Why did you choose RNY over the sleeve?

I'm getting towards the end of my insurance approval process and I thought I was certain in wanting the gastric bypass. My husband (an RN) has some valid concerns and would like me to consider the sleeve. I feel like I get why people prefer the sleeve, but I feel drawn to the bypass.

If you had a choice, why did you opt for the gastric bypass, rather than the sleeve? Would you do anything differently with the power if hindsight (and insurance cooperation)?

Thanks so much for anything you can share!

Alison

I did not have a choice 6 years ago, but if I were making the decision today (and insurance covered both), I would do the sleeve.  Yes, it would mean losing more slowly without the intestinal bypass, but I would be able to take NSAIDs (only taking Tylenol and prescription pain meds is much more of a problem with my arthritis than I expected it to be), would not have to take as many vitamins and be as diligent about the regular lab work to guard against nutritional deficiencies.  The caloric malabsorption with RNY is temporary (all but gone after 2 years) and this is a lifelong effort to maintain the loss), so in the end you basically end up with a restrictive-only procedure anyway, but still have the vitamin absorption issues.

Lora

My insurance would not cover the sleeve. Had I a choice I would have chosen the sleeve for the same reasons as posted above. However I may have looked into the DS had I known about it beforehand. My surgeons do not do it so I would have had to find one who did. Have you researched it at all?

I went in to this going for the lap band but my Dr told me about all 3 & told me a bit about each. 1 the sleeve was still to new for me & I knew of no one who had it. RNY has been around for 20+ years. Also, a main reason I'm doing this is my risk of becoming diabetic due to family history etc. RNY is basically curing diabetes.

 

I had the choice and I chose bypass.

I have weight related pre-cancerous cells so my dr wants me to lose a lot of weight, fast.

She gave me the choice, but because I need to lose fast, I felt that bypass would be best for me.

I also like the "threat" of dumping. I hope I dont find out for a long time if I am a dumper or not because I want that threat always on my mind so that I dont screw up.

Sounds cooler and European like Roux 

 

Seriously though it would get me where I needed to be faster.  My Co morbidities had me at a point where things needed to happen fast.

One word: results.  All the data I've seen shows average, long-term weight loss is greater with RNY than with sleeve.  If you're a big person, a difference of 10-20% can be 40+ pounds and mean the difference between ending up at a healthy weight or staying obese.

The malabsorption aspect of RNY is modest at best but I haven't seen any actual data that it goes away.  The restrictive aspect is more restrictive than the sleeve.  Dumping is a benefit, not a complication.  I consider all these strengths.

My surgeon said he still doesn't permit sleeve patients to take NSAIDs.

I was gung ho on the sleeve, until I had an endoscopy and found out that I had barrett's esophogus.  This is from severe acid reflux and it I had the sleeve, it would only make the acid worse.  My other option was RNY.  I was really sad about it at first because I didn't want to go this drastic, but I am SOOOO happy that I had RNY.  I haven't had any complications at all (knock on wood) and I feel better than I ever imagined.  I'm a few days over the two month mark, and down close to 50lbs.  Learning how to eat again has been a huge challenge, but every day it gets better and it's amazing how creative you get with foods!   You'll make the right choice!  Go with whatever you are most comfortable with!  Good Luck!

I have been stressing with this decision, too (still pre-op). I finally decided with RNY because the long-term results are known. How sleeve patients will do down the road is still new and unproven territory. Now that I've made my decision I am not looking back. I am excited to focus on 'what is' and I don't plan to look back on 'what could have been.' Hope you get your date soon! April 17th, here I come. :)

I had the choice and went with the Roux en Y for several reasons. First, the long-term studies seem to show more robust and sustained weight loss. Second, as a Type-2 diabetic, my endocrinologist advised me that if I were to have the sleeve I may find my blood sugars rising after my weight stabilized. With the RnY, my blood sugars will tend to stay lower. I also discussed this with my evaluating psychologist, who has extensive experience with bariatric procedures. Given my comorbidities, he said that the RnY would be just about the gold standard for me. I hope this helps answer your question.