Roux vs Sleeve

Wow, this is a can of worms. It's like asking which people prefer more, GMC, Chevy or Ford. I had an RNY 11 years ago, I also had a lot of chronic and autoimmune conditions. Do I occasionally get sour stomach, yes, I was prescribed Prilosec or The Purple pill or even Tums. I think sometimes it's more than WHAT I eat than true GERD. On the other hand, I knew the Sleeve wouldn't work for me because I needed the malnutrition.

That being said, After 11 years I have had a lot of illness and still autoimmune disease, but I would STILL do the RNY all over again. It gor the weight off, but like anything else weight loss surgery is simply a tool, NOT a solution. You still have to diet, eat slowly not eat big chuncks or eat to much sugar.

I cannot make your choice for you, you might like Ford's and I prefer the Chevy, talk very honestly to all your doctors. Best of luck.

Warmly,

Jackie E.

Love this reply.

The reply makes no sense, actually. It's not an aesthetic choice. It's not like picking a car brand, or drapes, or which cordless drill you like. There are things fundamental to our anatomies that dictate what surgery will work better for us -- and more importantly, if a surgery will actually create serious long term health problems.

Too many people choose a surgery based on a foolish internal "logic." Or they go with what the surgeon would rather do, instead of what is best for the patient long term. It's short-sighted and reckless.

I know there are reasons why each surgery is better for certain patients but honestly in the end it truly comes down to what the person seeking WLS wants to do. It's a major life changing surgery and we have to live with whatever we choose. I knew the facts before I signed up for this site but I still made my choice for my own reasons. Even when others were trying to sway me for a particular surgery based on my health. My surgeon didn't even care which surgery I chose. He presented the facts to a seminar group of about 200 people through a video that was about 30mins...He then took questions from people. I didn't get to see him again until about 6 months later when I had my consult. He spoke to me for 2 mins and said "Hello" "Nice to meet you" "I see you originally were interested in the bypass but now you want the sleeve" "OK" and "do you have any questions" and "i'm going to be making 3 incisions 1 here, 1 here, and 1 there..and if If there is any unforeseen events I am going to open you up and make 1 big cut down the middle" He then walked me over to the scheduling person to get me signed up for surgery and that was that.

You seem happy and proud of all this. Ok. I think it's really sad that you're happy with a doctor that was too busy to give a crap about whether something was the best medical decision for you. It breaks my heart, really. It sounds like the guy should be selling Fords. Or Chevys.

I don't know about being proud..it was just my experience. I didn't have the option to travel out of area for different doctors and I was told by many that the program I had my surgery done at was excellent. But my opinion of WLS is basically..it's an assembly line. In and out.

That may have been your experience, but it certainly wasnt mine. Most programs go to great lengths to educate people, and make certain they understand the choices, and the consequences.

Assembly line. In and out. That's a crappy method for serving food. If someone tried to sell me Barcalounger with that approach, I would have walked away. I certainly wouldn't stand for it for surgery.

Wow. This is scary. I would run from a doctor that obviously does not care about me.

Jackie I LOVE your response! :) It's so true - it is almost like picking a vehicle type! Coincidentally I'm currently vehicle shopping right now as well. Haha!! Choices choices.

That's the think I like and at the same time don't like about the RNY. I like the malabsorption because it means I'd be taking in less calories than I'm consuming but I don't like the malabsorption of the vitamins. Like others have said here though with the sleeve one still has to take extra vitamins not because of the malabsorption but because you are actually taking in such a small amount of food. I've come to think that no matter what I choose it will be the right decision because both surgeries are good tools and I WILL use the tool to the best of my ability. Can't wait to get the surgery date and get one with it! :)

Thanks again for your works of wisdom!

Following the car shopping theme, one can indeed look at the procedures in a similar light, though maybe with somewhat more diverse choices than just a Ford vs. a Chevy. Think of the VSG is something like a Mustang, while the RNY is more like a Jag or Alfa - either will get you to work or the store, but they can have very different personalities which will fit different people differently. And, overall, owning a Jag or Alfa is going to be fussier than owning a Mustang.

On the personality quality, here is a discussion about the different traits of WLS procedures and the interplay with different patient physiological needs to yield differing levels of success:

https://www.obesityhelp.com/forums/amos/4416773/quotDoes-the -Patient-Fail-the-Procedure-or-Does-the/

Relating to your malabsorption concerns, one of those personality quirks of the RNY is that its caloric malabsorption is temporary - dissipating after the first year or two - while its nutritional is long term. So, you do get a bit of a boost in weightloss rate in that first year or so with the bypass, but you pay for it with the extra supplementing needs for life. Both will, over time, allow a fair amount of additional eating volume - upwards of around half of your pre-op volume - which is enough to get you into trouble if you don't establish better and more sustainable dietary habits long term, but is also enough to allow one to get the majority of their nutrition from food.

This doc outlines a pretty good typical progression of eating volume - some may see somewhat more or less than his nominals:

https://www.youtube.com/watch?v=3_aahPETzH0

So, at least with the VSG, it is possible to get along on a minimum of additional supplements - about what one would normally expect to need from their own baseline needs (from whatever pre-existing conditions they may have) along with changes from aging or individual diet preferences. For instance, while I do take some calcium (one dose per day, rather than 2-3 that you may see with an RNY) due to some pre-surgery quirks, I no longer take a daily multivitamin (we are playing with 3-4 per week before going lower) as labs are showing that my diet is doing the job with less.