Quality/enjoyment of life with sleeve vs RNY

[E-mom 10]

I'm trying to decide between the sleeve and the RNY. I am retired and don't want to destroy my outlet of socializing with friends. Once you have healed up is there a difference between those two surgeries and being able to enjoy food and drink? Of course I expect limits on what and how much I ingest and I understand the dumping syndrome. My question is about enjoyment. I like the greater longevity of the RNY but not if I can't travel easily or go out and socialize without feeling deprived. Thank you for any insights into post WLS life.

[ShoppGirl 5,056]

I am six months out from the sleeve and I have enjoyed everything I ate preop. With RNY you are far more likely to dump than with the sleeve as you stated with sugar and grease but not everyone with RNY experienced dumping syndrome.

[Tomo 1,196]

No dumping here but then again I don't eat cakes, candy, sweets. It basically (to me) feels the same as when I had the VSG except that there is far more restriction. I feel great.

[catwoman7 11,223]

honestly, they are pretty much the same as far as lifestyle and eating go. I do pretty much the same things I did before surgery, other than I eat less now. I love my bypass and I'd choose it again if I had to make the decision today. But there are definitely fans of both surgeries, and the "after life" is pretty much the same.

P.S. with both surgeries, there are a lot of restrictions the first couple of months - but once you're a ways out, there really aren't any food restrictions with either surgery.

Edited September 26, 2021 by catwoman7

[waterwoman 183]

I had RNY and consistently go out with friends and enjoy food. My surgeon really discouraged alcohol, but I still have an occasional drink.

[E-mom 10]

Thank you all for the information and reassurance.

[RickM 1,753]

As others have indicated, there isn't a lot of difference, once beyond the first few months' transition period, between the two as far as eating and socializing. We eat out monthly with a group of DS patients (somewhat more extreme malabsorption than the RNY - no dumping tendencies but sometimes reputed to be worse on potential bathroom issues) and you can't tell who is who - DS, RNY, VSG or no WLS. There is a transition period the first few months or year where the body is adjusting to the changes, both physical and dietary, where GI issues are not uncommon (do a search for the Al Roker White House SHART story; yeah, he pooped himself at the WH.) The VSG leans more toward Constipation for a while (RNY can, too) but that's primarily from the limited diet - lots of Protein and minimal carbohydrate/fiber and fats to keep things moving,) Fiber supplements are the order of the day for a while, and Probiotics can help with general adaptation of the gut.

The RNY will be somewhat fussier on supplement need, all things being equal, to counter the malabsorption. That usually isn't a problem if people are reasonably diligent on such things, but can be problematic if one tends toward being overly casual on such things. Some things may not respond to normal oral supplements; infusions to maintain Iron levels are not unusual with the RNY (or DS) but are uncommon with a sleeve. You may run into medication tolerance issues - NSAIDs are the most common class of drugs that are sited (a big NONO with the RNY, but a better tolerated little nono with the sleeve or DS) but one may run into other drugs during ones life that may be restricted with the bypass (some of the osteoporosis drugs come to mind.) Other things that may be of concern, particularly as we get older, that aren't specifically lifestyle oriented are some common medical treatments and diagnostics are off the table with a bypass - owing to the blind remnant stomach and upper GI, a number of common endoscopic procedures aren't available (they're available by normal surgical means, but not endoscopically.)

You mention longevity, which I assume you are referring to longevity of weight loss or resistance to regain. From what I have seen over the years, there doesn't seem to be a significant difference between the two - people seem to be as prone to major regain problems with either, to a roughly equal degree. The caloric malabsorption of the RNY tends to dissipate after a year or two, so metabolically, one is left in about the same position as one who had a sleeve (though the bypass patient may have lost weight a bit more easily.) To get a significant difference in regain resistance, one needs to look into the DS, particularly the "traditional" BPD/DS. It has a somewhat different set of trade offs, but is worth considering (particularly since the bypass is so difficult to revise if it doesn't yield the desired results.)

Good luck - lots to think about, and none of it is easy!

[E-mom 10]

RickM thank you for your thoughts. Some of which I had not considered before. I have only the two choices with my medical plan. I'm adding to my list of questions for the Doc once I get that appointment.