Gastric Sleeve or Gastric Bypass?

[SillySavy 0]

Hello!

I have been researching surgeries for weeks now and I can't seem to choose between a bypass or a sleeve. At first, I figured I'd do the bypass as a one and done, but now, after more research, I'm not so certain.

I am a 25yo female who weighs 273 at 5"4' leaving my BMI at 46. I have always been heavy aside from a depression spell that left me at a healthy weight only to gain it all back. I have trouble with Portion Control and sweets and I often yo-yo diet unintentionally. I have a family history of diabetes and personally am one point away from pre-diabetic and have high triglyceride levels.

As I said before, I was all set on the bypass until I learned about the post op complications such as mineral deficiency, ulcers, and stoma obstruction.

I feel like the dumping syndrome thing will really help me with my sugary habits as I'm afraid of falling back into bad habits post op, but I also am worried about the complications.

The sleeve seems to have less complications, but is also less effective.

Some questions I have are:

▪️can you stretch your sleeve/bypass easily? Since I have an issue with portion control, this is a major concern for me.

▪️Is dumping syndrome really helpful or is it not worth it?

▪️Bypass patients: let's say I can control the Vitamin deficiency issue with supplements and the dumping syndrome issue with cutting out sugar and fats as best I can, do you think it was worth the complications (gallstones, stoma obstruction, etc)?

▪️Sleeve Patients: how many of you ended up with GERD? I personally don't have a lot of issues with acid reflux, but I do get it occasionally.

thank you for any advice or help you can offer. My consultation is the 20th of this month and I want to be as prepared and educated as I can be.

-SillySavy

Edited October 11, 2017 by SillySavy

[Anne Collura 0]

Hello there!! I will be having my 3rd wls on Nov 1. I started with the gastric band, but because of "band slippage" I had to have it removed, and converted to a gastric sleeve. After 5 years, I am now having problems with severe GERD. I will now have to have my sleeve converted to a gastric bypass because of it........So my opinion would be go straight to a gastric bypass...

[Anne Collura 0]

* I previously never had problems with GERD*

[enaking23 1]

I'm in about the same situation, looking for the same answer. I'm torn between the two surgeries. My mom had the bypass about five years ago, and she lost all her weight but deals with a lot of kidney stone issues and malabsorption problems. I'm thinking about the sleeve for these reasons, but I'm also a sugar/carb a holic and I think the dumping syndrome would help, but mom didn't really have that and she's a sugar person too. Gerd hasn't been a big issue for us either. Is sleeve a better option?

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[DropWt4Life 957]

Anne, I am sorry you have had to go through so much in search of a long-term solution. I know it must suck. I had problems with acid reflux as well, and started a course of 2Tbsp of Apple Cider Vinegar every day. I also got rid of spicy food. It seems to have done the trick. Maybe you could try that in the mean time while you are awaiting surgery. It might just help to lessen your symptoms. I wish you the best of luck.

As to my reply to the OP, I would probably recommend the GB as well as it has malabsorption properties for your sweet tooth. You are probably going to dump like crazy unless you get that under control though, and it might not be a long-term solution if you don't.

My main problem pre-op was Portion Control. VSG definitely took care of that one, but I will warn that NO surgery is going to help you if you can't get the snacking under control. Sugary and/or salty Snacks, processed food, junk food carry lots of calories, and are more than likely the cause of your food addiction. Many of these foods are sliders as well, so they aren't going to make you full. You can still overeat most of these foods.

A poster in another thread gave the example that a large bag of Doritos can be smashed down to a cup or two of food, and slide easily through your stomach without making you full. You aren't going to achieve much success unless you treat these foods like a good friend that you see maybe once or twice per month.

Good luck in your decision!

[Travelher 915]

10 hours ago, SillySavy said:

Hello!

I have been researching surgeries for weeks now and I can't seem to choose between a bypass or a sleeve. At first, I figured I'd do the bypass as a one and done, but now, after more research, I'm not so certain.

I am a 25yo female who weighs 273 at 5"4' leaving my BMI at 46. I have always been heavy aside from a depression spell that left me at a healthy weight only to gain it all back. I have trouble with Portion Control and sweets and I often yo-yo diet unintentionally. I have a family history of diabetes and personally am one point away from pre-diabetic and have high triglyceride levels.

As I said before, I was all set on the bypass until I learned about the post op complications such as mineral deficiency, ulcers, and stoma obstruction.

I feel like the dumping syndrome thing will really help me with my sugary habits as I'm afraid of falling back into bad habits post op, but I also am worried about the complications.

The sleeve seems to have less complications, but is also less effective.

Some questions I have are:

▪️can you stretch your sleeve/bypass easily? Since I have an issue with Portion Control, this is a major concern for me.

▪️Is dumping syndrome really helpful or is it not worth it?

▪️Bypass patients: let's say I can control the Vitamin deficiency issue with supplements and the dumping syndrome issue with cutting out sugar and fats as best I can, do you think it was worth the complications (gallstones, stoma obstruction, etc)?

▪️Sleeve Patients: how many of you ended up with GERD? I personally don't have a lot of issues with acid reflux, but I do get it occasionally.

thank you for any advice or help you can offer. My consultation is the 20th of this month and I want to be as prepared and educated as I can be.

-SillySavy

For starters Gallstones are not a complication of any one surgery or even surgery at all they are a complication of obesity. if someone wants to lower the risk of gallstones they should not become obese to begin with. it can become exacerbated by weight loss (of any kind). Weight loss is the goal of weight loss surgery so they will be a risk regardless of surgery choice (about 30% vs. 12% in the general population).

