Considering VSG & the switch

Considering both surgeries.. what is the difference ? What would be a reason to choose one over the other?

The sleeve is just another diet with a smaller stomach. Low carb, low fat, low cal for life. The switch is a smaller stomach plus malabsorbtion. It has the best statistics for weight loss and the least chance of regain. The tradeoff is you have to take a lot of supplements and get lab work done once a year or so. You have to be willing to manage these supplements and learn about them.

The DS is the only WLS I have ever seen really work long term for almost everyone.

I had VSG 5 years ago and am now about to get the switch.

The biggest difference is that one works a lot better than the other. The DS has the best statistics of any bariatric surgery for percentage excess weight loss, for maintaining that weight loss, and for resolution of almost all comorbidities. The DS includes a sleeve, but also includes the "switch" part of the small intestines which provides both malabsorption and also metabolic changes that help keep the weight off. We are seeing new people all the time wanting to revise from sleeve to switch because either they are experiencing significant weight regain, or they never lost enough weight to start with.

With the sleeve, you have to maintain a low calorie, low carb, and low fat diet for life. You get to do it with a smaller stomach, that's the only advantage. With the DS, we need to emphasize protein because we only absorb about 40-60% of the protein we consume, and we can eat fat freely because we only absorb about 20% of it. That allows for a much more normal diet, lots more food choices, different cooking methods, etc. It's a much easier diet to sustain. The tradeoff is that we are required to take various vitamins and minerals for life, which is crucial but not really difficult once you get into the routine.

Keep doing your research!

Larra

Many of us spent years losing weight on different kinds of diets and then gaining the weight back ( or in my case more than I lost ). If you think restriction will work for you long term that would lead you to the VSG but if that hasn't worked for you in the past pretty unlikely, I think, the the VSG will have a different result. It might, some people can make that switch but it wouldn't have worked for me.

I liked the DS instead because the stats on regain are so much better. Also, given my dieting history I didn't consider just the VSG at all.

Pete

The VSG is a restrictive only surgery. The only thing the surgeon does is reduce the size of your stomach (sleeve).

The DS is considered a two-part surgery (but done all at once). The first part is the sleeve (exactly as the VSG) but the "switch" part is the shortening of the intestines. The intestines are where you absorb the majority of nutrients (and calories) so by shortening them, you are reducing the amount you absorb (hence the term malabsorption). Like everyone's stomach, the sleeve will eventually start stretching so the restriction is reduced - which is why some people gain their weight back after the initial weight loss. You have to maintain some type of "dieting" with the VSG - watch calorie and fat intake, etc.

With the DS even when the restriction is reduced because of the sleeve stretching, the malabsorption continues to work so even though you end up eating more as long as you eat healthily (for the DS) you can continue to lose and maintain your weight long-term.

With the DS you must be committed to a lifetime of vitamins (to make up for the nutrients you don't get through food). It's also a monetary commitment - vitamins are expensive. You also need to eat a higher protein diet, which is also expensive.

I am 14 years post-op from the DS and have maintained my weight loss the entire time. I eat alot of food but as long as I stay mindful of sugar/carbs, I'm good.

You must do your research to make sure this is the right surgery for you. Also critically important is finding a surgeon who is an expert in the DS (not all surgeons can or will perform this type of surgery).