gigiwalter1

RNY vs. Sleeve...can't decide!

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Hello All,

My name is Angie and this is my first post here. I just went to my orientation seminar last night but on July 3rd I will have 3 of my 6 month PCP supervised visits done. So I like to think I'm halfway there! Anyhow, I had originally had my mind made up that I wanted the RNY but the more research I do and the more reading of forums here I'm starting to lean more towards the sleeve. Actually, I keep going back and forth. As bad as it might sound the malabsorption aspect of the RNY and food restrictions is one of the reasons I was leaning that way. I feel that this would help me more in the long run. A way to keep me on track that the sleeve wouldn't provide. Any input on why you chose the surgery you did would be appreciated. 

 

Thanks!!!!!

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You should take into account if you want/need to take NSAIDs post op. And, how you feel about alcohol. If you don't drink or can give it up forever, either is a good option. If you want to be able to drink in moderation from time to time, the sleeve might be better for you. I have a sleeve and I love it. But, most people here are happy with the surgery they chose. Welcome to TT and good luck with your decision. 

 

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Honestly in the long run it's less about which surgery you have and more about working the plan and staying on track.  That is the truth.  I love my sleeve, that is also the truth :)

I chose the sleeve because I wanted to preserve the normal function of the GI tract.  Yes, they removed 80 % of my stomach permanently which is not normal but of the 2 I liked the idea of normal function better.  I also couldn't imagine a life without NSAIDS although at normal weight I don't need nearly the ibuprofen I used to! 

Diabetics get a faster return to normal blood sugar with bypass and no issues with reflux so if you have either of those issues you should strongly consider bypass.  Do your research, talk with your surgeon make a decision and go for it.  You are on your way to a gloriously healthy new life, whichever route you choose!

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42 minutes ago, gigiwalter1 said:

Hello All,

My name is Angie and this is my first post here. I just went to my orientation seminar last night but on July 3rd I will have 3 of my 6 month PCP supervised visits done. So I like to think I'm halfway there! Anyhow, I had originally had my mind made up that I wanted the RNY but the more research I do and the more reading of forums here I'm starting to lean more towards the sleeve. Actually, I keep going back and forth. As bad as it might sound the malabsorption aspect of the RNY and food restrictions is one of the reasons I was leaning that way. I feel that this would help me more in the long run. A way to keep me on track that the sleeve wouldn't provide. Any input on why you chose the surgery you did would be appreciated. 

 

Thanks!!!!!

HI @gigiwalter1 Perhaps I misunderstood your post, but you will have volume restrictions with both kinds of surgery. There are some scientific studies that I think were quoted in some posting a couple of months ago... somewhere around 10% of the weight loss people have with a bypass is due to malabsorption. Some studies then suggest the intestine adapts and the malabsorption element decreases, at least for some nutrients, over time. 

I had a sleeve, but easily could have chosen a bypass. You can be successful with either. My logic was:

First: I was quickly heading to disability, and was pre-diabetic and borderline hypertensive with worsening sleep apnea and terrible orthopedic problems due to weight. The low risk of surgery was much lower than the high risks of remaining obese with these problems. Solution: have surgery since there is a high rate of success with it. The success rate for dieting is < 1%. 

Second decision point - I didn't have diabetes --> therefore sleeve or bypass okay. (Bypasses are better at ameliorating or curing diabetes).

Both kinds of surgery are safe - less risk than having your gallbladder removed electively. Mortality risk is ~ 1 in 1,000 for a sleeve, about 2 in 1,000 for a bypass (these are round numbers, your surgeons may have different ones).

Third decision point: Even though the difference in risk is very small, I chose the sleeve to minimize risk. Plus I didn't want to deal with malabsorption. 

- The percentage of excess weight lost after a sleeve is a bit less than that seen with bypass. 

- People who exercise, even relatively minimally, end up with a lower BMI than if they did not exercise, based on about 10 studies. The difference is 2 BMI units. My BMI varies between 25 and 26, and I get some exercise: without it, I am statistically likely to have a BMI of between 27 and 28. 

Fourth decision point: Get some exercise, as this will tend to get me to about the same weight I would achieve with a bypass and no exercise. 

[Exercise is critical to an healthy life; people who do not exercise have more heart disease, strokes, and shorter lifespans. So the decisions outlined above are those just relating to weight loss surgery. Not getting exercise is NOT compatiable with an healthy lifestyle, in my opinion, but it is NOT critical to weight loss after surgery].

... and as @cinwa writes, no reflux after bypass; use of NSAIDs after sleeve; and rapid uptake of alcohol after a bypass are also issues that could affect your choice.

Hope this helps...

Edited by BurgundyBoy
reference to cinwa

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I honestly could have gone either way - I had no strong reason for one procedure being the obvious choice for me. I had quite a bit to lose, though, so opted for the procedure that looks like it has a slightly greater statistical loss rate: RNY. In the end, I’m pretty sure I would have been happy with either one, though. I think it’s more about committing to the lifestyle changes than anything - there are so many here who have seen success with either of those two options. In the end, most people report being happy with their choice, whichever of the two they go for! :) 

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The good news is, it really doesn't matter all that much. You can be successful with either one. I wanted the unused stomach removed, didn't want to mess with my intestines, and didn't want to live without NSAIDs. So, the sleeve was for me. 

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I was diabetic so bypass for me:). Either surgery can be successful.  And on the down side, you can fail either surgery.  I’m a firm believer it’s all about what you put in your mouth.  You will have to make good choices and learn a new way of eating.  Many times I have to tell myself I don’t need something.  Sometimes I feel the good angel of food on one shoulder and the junk food angel on the other, I know I’m crazy..

btw- welcome!  This is a great bunch.  Feel free to ask any questions, we’ve all been there..

Edited by Cheesehead

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I wanted to say thank you to all of you for your input. Lol I’m still undecided though. Luckily I still have time to decide. I haven’t had my appointment with my surgeon yet so I’m sure he’ll be able to guide me too. Not that y’all don’t know what you’re talking bout....I just like all the knowledge I can get! Thanks so much and keep those opinions coming!!! :D

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7 hours ago, gigiwalter1 said:

I’m sure he’ll be able to guide me too

Since he knows your medical situation, he will be the best guide. I think you're still undecided for a good reason: there's not an obvious "best" procedure. People are happy with both and successful with both. That should put your mind at ease - there isn't a wrong answer :) 

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You will find a lot more on this topic here:

I had a RNY gastric bypass about five years ago, and I have never regretted my choice.  It allowed me to lose all of my extra weight, and then maintain at my goal weight since then...

While both surgical choices are good ones, there are important differences between the surgeries and you, as an informed consumer, should make the choice that is best for you.

To be clear, on one issue raised above I had a gastric bypass and still drink a glass of wine most nights - so having a gastric bypass does not mean giving up alcohol for the rest of your life.  

We are here to support you in whatever choice you make.

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