Strictures, deficiencies and ulcers can also occur with either surgery. You will be given instructions like no NSAIDs to help avoid conditions that can invite ulcers. Strictures are treatable as are deficiencies (with supplementation)

both surgeries are viable options. I chose bypass as I had a history of reflux and could not afford the risk of a second revision and Gerd is the #1 reason for Sleeve to bypass revisions. also my doctor recommended it. Having said that, sleeve was my back up should the band damage have been so bad as to prevent a bypass.

I strongly suggest you talk to your surgeon for guidance and for his/her own practice results and complication comparisons. every doctor should be able to provide that. I looked at the comparison between the two and found the complication rates to be negligible between them. eg at most a 1% difference. eg. in his practice RNY Vitamin deficiency was 2% RNY vs. 1% sleeve. the only big difference being anemia 10% vs 5%.

Dumping syndrome happens for about 30% of patients and if you are lucky enough to get it, it really works as a deterrent.

research shows that the size of the pouch is not the determinant of long term weight loss. that people who regain typically have pouches the same size as people who do not regain. it is healthy eating and lifestyle habits that are the greatest determinant in long term success. the surgery buys you a metabolic reset for a period of time and rapid weight loss. that period is ideally used to develop good eating and lifestyle habits so that you can maximize loss and maintain it in the long run.

[shedo82773 1,236]

Hi there, I had my RNY July 2, 2013. My blood work has been spot on!! I do have high B12 so I had to cut back on my sublingual Vitamin. I also feel like I make a great choice of what Vitamins I take. I know there are lots of peeps and DR.'s that say FLINTSTONES with Iron are ok. My Surgeon told me from the start that I have to be on BARIATRIC vitamins for the rest of my life. I use to take 12 different medications and 100 units of Insulin 2 times a day. Now I am off all of the insulin...I now take 4 medications. Plus my vitamins. I will take that anytime!! BTW plus I am able to get out and exercise!! Plus I lost 132#'s and gained only 8 to 10 #s!!! That is a win-win for me!! Hubby had the Sleeve done and I know plenty of people have had Sleeves and were very successful, he has lost 135# in 16 months. He isn't compliant!! I also got to my goal weight in 6 months. Just as a comparison. Just remember any surgery is a TOOL!! You still need to put in a whole lot of effort and time!! KEEP ON KEEPING ON!!! Good Luck in your Journey!!

[sleepingbeauty30 9]

Hi there, I had my RNY July 2, 2013. My blood work has been spot on!! I do have high B12 so I had to cut back on my sublingual Vitamin. I also feel like I make a great choice of what Vitamins I take. I know there are lots of peeps and DR.'s that say FLINTSTONES with Iron are ok. My Surgeon told me from the start that I have to be on BARIATRIC vitamins for the rest of my life. I use to take 12 different medications and 100 units of Insulin 2 times a day. Now I am off all of the insulin...I now take 4 medications. Plus my vitamins. I will take that anytime!! BTW plus I am able to get out and exercise!! Plus I lost 132#'s and gained only 8 to 10 #s!!! That is a win-win for me!! Hubby had the Sleeve done and I know plenty of people have had Sleeves and were very successful, he has lost 135# in 16 months. He isn't compliant!! I also got to my goal weight in 6 months. Just as a comparison. Just remember any surgery is a TOOL!! You still need to put in a whole lot of effort and time!! KEEP ON KEEPING ON!!! Good Luck in your Journey!!

So happy for both of you! I hope I get to meet my goals also pray everything goes well. Still debating on sleeve or bypass. Now did you get any loose skin? How many weeks did it take you to heal before exercising??

[James Marusek 5,244]

I am over 4 years post-op RNY gastric bypass surgery. I was taking 5 prescription medications prior to surgery (2 for diabetes, 2 for high blood pressure, and 1 for asthma). Now I take none. I took some supplements (vitamins, minerals) prior to surgery. Now I take more. But the cost of the added Vitamins is less than the cost of the prescription medicines that I use to take. So I am money ahead. I also had severe acid reflux prior to surgery. That is gone now. I had sleep apnea. I would keep my wife awake at night, all night long because she was a light sleeper, prior to surgery. Several months after surgery, I would find her hovering over my bed at night. I would ask her what she was doing and she said, I was sleeping so silently, that she thought I was dead and she was trying to see if I was still breathing. I had several other conditions as well that went into remission after the surgery.

Before you make up your mind about which surgery, it might be good to listen to what your surgeon recommends. Also some insurance companies will pay for one type of surgery but not the other. So it is worth investigating this element.

As far as your specific questions:

▪️can you stretch your sleeve/bypass easily? Since I have an issue with Portion Control, this is a major concern for me. I believe the answer is NO, stretching is a myth.

▪️Is dumping syndrome really helpful or is it not worth it? Helpful

▪️Bypass patients: let's say I can control the Vitamin deficiency issue with supplements and the dumping syndrome issue with cutting out sugar and fats as best I can, do you think it was worth the complications (gallstones, stoma obstruction, etc)? I did not experience complications. Also right after surgery, your body may reject fats and sugars because the part of the stomach that normally processes these has been cut away but as time goes on at about a year, your intestines will realize something is wrong and step up to the plate and your body will again be able to absorb these food types without dumping. I had a major sweet tooth prior to surgery and this contributed to my weight and to my diabetes. So I have to avoid sugars like a plague. I rely on natural no calorie sweeteners (such as stevia) and synthetic sweeteners (such as Splenda) to put the sweetness back into my life.