Sleeve or Bypass?

[Swanton_Bomb 522]

I'm about halfway through my pre-op requirements and I'm still debating between the sleeve and bypass. I like the idea of the sleeve because of the reduced gherlin/hunger, less time on the operating table and no malabsorption of nutrients. I am afraid of it being too easy to eat too much, and I'm afraid of the reflux. As for the bypass, I like the idea that it might result in better long term results, no reflux and no tolerance of sweets, but I'm scared of it being extreme and I'm scared I will lose even more hair than I would with the sleeve. My BMI is 43, same as my age, and I've been big my whole life. Any advice? How did you choose your surgery?

[Matt Z 4,139]

28 minutes ago, Swanton_Bomb said:

I'm about halfway through my pre-op requirements and I'm still debating between the sleeve and bypass. I like the idea of the sleeve because of the reduced gherlin/hunger, less time on the operating table and no malabsorption of nutrients. I am afraid of it being too easy to eat too much, and I'm afraid of the reflux. As for the bypass, I like the idea that it might result in better long term results, no reflux and no tolerance of sweets, but I'm scared of it being extreme and I'm scared I will lose even more hair than I would with the sleeve. My BMI is 43, same as my age, and I've been big my whole life. Any advice? How did you choose your surgery?

First and foremost, there is no surgery that guarantees your hunger will be reduced, none.
Also, not everyone gets dumping syndrome, not everyone loses their hair (I haven't, and I'm over 4 months out now). You see a decent amount of folks getting revised from the sleeve to the bypass.

The bypass isn't as extreme of a surgery any longer. I was afraid of it when I first started my whole process, back in 2010 when I was 370. I chose the band, because it was removable, there was no malabsorption, etc. What a mistake. I spent years trying to get things to work... and in the end, I has the band removed and revised to the bypass. I can say that, I can't feel the changes. I don't have a major hunger sensation at all. I don't feel full exactly either but I do get to a point where the act of eating just doesn't interest me any more... so that coupled with proper portion sizing gets me to "full".

Time on the table isn't a guarantee either... actually from an outside view, you'll have a hard time telling which person had which surgery based on surgery time and incisions.

At the end of the day, you have to pick what's right for you. If you've got reflux/gerd issues now, then the sleeve is going to potentially make that much worse. For me, the sleeve wasn't an option due to the scaring from the band. But, overall, I'm super glad I did the bypass. The malabsorption isn't really that hard to overcome with just a new daily morning routine. Sugar intolerance isn't really even much of a problem for me either... to my dismay... because I WANT to not be able to eat the crap I shouldn't be eating.

At this point, potential losses between the 2 are very close, with the bypass having a higher loss and higher % of keeping it off vs the sleeve, but the differences are slight.

Good luck with your choice. For me, I'd chose the bypass over the sleeve.

[Swanton_Bomb 522]

Thank you for the info. So much to think about. Six months seems like an eternity but with so many decisions I guess it's a good thing in a way.

[Briswife15 890]

Wow, I could have written your post! I am 2 months into my 6 months of requirements. I started off wanting the bypass because I have GERD, but I take some meds for depression which may not be absorbed properly with the bypass, so in that sense the sleeve would be better. I'm so conflicted, but still leaning towards the bypass. Good luck with your decision!

Sent from my SM-N950U using BariatricPal mobile app

[Bryn910 519]

7 hours ago, Matt Z said:

First and foremost, there is no surgery that guarantees your hunger will be reduced, none.
Also, not everyone gets dumping syndrome, not everyone loses their hair (I haven't, and I'm over 4 months out now). You see a decent amount of folks getting revised from the sleeve to the bypass.

The bypass isn't as extreme of a surgery any longer. I was afraid of it when I first started my whole process, back in 2010 when I was 370. I chose the band, because it was removable, there was no malabsorption, etc. What a mistake. I spent years trying to get things to work... and in the end, I has the band removed and revised to the bypass. I can say that, I can't feel the changes. I don't have a major hunger sensation at all. I don't feel full exactly either but I do get to a point where the act of eating just doesn't interest me any more... so that coupled with proper portion sizing gets me to "full".

Time on the table isn't a guarantee either... actually from an outside view, you'll have a hard time telling which person had which surgery based on surgery time and incisions.

At the end of the day, you have to pick what's right for you. If you've got reflux/gerd issues now, then the sleeve is going to potentially make that much worse. For me, the sleeve wasn't an option due to the scaring from the band. But, overall, I'm super glad I did the bypass. The malabsorption isn't really that hard to overcome with just a new daily morning routine. Sugar intolerance isn't really even much of a problem for me either... to my dismay... because I WANT to not be able to eat the crap I shouldn't be eating.

At this point, potential losses between the 2 are very close, with the bypass having a higher loss and higher % of keeping it off vs the sleeve, but the differences are slight.

Good luck with your choice. For me, I'd chose the bypass over the sleeve.

