Question:
drastic weight loss

I am sea sawing between the lap band and the gastric bypass. My biggest concern is the after affects. I am nearly 500 lbs and I really want to lose at least 300 lbs. I am aftaid of looking like a monster with all of the hanging skin. I know that I am definatley having one, I just want to know what I am in for. Please give me some advice.    — Crybaby1 (posted on March 9, 2008)


March 9, 2008
Have you considered the Duodenal Switch? I chose the DS because I Wanted a surgery that has the least chance of long-term re-gain, is BEST at curing Diabetes (98%+), removes much of the hunger hormone Ghrelin, NO DUMPING, NO MARGINAL ULCERS and NO STOMA / STRICTURES, I chose the Duodenal Switch surgery. Do investigate all the options. I wanted my system to still operate the same which is why I chose to keep my pyloric valve intact with the DS. DuodenalSwitch.com With the DS: there is no stoma, so no stoma strictures; there are no limitations (other than volume) against drinking before, during or after meals; 80% of ingested fat is malabsorbed, allowing liberal use of eggs, butter, mayonaisse, healthy oils, marbled meats, cheese, etc., in the diet; 98.9% of type II diabetics are CURED of this devastating disease, with data showing stable cure over 10 years out; there is the best average weight loss and most durable (average 76% excess weight loss going out 10 years) of all of the bariatric surgeries. That's why I had a DS! Good luck to you!!!
   — SameButDifferent

March 9, 2008
I think your decision has to be based on more than how you will look after your weight loss, only because in either case, RNY or Lapband, you're going to be left with excess skin. Why not talk with your doctor about this? I decided on RNY because I know myself and Lapband would be too easy for me to "eat around". Good Luck!
   — Shirley D.

March 9, 2008
Hi CeCe, I was 386 when I decided to have surgery. I did a lot of research as we all do - and really wanted the lapband. However, after all the research, I realized that to lose most or all of the weight I actually need to lose in order to not be obese anymore, the lapband would not work for me. You lose more weight with the RouxNY. The lapband is really more for someone who needs to lose 100 lbs or less. Some lose more than that, some lose less, but the statistics show that the more you weight, the more the lapband is not going to work for you. Of course, you would lose weight with it - but for me, I decided I'm only going through surgery ONCE. And if I did the lapband, and lost 1/2 of the weight I needed to lose, which would be considered a huge success, I'd still have another 100 - 130 pounds to lose. So I chose to go with the gastric bypass in order to lose more weight in the long run by using my tool to the best of my ability. You will need to choose what works best for you - do all the research you can before making the final decision. Good luck!
   — itzmetami

March 9, 2008
Each WLS surgery has it's pros and cons. Lap band is normally for lower weight los, 100 to maybe 150 pounds. For a larger wt. loss, RNY or DS would be needed. DS has some malabsorption issues, where as RNY is somewhat less problematic in that regard. You really need to speak to a surgeon to does all 3 to properly inform you. RNY is a surgery that most insurance companies do cover due to it's limited complications and it's higher wt loss success rate over lap band. My insurance company won't even do lap band, only RNY.
   — Dave Chambers

March 9, 2008
Duodenal Switch is targeted for people who need to lose a drastic amount of weight, therefore if I were you, I'd go with DS. If, for some reason, you can't have DS, go with Roux-en-Y (RNY). Lap Band truly is for people who don't need to lose large amounts of weight.
   — Gina S.

March 9, 2008
Additional comment: I would not waste my time with VSG/VBG (Stomach Stapling). I had it back in 1995 and it only works to a point, then the weight comes back. Go with DS or RNY. Best wishes.
   — Gina S.

