New to WLS

[Ed_NW 684]

Hi all. I'm just now at the required weight and need to go weigh in and schedule surgery. Still haven't spoke to the surgeon about which procedure is best. I'm thinking RNYGP. Any thoughts?

Ed

[James Marusek 5,244]

Generally if you have severe acid reflux (GERD) then RNYGP is the best approach because the sleeve will only make that condition worse. Many individuals with GERD who opted for sleeve surgery had to have a revision to RNYGP afterwards because it made that condition unbearable.

[Ed_NW 684]

Generally if you have severe acid reflux (GERD) then RNYGP is the best approach because the sleeve will only make that condition worse. Many individuals with GERD who opted for sleeve surgery had to have a revision to RNYGP afterwards because it made that condition unbearable.

Thanks for your reply. I've never had any problems with acid reflux but my concern with the VSG would be the possibility of stretching the sleeve due to my food addiction. In a lot of the videos I've watched, people experienced regain and ended up getting another surgery to switch over to the RNYBP. My only concern with the RNYBP is the possibility of vitamin/nutrient malabsorption. I have a tendency to overthink things haha [emoji16]

Ed

[James Marusek 5,244]

Prior to surgery I had a number of health issues and as a result, I took 5 types of prescription medicine daily. Those health conditions were resolved by the surgery. But because of the surgery I have to take a variety of Vitamins daily for the rest of my life.

So cost wise, the vitamins are less expensive and more readily available than the prescription medicine I was taking. (Since I had the surgery 5 years ago and because the cost of some of these prescription medicines have shot through the roof in this time - the cost of the vitamins are dramatically cheaper now).

It is common for some individuals to gain weight after they bottom out in their weight loss. It is called the 20 pound bounce. But if you adhere to the program guidelines, you should be able to keep this under control. Generally the surgery RNY or sleeve permanently modifies you stomach. You do not stretch your sleeve or RNY stomach. The tool is still there. If you gain too much weight back you can apply the guidelines and drop the weight.

[Ed_NW 684]

Prior to surgery I had a number of health issues and as a result, I took 5 types of prescription medicine daily. Those health conditions were resolved by the surgery. But because of the surgery I have to take a variety of Vitamins daily for the rest of my life.
So cost wise, the Vitamins are less expensive and more readily available than the prescription medicine I was taking. (Since I had the surgery 5 years ago and because the cost of some of these prescription medicines have shot through the roof in this time - the cost of the vitamins are dramatically cheaper now).
It is common for some individuals to gain weight after they bottom out in their weight loss. It is called the 20 pound bounce. But if you adhere to the program guidelines, you should be able to keep this under control. Generally the surgery RNY or sleeve permanently modifies you stomach. You do not stretch your sleeve or RNY stomach. The tool is still there. If you gain too much weight back you can apply the guidelines and drop the weight.

Makes perfect sense. Thank you.

Ed

[SteveT74 360]

I agree with James. There can be some temporary stretching of the RNY pouch or sleeve if you over eat, but the idea that the pouch or sleeve can be permanently stretched out is urban legend based on outdated theories. What does happen is that over time, your hunger can return (this can take 5 years to happen with RNY and 3 years or so with Sleeve). The stomach capacity, however, remains where it was at the time of surgery and you still get full with small portions. People can then defeat the benefits of surgery by eating bad foods more frequently, slider foods (milk shakes, potato chips etc.) or by over eating (which ends up resulting in stacking food in your esophagus--which is bad for many reasons). Surgery is just a tool so if you don't use the first couple of years post-op to change your bad lifestyle habits, weight regain is possible (even likely).

As for the bounce, that's a normal part of the process. The surgery changes your set point weight, so your body thinks it's suppose to weight 190 pounds instead of 300. This is called the set point theory--which is how your body maintains a certain weight. When you're on your way down the scale post up, you'll likely drop below your new set point if you follow the new dietary guidelines so you might hit 170 or 180 at your lowest. You'll then gain some weight back and stabilize at your new set point (190). In truth, if you follow the guidelines and do your part, you probably aren't "regaining" weight in the first year or two post op. Your body is just adjusting for your new set point. If you don't follow the guidelines and you eat the the wrong foods, your weight game can be genuine and that's issue. If you're working with a nutritionist (which will be required as part of post-op care), you'll know if you're going out of bounds with the food. If you have RNY, you'll probably get that info every time you have a dumping syndrome episode.

[Ed_NW 684]

Great information. Thank you