RNY vs Sleeve

[ICAWM]

I've been researching surgery for years and had my group session with Kings Hosp in March.

I have a BMI if around 48.

I thought that the RNY was the perfect combination of restriction vs malabsorption to help combat my large portion size and grazing, with great weight loss results. However I'm now seeing a lot of favouring of the sleeve and research says if has even greater weight loss results.

What are your thoughts on pros and cons for each procedure?

 

[marywithoutsound]

For me, I'm having the sleeve because it seems far less 'drastic'. I didn't like the thought of my insides being rerouted like in the RNY. Inside after my sleeve, I will still be 'normal', but just with a smaller stomach.

I also didn't like the thought that with a bypass, there would be things I could never, ever eat again. I know eating what I want to is what has got me into this situation, but, for example, I don't want to get married without a small slice of cake - which with dumping I wouldn't be able to do with a bypass.

It's worth bearing in mind that the sleeve can be changed into a bypass in the future, if you find a sleeve isn't enough!

 

[chrisa]

Hi I am 2 years post bypass, there have been lots of good results from both operations. I have heard people say that the sleeve is more painful afterwards than bypass, I didn't really have too much pain a little discomfort it was really. AS for eating things I can eat everything and yes you will always be watching yourself its all about moderation and healthy choices. I am maintaining now and my weight has stayed at 14 st 10. You MAY THINK THIS IS STILL HEAVY. I was 24 st 11 at the start and went down to 14 st 5lb just after Christmas but sibce then half stone has gone back on as my body has plateaud out now. There is nothing I haven't tried food wise, I still eat small portions, I do eat out, I bring some of it home. I do have cake but only a very small piece. I do dump from time to time but try to be careful the regular for me is a hot flush when I have had something with sugar ie a biscuit. My dumping is usually hot flush, sweaty sometimes palpatations if I eat more than I should. I once tried a snack size toffee crisp bout 6 months ago. Whooooa did it get me, I had palpatations, dizzy, profuse sweating, ha dto go in shower then nice sleep. Ver rare when it has gone to stomach cramps n diahorrea. Each person is unique and will be able to tolerate different things. But what suits the body one day might not the next. Any way enough of my ramblings its your decision, both ops are effective, the doc told me which would be best for me, all depends on how you eat, portion sizes, snack etc. xxxxx Good luck xx

 

[Sashie1977]

I had a sleeve converted to a bypass. I never wanted the bypass because I was too scared but since having both, there is no difference in recovery, scarring or pain. I dumped very badly with the sleeve whenever I had chocolate, cake etc but I haven't had any dumping at all with my bypass. I can eat anything, just less of it which is ideal for me. Each surgery is different for different people. Your surgeon will discuss your eating habits and will suggest the best surgery for you but ultimately it's your decision. Good luck xx

 

[ICAWM]

Thank you all.
Strangely I like the idea of the permanence of the bypass. No turning back. But I need to think long term.
Certainly giving me something to think about.

 

[tealovingsleever]

I love my sleeve. I think it only works on portion size though. If your diet is poor and you snack a lot it won't fix that.

 

[Jozefina]

Your surgeon will discuss your eating habits and will suggest the best surgery for you but ultimately it's your decision. Good luck xx

Absolutely this.

I also do regard my sleeve as permanant. This is it for me, now. Done!

 

[rudders]

I had also done tonnes of research and settled on the sleeve, however, after meeting my surgeon he pointed out that if I'm undertaking major surgery then why not have the best proven procedure which is considered the gold standard in WLS and he also gave a very high percentage of conversions he does from sleeve to bypass.
Hence I changed my mind and had the bypass. It's perfect for me. I don't dump but I eat small amount of anything.
Good luck with your decision.

 

[Madcatwoman]

I had the sleeve back in March but went in for a bypass! However I'm really glad I had the sleeve as there is no malabsorption, and I don't dump. I've lost 5 stone so weight loss is fine. I think everyone is individual though and I did choose the bypass because I thought the weight loss would be better. My choice was taken away but looking at the overall picture I would come down on the side of the sleeve now, as it has suited me so well. All the best with whatever you choose x

 

[ICAWM]

I had also done tonnes of research and settled on the sleeve, however, after meeting my surgeon he pointed out that if I'm undertaking major surgery then why not have the best proven procedure which is considered the gold standard in WLS and he also gave a very high percentage of conversions he does from sleeve to bypass.

Gold standard analogy certainly makes sense.

Is the RNY known as bypass? I thought it was a combination of bypass and something else.

Your comments are all appreciated, they're are definitely giving me the insight I craved.

 

[fjsinc]

I had the bypass (yes the RNY is a bypass), I didn't consider the sleeve because it wasn't an option at my chosen hospital. Sometimes I think I should have considered it though, knowing what I know now about wls. What I mean by this, is that real success comes from you (you still need self control and determination) and not the procedure you choose. The one thing about my bypass that worries me is the malabsorbtion of micronutrients. BUT I can eat anything I want, I have no problems (no dumping or sickness etc). I can have a bit of cake if I want. But I make sure that I have all the good foods that will nourish my body, because I know I need these for my health. And I have had no nutritional issues thus far.
Funny people say that they dont like the idea of their guts being rewired, because I'm fine with this. I didn't like the idea of a large part of the stomach being removed from my body (forever). The bypass can be reversed, its a difficult and risky procedure, but if the circumstances are dire, it is possible.
Its such an individual choice, and I think you have to go with your gut feeling (LOL).