March 9, 2008
The fact remains, 300lbs that once occupied your skin will no longer be there. The skin will hang. Cross one bridge at a time. This will help you to succeed wherever you are at in life.
   — bariatricdivalatina

March 9, 2008
In my opinion I dont think you will be happy with the results of the lap band. The weight loss is slower and less than gastric bypass. After the bad surgery you can eat what ever you want. sugar carbs etc..... So there is a good chance you can gain all the weight back. I would to bypass. You will be much happier
   — Joanc

March 9, 2008
I was 509 day of my surgery. I knew I had wanted RNY for many reasons over lap band. First I was super obese, 2nd lap banders lose more slowly, 3rd, to have a foreign thing inside of me didn't thrill me etc. It is more effective for someone of a higher weight to have RNY and more successful. Continue doing your research and asking questions. It will come to you. I am very happy w/my RNY decision and would do it again in a heartbeat! Good luck, God bless and see you on the losing side!
   — crystalsno

March 9, 2008
You will never reach your goal with the lap band. The lap band is not for people who have that much to lose. The average weight loss with the lap band is 40-70 lbs in a year. I would seriously consider DS or RNY.
   — [Deactivated Member]

March 9, 2008
I know where you're coming from and you'll get a lot of advice...and many lap-banders that have had success will swear by it, but I do think the other posters are correct in saying that it's more for those that don't need to lose excessive amounts of weight. You really want to feel the positive affects of weight loss surgery more quickly when you're weighing in at 500 pounds. You want to move more easily, and have any health issues diminish more rapidly, so that you can stay motivated and exercise and get that weight off. That's why I went with the RNY and did consider the DS surgery. I started off checking into the Lap-band. But per several surgeon's that I consulted with, and research I did for myself, decided the RNY was best for my situation. I went with what my heart was telling me. I went with my gut. You'll know and will feel more confident about a decision once you get the information you need and have spoken to your surgeon. As far as the loose skin. It's inevitable. Depending on your age, and your skin's ability to bounce back, it might be better than some....or worse than some. For me...it was also a huge consideration when deciding on this surgery. Fact remains... it's primarily for your health....the skin....it can be removed. Yes...it's expensive...but you might find that you feel so great....it won't be a priority. Start a plastic surgery fund...and if you need it... use it...if you don't..go on a fabulous vacation! You'll have earned it! Best wishes! Hugs..Cheryl
   — Cheryl K.

March 10, 2008
Each of us are going to have different opinons supporting the methiod we choose. First, go to several different doctors seminars, and see what they have to tell you. I went all over to more than 20. I found a surgeon that had an open RNY in 1998. He now does two types of surgery all laproscopticly. I heard the Duodenal Switch (DS) give you a lot of diariea and gas from those that had it in one of the support groups I attend. I also had two freinds that had a Lap Band and they did not loose much weight. From the support groups and my surgeon, I selected the RNY. It seem to give the best results and I needed to loose 200Lbs. In three months I lost 75 and never felt better. I got to the Gym every day and that is an important part of lossing some of the loose skin. I am 62 so it will take more surgery for me to get rid of all my loose skin, but I will be aliver to do it. I took 8 diebatic drugs and I take non today. My blood sugar is normal, and I am off blood pressure and colosterial drugs as well. Atten a support group before you choose. They will welcome you with open arms, as will a good sergeon. You need to find the one that you have confidence in and one that you like. I did and I am glad I took the time to find the right sergeon and right proceedure. I hope the RNY is right for you to.
   — William (Bill) wmil

