many problematic food as the stomach continues to function normally, but high-calorie and high-fat foods and drinks must be avoided and daily calories limited for weight loss to occur	Foods that are dry, sticky, or fibrous can cause discomfort or blockage, including tough meat, bread, Pasta, rice, raw vegetables, nuts, popcorn, and skins of fruits and vegetables, and chewing gum Sweets can cause Dumping syndrome Carbonated beverages can cause bloating High-calorie, high-sugar, high-fat foods and beverages will ruin weight loss efforts
Nutritional Supplements	Multivitamin Calcium Vitamin B12	Multivitamin Calcium Vitamin B12 Iron
Average Weight Loss	Studies show greater than 60% excess weight loss at 12 months after surgery and a maintained excess weight loss of 53-69% at 5 year follow-up.(1)	Rapid weight loss during first 6 months Weight loss settles 18 to 24 months after surgery 70% excess weight loss at 1 year 60% excess weight loss at 5 years

Wow! this is an awesome post I totally learned something.

[DropWt4Life 957]

Sorry, the chart doesn't show up well on mobile.

A general outline of the advantages/disadvantages of each:

VSG Advantages: Safer and less complex procedure; Limits food ingestion; reduces hunger sensations by removing the portion of the stomach that produces Ghrelin, the hunger hormone; digestion occurs naturally and does not cause nutritional deficiencies resulting from intestinal bypass; does not cause dumping syndrome as the pyloric valve is kept intact; few problematic foods; option for high-risk patients (very high BMI or medical issues such as anemia, Crohn's disease, anti-inflammatory drug use, or extensive prior surgery)

VSG Disadvantages: General surgical risks including infection, bleeding, and blood clots; Leakage along the stomach sutured/stapled edge; Not reversible; Lack of long term data; considered investigational and not covered by some insurance companies.

GBP Advantages: Greatly controls amount of food that can be eaten; malabsorption assists with weight loss; dumping syndrome prevents the intake of sweets; Considered the gold standard for bariatric surgery base on long-term use and results.

GBP Disadvantages: General surgical risks including infection, bleeding and blood clots; complex operation; leakage along the staple line of the stomach; stoma obstruction; nutritional deficiencies; gallstones, ulcers, reflux and bowel obstruction; dumping syndrome.

[Introversion 1,876]

With a lowish BMI of 35 and less than 75 pounds to lose, I'd be reluctant to undergo gastric bypass unless I had PCOS or a confirmed diagnosis of diabetes.

You're prediabetic, but not yet diabetic. While both surgeries offer amazing benefits, I'd lean toward a sleeve if I were you.

It would be disastrous if you lost 100+ pounds with a bypass when you are a 'lightweight' who doesn't need to lose nearly that much.

Good luck with the decision-making process.

[brightfaith 187]

I have chosen gastric bypass for myself (high BMI, diabetes), but I think if I were in your position, I would choose the sleeve and agree with Introversion. Good luck!

[Danny Paul 761]

I chose the sleeve because it was a less invasive surgery with similar results.

[shedo82773 1,236]

5 hours ago, DropWt4Life said:

Sorry, the chart doesn't show up well on mobile.

A general outline of the advantages/disadvantages of each:

VSG Advantages: Safer and less complex procedure; Limits food ingestion; reduces hunger sensations by removing the portion of the stomach that produces Ghrelin, the hunger hormone; digestion occurs naturally and does not cause nutritional deficiencies resulting from intestinal bypass; does not cause dumping syndrome as the pyloric valve is kept intact; few problematic foods; option for high-risk patients (very high BMI or medical issues such as anemia, Crohn's disease, anti-inflammatory drug use, or extensive prior surgery)

VSG Disadvantages: General surgical risks including infection, bleeding, and blood clots; Leakage along the stomach sutured/stapled edge; Not reversible; Lack of long term data; considered investigational and not covered by some insurance companies.

GBP Advantages: Greatly controls amount of food that can be eaten; malabsorption assists with weight loss; dumping syndrome prevents the intake of sweets; Considered the gold standard for bariatric surgery base on long-term use and results.

GBP Disadvantages: General surgical risks including infection, bleeding and blood clots; complex operation; leakage along the staple line of the stomach; stoma obstruction; nutritional deficiencies; gallstones, ulcers, reflux and bowel obstruction; dumping syndrome.

Just a couple of things. Some people do get the dumping syndrome with the Gastric Sleeve. The Sleeve surgery is kind of invasive, they remove 75 to 80%. In extreme cases they can reverse the RNY (I have been told) Also many have their Gastric Sleeve revised to a RNY. It all boils down to both work. You need to also do the work with both surgery. Good Luck in your choice of surgery and your ongoing journey.

[shedo82773 1,236]

4 minutes ago, shedo82773 said:

Just a couple of things. Some people do get the dumping syndrome with the Gastric Sleeve. The Sleeve surgery is kind of invasive, they remove 75 to 80%. In extreme cases they can reverse the RNY (I have been told) Also many have their Gastric Sleeve revised to a RNY. It all boils down to both work. You need to also do the work with both surgery. Good Luck in your choice of surgery and your ongoing journey.

My husband had a Gastric Sleeve and if he eats anything that is real fatty or sweets he gets the dumping syndrome within 15 minutes.

[saltykisses 27]

Sleeve will work well for you (you don't have GERD, do you?)

No I do not. Very little acid reflux ever.

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[saltykisses 27]

Sleeve will work well for you (you don't have GERD, do you?)

Not at all. Very little acid reflux

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[mnyap79 7]

According to my doctor, the sleeve is actually or more complicated surgery and the recovery time is longer. The possibility of leaks is greater in a sleeve then a gastric bypass. Ultimately it's what you feel comfortable with. I know people who have done both. Some have kept the weight off and others have not. It's about what you feel you can maintain.