Buyers Remorse Re: WLS You Chose?

I am a newbie, wrestling with the oh so famous "VSG or Bypass" question.  I've done my research and I feel like I am close to making a decision.  I have spoken with 2 surgeons who led a support group I just went to.  One of the surgeons (the one who I chose to go with originally), told me that RNY is the "Cadillac" of WLS and that you can't go wrong.  Honestly in that moment, he did sound like a used car salesman - he's no longer my surgeon based on that comment alone.  The other surgeon, after hearing a little bit about me, said that he thought that I could go with either one and it would do very well for me based on what little he had just heard.  Obviously it would take more thought and personal consults with my surgeon, but I basically left thinking OK, I this decision is even more difficult now!  That said, I'm reaching out to hear anything you would be able to share if you are in a position post op where you think you may have not chosen the right surgery for yourself.  Do you wish you would have gotten VSG instead of RNY, or vice versa? 

RNY is widely considered to be the gold standard or Cadillac of WLS because it has statistically provided the best results and has been performed longer than any of the other surgeries (since the 1970s). As a consequence of its relatively long term history, there is a larger body of knowledge of the results, complications, effects of RNY as compared to the other surgeries.  RNY is an effective tool for many, many people but choosing the right surgery for you necessitates a thoughtful evaluation of your medical history and condition, your behaviors and attitudes and the professional advice of a qualified and experienced surgeon.

I don't think the first surgeon was sounding like a used car salesman in the least.  He was simply stating a fact that is widely accepted in the weight loss field. While communication is important, the surgeon's technical skills and experience are the primary reasons for selection.  What he/she does while you are in the operating room will impact you every day for the rest of your life. By comparison, you will most likely be dealing with the surgeon's communication skills for perhaps a total of 1-2 hours in increments of brief appointments over the first year or 2 post op. Just something to consider.

I'm quite happy with my RNY. I found a surgeon and clinic that I liked/trusted and worked WITH them to make the decision. Typically there are health and eating/food issues/history that point to one or the other. In my case sweets were an issue... I'm terrified of dumping and have decided to not test the waters to see at what point I will dump. Approaching a year out, I am at my goal weight.  

Your results may vary... work closely with your clinic professionals to make the best decision FOR YOU. 

You're going to find all sorts of passionate positions here on OH as to the best type of surgery to get, including the DS which you are not asking about. But all you can get here is personal opinion and anecdotal experience, which can be useful but are not sufficient. We are none of us Bariatric surgeons and you should take that into consideration, and use your surgical consults as the basis on which to make your choice.  

All of the types of weight loss surgery have their benefits and disadvantages- there is no perfect one. They also have differing levels of extensiveness and risk. They have differing levels of possibility of complications. They have different risk factors. Also, everyone is built differently and has different needs one from the other, so the type of surgery you choose will depend on that. You have to live with whatever your choice is.

There is no right answer, no magic surgery that is going to handle things forever. The body changes are permanent and irreversible with the sleeve, the RNY, and the DS. Some of the surgeries can be reversed or revised, but the damage and scarring will always be there. There is the risk of complications, both short and long term.  

Any weight loss surgery is only good if you work it- it requires tremendous changes of habit and daily attention with managing it- diet, exercise, daily vitamins. It takes the weight off; maintaining the weight loss will be up to you. Habits simply have to change in order for any weight loss surgery to be effective over the long haul.   

The gift of WLS is the weight loss and the small tummy afterward. It takes work, but it happens. The small stomach will still be available, but it will only be a tool and can be worked around so easily.  

After the losing part comes maintenance, which I assure you is no walk in the park- for me it is as hard as dealing pre-op was. That is forever. Plus all of the surgeries can be and often are sabotaged with subsequent regain.  

The RNY and the VSG are similar with their statistical results. The VSG is not good for GERD and is irreversible. With the RNY you lose your pyloric valve and can't take NSAIDs, and it can be reversed if necessary. So it is a trade off, and you will have to figure out what best fits you- again, through professional consultation.  

Am I grateful for my RNY now 3 ½ years ago? You better believe it! I had severe GERD, so it was the right choice for me. Plus I was ready to make the changes needed. I lost and have kept off half my former body weight. My health is so much better. I manage myself well, eat right and I exercise regularly. I am entirely happy living in my shoes these days. And I am not about to blow the gift of weight loss my surgery gave me.  

So again, please make sure you consult Bariatric surgeons and attend info sessions as the main part of your research. Find the one you trust and feel they have your best interests and needs first and foremost.

I would also suggest looking into as many different sources of information as you find including books, internet, and support groups, as well as reading the different forums here. You can also keep posting with your questions.  

Good luck making your choice, and have a rewarding, life changing journey! I don't think you will regret it.  

Thanks for the encouragement - I get that it's totally personal and trust me, all I do is research these days.  Not so much asking for advice on how to pick the surgery type, but just curious if there are people online who wish they would have chosen a different surgery and why.  I think that this site is great for getting POV from those who've experienced what I'm about to experience.   

You're so right, about finding out personal experience here- trust me, you'll get lots of it! And I'm glad to hear the research part. You might want to post your question on both the RNY and VSG forums here.

You can find some insight on this on the failed and revision boards here on OH too. Good luck in whatever you choose!!! 

I had RNY over six years ago, when sleeve was not an option. Based on my BMI of almost 57, I would have been a good candidate for DS, but I didn't like the idea even of the RNY bypass let alone the DS bypass (my concern is not just with vitamin issues now, but once I am elderly and my body is naturally much less efficient at absorbing nutrients), but sleeve wasn't an option back then and the surgeon (who did all 3 surgeries) said there was no way I would lose almost 200 pounds with the band.  So I had RNY.

I have been happy with the results (I would like to be 5-10 pounds lighter, but have a body fat % of 24, so am happy whet I am 95% of the time), and am maintaining my loss, but if I were doing it again, I would have the sleeve.  IMO, trading the potential vitamin deficiencies (and having to take pills 5 times a day every day) and the inability to take NSAIDs with RNY isn't worth the 18 months of somewhat faster weight loss while there is some caloric malabsorption.

After 2 years, the process of maintaining is basically the same, because then they are both essentially restrictive only surgeries (yes, a small amount of malabsorption remains with the RNY but very little), but with the RNY you still aren't absorbing all your vitamins.  So, after 2 years you lose the advantage of RNY but are stuck with the disadvantages.

The sleeve also doesn't carry the increased risk of kidney stones and reactive hypoglycemia (or even regular hypoglycemia) that RNY does.

Both are effective surgeries for people who are willing to be serious about changing their eating habits, and people can easily fail with both surgeries. It really depends on what is important to you, and which surgery will work best for your particular food issues.

Good luck with your decision.  

Lora

Lora thanks so much for sharing! The concerns you list are what I think about most. Arthritis has been a problem for the women in my family. Im 41 now and pretty healthy on paper, but worried about down the road.I thimk the malabsorption and nsaid restrictions are the biggest fear factor for me. Very helpful perspectives given!

If you have arthritis, or think you're likely to develop arthritis, you're going to want to be able to take NSAIDs. That pretty much rules out the RNY. I've had extensive arthritis since I was 20, so when I was choosing a WLS at 45 I knew I really needed to factor that in. I chose the DS for that and many other reasons, and I've had zero regrets. I take Aleve morning and evening, every day, and have for about 25 years now. (I'm 55.)