anybody 4+ years post-op?

i'm not finding a lot of long term data on VSG success so i thought maybe you guys would have some anecdotal info to share :) if you had the surgery some years ago, how do you feel? are you happy with your weight loss? how much have you regained? would you recommend VSG to someone just looking into WLS?

i'm in the "looking into it" stage and can't decide what is best. i like the possibility of dumping syndrome with RNY, but don't like the malabsorption of vitamins.. VSG might be a great idea but i don't know whether it has similar long-term success.

You may want to post this on the maintenance board.

Here's the thing: pretty much any WLS is NOT fool proof. My uncle had the RNY a few years before I had my VSG. He has regained a ton of weight - not all - but at least half. He eats around his pouch and he has stretched his pouch out by continually over eating. He dumps regularly - pretty much daily - but it doesn't stop him from eating the crap and carbs he eats. He just goes and takes a "lie down" to get over it. At Thanksgiving I couldn't believe what he put on his plate and then later he ate the biggest piece of sugar free pie (brought by me for me and my diabetic brother in law) because he was so excited to have a sugar free dessert.

Also, not all RNY patients get dumping syndrome. You shouldn't count on it.

I'm only a year out, so I won't relay my experience, but I do know of RNY and Sleeve patients that are 4 and 5 years out and they are all doing well. Overall, my VSG friends are far thinner and healthier than my RNY friends. No science there, just personal observation.

There are papers out there that really tout the retention of the pyloric valve as the new gold standard in WLS. VSG is showing similar and even better results than RNY in a few short term studies that have been done.

I am approaching 5 1/2 years out from my VSG. I feel great, lost to a BMI of about 22 and have not regained. However, it does take work. I am careful with what I eat and exercise 5X/week. We generally don't malabsorb our vitamins, though some of us have trouble with B vitamins (because there is not as much stomach to absorb them) and and I know of others who have had some difficulties with protein absorption. For me, the VSG has been the perfect surgery. I know others who were sleeved in my time range and most are doing well. Many have regained a fairly small amount of weight but most are maintaining in a healthy range. A few have regained significantly.

How much weight do you have to lose? If you feel that you may need malabsorption, I would recommend that you consider the duodenal switch, which is a much more logical and powerful surgery than the RnY. It gives you the same fully functioning stomach as the VSG, preserving the pylorus valve, and a powerful malabsorption component that doesn't go away like the RnY. However, you would need to be EXTREMELY vigilant about supplementation.

Lizanne

thank you for your responses. the DS is not available in my area, so it's either sleeve or RNY :) i really don't know if i want malabsorption - if VSG alone will be effective ten and twenty years from now that's what i'd rather, but if it's not going to be effective i'd want to go with something that is.

going to another area is not an option, i need the surgery to be covered by my health plan locally.

The sleeve is as effective as you make it.

My husband is 3 years out (actually it will be exactly 3 years for him tomorrow) and he can eat considerably more than I can at 9 months out.  However, he's also in the gym several evenings a week, and his current goals have more to do with building muscle than with losing weight.  He has lost over 200 pounds and has kept it off with little effort beyond exercising and making sure he is eating the right foods 99% of the time. 

However, as with any other tool, this is not magic.  None of the surgeries are.  He and I could both drink milk shakes all day and be back up to our starting weights in no time (actually, this isn't entirely true... I do get sick in a fashion similar to "dumping syndrome" when I have too much sugar at a time, so in that regard I can only cheat so much). 

Ultimately, it has to be up to you, but I wouldn't trade my sleeve for anything.

My boyfriend had his surgery over 3 yrs ago and lost over 300 lbs. He's a huge advocate for surgery and would tell you to go for it. He is still loosing, feels great and can't eat what he wants most days and maintain his weight. Its changed my life (only a year out) and I wish I did it YEARS ago!

I am 3.5 years out and I would certainly do it again.  I lost my weight in about six months and have maintained ever since.  It is not always easy.  Yes, I can eat more than I could at six months, but not anywhere near what I could pre-surgery.  I have to tell you that I have lost and regained weight prior to VSG and this feels very different.  I really do believe that I can maintain my weight ( I am 105 lbs. ) through staying vigilant and committed.  It is not easy, but it does feel doable.  If you look at the stats for RNY, they are not so great in the long term.  The truth is, this is just a tool, a great tool, but only a tool.  You still have to do the heavy lifting.  Most of the people that stay successful long term with any WLS have done a great deal of work on changing behaviors and habits in the long run, exercise and watch what they  eat.  Sort of like most naturally thin people do.

your success is inspiring elina :) i've been reading your posts.

i am well aware that WLS is only a tool.. surgery or no i am going to have to do hard work to change thoughts and behaviours. i just would like the most effective hammer in the toolbox, kwim? :)

Like you, I considered both VSG and RNY, and thought RNY might be a good idea for me because of the dumping - I thought I might need an additional nudge to keep me on the straight and narrow because I have a monster sweet tooth.  I ended up going with VSG for a number of reason, and at 18 months out I'm glad I did.  Most RNY patients find that the caloric malabsorption adjusts after the first few years, so they have to make additional adjustments to maintain their weight.  I believe this is why some regain is so common with RNY.  Also, when I was thinking of dumping, I was thinking of things like cookies and chocolate.  I was not thinking about how easy it is to get a nasty surprise with something unexpected - peanut butter, or a condiment for example.  I think with RNY you have to be a lot more careful reintroducing foods until you know how you'll react to them.

I have continued to struggle with my monster sweet tooth, but I believe if you're enough of an "addict", you'll continue to eat it even if it makes you feel ill.  I was certainly capable of eating to the point of nausea pre-op!

I've found that a combination of low-carb, high-protein, and natural supplements helps me keep my addiction to carbs and sweets under control.

I lost 113% of my excess weight before running into serious trouble with "recreational sugar", but I've got that back under control and am making good progress towards getting back to my lowest weight.  It can be done, but as you already know, it takes work and commitment, regardless of which surgery you choose.  I suspect RNY might have gotten me to my lowest weight a little faster, but it would have set me up a bit for a need to adjust when the malabsorption of calories declined, and I honestly don't think it would have saved me from my face-plant into sugar. 

One last note - Sleevers don't have malabsorption of vitamins to the extent that RNY patients do, but you still have to stay on top of your vitamins.  We can still develop deficiencies - calcium and B12 are well known.  I developed a serious Thiamine deficiency post-op, and though it's not a common experience, I've seen several others on the boards that have as well.  Commit to taking good quality bariatric vitamins long term - it's just common sense, and well worth the investment.