All of this!! I agree

and I am a revision of sleeve to bypass.

had the GERD, hunger was there, I could eat full plates of food, lost the hair with the sleeve

had the bypass and my recovery was easier, I can still tolerate sweets (the sugar free ones I have tried), never hungry (for now lol) and I have already lost more weight my revision of bypass than I ever did with my sleeve.

discuss your concerns with your doctor and get feedback from him/her. Not every surgery is cookie cutter. The sleeve was part 1 of the 2 part bypass years ago and many have found the sleeve to be successful enough. The bypass is a safe surgery.

again, this is MY personal opinion/feelings. You gotta do what’s best for you. Good luck in whatever you choose

[Swanton_Bomb 522]

This is what I am really confused about: hunger and gherlin. That is what made the idea of the sleeve seem so attractive, since with the bypass your stomach and fundus remain. It seems like torture to be constantly hungry but have a pouch the size of an egg. A lot of people say though that the absence of hunger is brief. I'm so conflicted and confused. Thank you all for answering my questions that I have been posting recently.

[Frustr8 7,886]

As the old carnival barker said
You pay your money---
You take your choice---
Think about it, pray about it, consult your surgeon and his team
In the long run the decision will be yours. Since there are seldom do-overs, unless sleeve/band to bypass, make sure it is a decision you can live the rest of your life with.
I chose a RnY bypass myself but it is doubtful my reasoning would be the same as yours. Maybe that is why in the US insurance companies frequently mandate 6 months so you have time to think thinds over!

[maureenmurphy 0]

My Dr. Gave me 27 pages from www.uptodate.com medical outcomes following B S. Some is over my head but helped me decide.

Sent from my LG-K373 using BariatricPal mobile app

[Frustr8 7,886]

A facet to consider;
Would you prefer:
A stomach the size of a garden hose?(VSG)
or would you prefer:
A stomach the size,of a large chicke-small turkey egg (RnY bypass)
Either way YOU will never be quite the same
But for most of us it is a choice We Gladly Make
For it is far better to be gastrically rearranged , surgically altered , abdominally realigned than to continue living sick, obese and inching daily closer to a sad undignified sorrowful death.
And That, My Dear Friend, Is The Bottom Line.😪💦😪

[Matt Z 4,139]

On 7/27/2018 at 9:55 PM, Swanton_Bomb said:

This is what I am really confused about: hunger and gherlin. That is what made the idea of the sleeve seem so attractive, since with the bypass your stomach and fundus remain. It seems like torture to be constantly hungry but have a pouch the size of an egg. A lot of people say though that the absence of hunger is brief. I'm so conflicted and confused. Thank you all for answering my questions that I have been posting recently.

I can tell you right now, as a bypass patient, I'm not "constantly hungry", I'm over 4 months out since surgery, and I won't say I don't have some level of hunger, I have to remind myself to eat most days. Everyone is going to be different, but I haven't seen or heard of any bypass patients that are "constantly hungry".

[AtlantaRed 651]

I am converting to bypass from sleeve. I had no issues, could eat, was hungry. hair falls out with most surgeries, but tends to cycle back back once your Protein is up. I'm 45, clearly I've tried eating less and exercising to lose weight (which is basically the sleeve). For me, I maybe should have considered that in the beginning and had the bypass for the added malabsorption benefit. No guarantee to won't tolerate sweets. Best thing to do is don't try to find out!

[Neri 73]

I haven't had my surgery yet, but I've decided to go with the sleeve. For me personally, I like the removal of part of the stomach and reduced ghrelin. Also, I like the idea that if later down the line I want to switch to the bypass, I can.

[bariatricbride 11]

So, I am also debating between surgeries. My surgeon said that I can't go wrong with either RnY or Sleeve, and my dietitian thought RnY might be a better option for me. I had gone in to my information session convinced on the sleeve based upon my 2+ years of researching bariatric surgery, but now I'm at a standstill and leaning more towards RnY. Statistics on RnY show more weight loss (average of 60%-80%), in comparison to sleeve (capping on average about 60%). However, the sleeve seems less invasive (not rerouting your intestines). There are pros and cons to both surgeries for me, personally. If I got the RnY, I would have to find a different medication to manage my headaches and other pain besides NSAIDS. If I got the sleeve, there is a possibility that my acid reflux would get more persistent.

I wish my surgeon would tell me which surgery would be better for my circumstances; my pros and cons list is not helping me decide! He seemed sort of nonchalant about the options I had!

[Nesa 51]

I got the sleeve 4 years ago. It was best for me personally. I still feel restriction so I can’t eat too much but I became a stay at home mommy and started to graze I’ve stopped that though. Also with the sleeve you can enjoy something sweet once in a while with no dumping syndrome. The recovery was easy and fast. My hair fail off but not too much since 4 months before surgery my Nut had me on 10k of Biotin so I think that helped. I had no acid reflux no gerd. Again this is from my personal experience everyone’s is different. Good luck!

[_Shane_ 63]

If I had to choose between the two myself, I'd go with the bypass. Far less chance of reflux, better remission of morbidities like diabetes, and possibly better long-term weight loss.

Edited August 9, 2018 by _Shane_