 

[ICAWM]

Thank you, that helps - are you glad you can eat what you want? Were you surprised?

It's hard sometimes trying to explain why I think I need this operation.

I know I eat too much. I know diets do work if you stick to them. I know this isn't an easy option. I don't mind being rewired, as I know it will, in part, physically stop me eating some foods. Malabsorption sounds ok too although I'm not silly enough to think all calories will be untouched.

I will consider op as permanent. I just want to be slimmer and healthier. I want to be able to reclaim my life. I want to stop hiding my failures behind my weight. I don't want to be judged by others on my size, my health and restrictions, but I also want to stop beating myself up over it too.

 

[Sashie1977]

Thank you, that helps - are you glad you can eat what you want? Were you surprised?

It's hard sometimes trying to explain why I think I need this operation.

I know I eat too much. I know diets do work if you stick to them. I know this isn't an easy option. I don't mind being rewired, as I know it will, in part, physically stop me eating some foods. Malabsorption sounds ok too although I'm not silly enough to think all calories will be untouched.

I will consider op as permanent. I just want to be slimmer and healthier. I want to be able to reclaim my life. I want to stop hiding my failures behind my weight. I don't want to be judged by others on my size, my health and restrictions, but I also want to stop beating myself up over it too.

I'm glad I am able to eat what I want. Food is important to me. I am a chef and I am Italian so food features in my life every day!
I was told before I had the op I could eat anything but less of it. That to me is perfect. If I am told I can't have something, I crave it more. I have no willpower which is how I got myself into the mess I was in. I can now live a very normal life. When I had my band, life wasn't normal. I was too scared to go out for a meal, have a takeaway with friends or go out on a date in case I had to suddenly go and be sick. The fact I can go to a restaurant, have a starter and a dessert is perfect for me. I can go out with friends, and be normal! People who don't know about my op need never know because I eat the same as them just less of it. My team don't believe in dieting or counting calories which suits me too. I never wanted to be on a diet for the rest of my life. I am careful, I don't overeat and I don't eat a lot of the bad stuff. I don't drink alcohol and I cook with good food. I am pretty much at target. I have lost 7 1/2 stone in 8 months with 6lbs to go which is apparantly my excess skin although they think I have about 10-12lbs of excess.

Good luck with your decision. It will be the best thing you ever do! xx

 

[Yvessa]

I had the bypass. And I have to say I think diets don't work, because we're biologically wired not to stick to them. Chemically our hormones have far more control over us than we realise - I don't think anyone can understand the compulsion to eat that we are sometimes faced with if they haven't been there themselves.

Personally, I love my bypass. I do have a limit with sugar and can dump if I don't check labels, but usually I can eat whatever I want so long as I'm clever about it. I work pretty hard at it and am super happy with my losses today

I also was told that the bypass was the gold standard, but bear in mind part of that is because its the longest available and the surgeons will have perfected their technique. I do feel that the difference between the sleeve and the bypass is not as big as we are led to believe - the difference in losses tends to be an individual thing. Part of it is how committed we are to the lifestyle change, and part is how much our bodies are prepared to give up in all honesty. Our bodies are designed to store energy :/

It might help to do a weeks honest food diary and show it to your surgeon and discuss it with him. He will have seen hundreds of patients and will be able to best advise you.

But for me, I couldn't bear to be fat anymore. I was so ill by the time I agreed to go for wls (my gp had suggested it for a while) that I went for the most final, most drastic option available. In fact, I asked for the DS but was told they didn't do it because of nutritional deficiencies and the bypass was my best option.

As Fiona has said, ultimately its your choice. Whatever you go for, be confident with it and work with it and you will lose the weight.

 

[Ines4C]

Same here. I have the bypass and I'm very happy with it. I dump on high sugar and fat foods, and I'm glad I do as it keeps me from eating rubbish. But it all depends and it is really up to you and your team which operation you choose. Good luck with whatever you decide. X

 

[ICAWM]

I have to say I think diets don't work, because we're biologically wired not to stick to them.

I do feel that the difference between the sleeve and the bypass is not as big as we are led to believe - the difference in losses tends to be an individual thing.

Part of it is how committed we are to the lifestyle change, and part is how much our bodies are prepared to give up in all honesty. Our bodies are designed to store energy :/ It might help to do a weeks honest food diary and show it to your surgeon and discuss it with him. He will have seen hundreds of patients and will be able to best advise you.

I am due to see consultant on Friday. I was asked to do a weeks food diary, but I am doing two weeks. The first week, I've been on steroids as been ill, so hopefully it'll show accurately. As I'm not as work, it'll be skewed slightly.

I don't WANT to dump, but in my mind, it would help limit my intake. I also like the idea of eating in moderation. Sounds silly, but I feel like I don't have an 'off' switch or know when I'm full up.

 

[Yvessa]

I am due to see consultant on Friday. I was asked to do a weeks food diary, but I am doing two weeks. The first week, I've been on steroids as been ill, so hopefully it'll show accurately. As I'm not as work, it'll be skewed slightly.

I don't WANT to dump, but in my mind, it would help limit my intake. I also like the idea of eating in moderation. Sounds silly, but I feel like I don't have an 'off' switch or know when I'm full up.

I was exactly the same. And I didn't want to have dumping. But realistically it's good thy I know there's a limit and to be fair I'm not particularly restricted in what I can and can't have.