March 10, 2008
CeCe, thanks for writing. You are being very brave to state your questions the way you did, and I want to say up front that I appreciate your honesty and know that you are genuinely concerned about these things. Having said that, I need to be honest with you, just know I am trying to answer your question honestly, not unkindly. First, the skin issue. If a body goes from 500 to 200 pounds, you will incur a lot of skin issues. There is no doubt about that. You will NOT look like a monster, but you will have problems. You have to mentally be ready for this. I was 250 and went to 120, but I had skin issues. Not nearly what you will, but I have learned to live with them, and spandex is my friend with clothing. I would rather have my skin issues (my legs look like charpea puppies, I call them Mut and Jeff:)). My arms sag, but I am so glad to be at a normal weight for the past four years of my life. You will feel that way too. You cannot base your decision to have surgery on what others might think you look like. You have to learn to be satisfied with how your look and feel, and carry that confidence into your daily life. Now, regarding my opinion about your surgery, which is solely my opinion, ok? I had to choose which one I wanted too. I loved the idea of the lap band being less envasive, but I like the mal absorptive quality of the rny. I choose the RNY because I knew that I could cheat the band back into losing weight. I had already tried to diet and exercise. I was walking 8 miles every day, 1200 calories a day, and not losing weight (past 30 pounds). It was pathetic, and I just knew that I need to have the mal absorptive function of the RNY. As it turned out, I was right! I only lost about 2 to 3 pounds a week, sometimes 1 to 2 pounds a week, I was walking 5 miles every day and eating small portions. I did lose it all though, but it was hard work. I didn't have an easy week, not once. You have to be committed to diet AND exercise. Even at 500 pounds, you need to start walking, get out there and don't let anything stop you. You have to fight the head issues of eating when you only truly hungry, not when you head tells you (about every30 minutes). It is a fight to take off the weight, but for me, the band was not the answer. I have seen a lot of women be sorry they choose the band because they know all too well how to cheat their way into obesity. It is the obese way to cheat ourselves into obesity. You choose for yourself, but I think the RNY would be more affective for you, but you have to be sold out to exercise and water and diet to get your result, if you don't exercise right away (I began at 2 weeks post surgery, and it was tough, but I started with 2 miles every day and worked up to 5), anyway if you don't start right away, you will not take off all the 300 pounds you hope to. It will not happen on it's own. I hope you do well, and you have much to think about, but you can do this, it is just tough work! Take care. Patricia P.
   — Patricia P

March 10, 2008
I started out at 526 lbs, my surgeon made me lose atleast 10% of my total body weight before I could get the RNY. I had surgery on August 22, 2006 and I am down to 243 lbs. I lost approx. 150 before surgery, I took xenical that was perscribed by my PCP, ( now alli) I have a whole lot of hanging skin, especially on my arms. I work with a personal trainer 3x a week. He told me no matter how much I exercise, my hanging skin will not go back to what it was. I am looking at plastics maybe late summer, early fall. Good luck with what ever surgery you choose, Peggy
   — DBlazer325

March 10, 2008
Hello I was 400 pounds and I chose the RNY because it is the most successful and you will lose the weight faster. It is recommended if you are over weight a lot more. With any surgery you will have excess skin. I have excess skin as well. I can live with it I do not look like a monster. I am healthy. ALSO if you work out during the weight loss the whole time you will ton while losing and will look much much better. BUT you yourself have to do that. It will not look better on it's own. There comes sacrifice and you will want to chose what you want to do. You will be able to eat normal afterwards you just have to watch how much and what you eat. It is not bad, I have to lose 13 from my baby and it is hard but I am not eating like I should as in items I should eat. But I just have to try harder and it will come. So much suggestion is that you get the RNY because it is the best for you and you will do better probably in the long run.
   — tl_morgan

March 10, 2008
Sorry, I just had to correct Gina about the VSG. The Vertical Sleeve Gastrectomy is NOT stomach stapling. Eighty-five to Ninty-five % of your stomach is actually removed. The surgery is a relatively easy surgery for the doctor and there are almost never any complications from the surgery. In the process of removing most of the stomach the Grehlin producing portion is removed. Grehlin is harmone that makes us hungry. Also with VSG there is virtually no dumping or malabsorption. In other words you can be sure that the medicines and vitamins you take will be absorbed correctly. The VSG is relatively new. It has been performed since 2002 and the long term results have proven to be comparable to the RNY. Actually some medical reports show that after three years the results of the VSG may be slightly better than RNY. The VSG can be done as the first part of a two part DS. The only problem there is that the doctor uses a much larger Bougie as a guide to removing the stomach in the DS and therefore the stomach that is left is much larger than that of the VSG surgery alone. Also many patients who have had the VSG done as a two-part operation have found it so successful that they did not need to have the second part of the DS operation done. If you MUST choose between the lap-band or the RNY I would go with the RNY since you have so much to lose. As far as the loose skin it is going to happen no mattter what so start saving your money to take care of that as well if you want. You can get the insurance to pay for the plastic surgery if you have certain problems with the loose skin, but you have a long time to think about that. Good luck and keep us posted. Pat
   — pjennjr




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