Pondering why the RNY is considered the "Gold Standard"?

I was told the "reflux " issue, in June, so I went to the lead group for esophagus surgery in NYC at Columbia hospital,,,for a second opinion,, which was easy since i was already a patient there for my barrettes .  the reflux would not be a issue, or presents any increased cancer risk, and they had corrective procedures if the reflux was not controlled . by medication.

  Not only do you have to consider if a patient is smart enough,or committed to the required
dietary regiment, but economically able to  afford the vitamins, and enhanced diet for life.  a rny just might be the better choice.  
  A doctor cant during a consult say to a patient, i think you too stupid for this, or  i only do this for middle class.  sounds snobbish, but, what happens if insurance and money disappear ? MALNOURISHMENT. 

 besides all the reasons (from stupidity to lack of money) one would need to have an RNY over another surgery.....

what makes the procedure itself the determined 'gold standard'.

RNY is the gold standard surgery for obesity because ________.

They just don't know better.  That being said, though.  Have you read some of the idiots on the MB?  They would let themselves die with the DS.  It's definitely not made for everyone.

I would guess because in order to live a "healthy" life after WLS, the average person (for various reasons) is a better fit for RNY than DS.  Those reasons are different for every person.  Commitment to vitamins and labs, advocating for your own healthcare, eating enough protein every day, and on and on.  You can be lazier with the RNY, and lets face it, most people are lazy.  I can see how several years out from DS how you could fall into bad habits really easy.

But what I respond to if people say "gold standard" to me is this:  "RNY may be the gold standard, but DS is the platinum."  That says it all.

RNY isn't the GOLD STANDARD.  It's STANDARD but far from GOLD.

Whoever said that is talking out of their BEHIND.

There I said it. 

I wanted the Cadillac procedure for weight loss - so I got the DS. And I have a fully functioning stomach (just smaller than normal) - not some silly POUCH.

Oh pooh, don't get me started. . . .

 Hey Cookie!  How's the DS doin ya these days?  I love your avatar :)

But even if the doctor worries about compliancy, or setting aside all financial reasons, wouldn't the VSG still be better than RNY? I'd think it's easier to do VSG than RNY? But maybe I'm wrong.


Girlygirl I am so jealous. I wish I loved my DS. But totally not yet. The last week for some reason I have just been hating it and questioning every day whether I made the right decision.

The VSG isn't covered by all insurances. Again the answeris:$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

 You are only a couple days shy of a month out.  I wasn't too thrilled at that point either. At that time I was dehydrated and low in potassium.  I was so lethargic.   Give it some more time for the swelling to go down.  I honestly did not feel better till I went in for fluids and was able to take my vites.  It's like a flip switched.  I went from sipping tiny portions of protein to a 20oz double protein coffee.

Let's see how you are feeling at Thanksgiving :)  I bet you'll notice a world of difference.  
What has been making you hate it this past week?  ~GG

http://www.yourbariatricsurgeryguide.com/duodenal-switch/    states:

The duodenal switch may be effective for people with very high BMIs of greater than 55. In fact, a study found that the duodenal switch produced more weight loss than the Roux-en-Y gastric bypass in patients with a BMI of at least 50.

That said, this complex surgery does have more complications and may not be the right choice for certain high risk individuals, including those with heart failure and sleep apnea. Talk to your surgeon to determine if the duodenal switch is right for you.

****
if you search internet you get tons more sites stating more or less the same touting RNY as "gold standard by which all others wls are measured".

I have not had my revision yet and am still researching and fighting with insurance.  But I will tell you this, I have had THREE surgeons refuse to perform the DS revision on me.  One in GA, LA, and MS.  Their reasons shave ranged from they dont revise VBG, will revise to RNY but not DS, just simply no.  lol  (and i had references to all 3 stating they performed DS) I have a consult in Nashville end of this month with Dr. Houston (not sure I am even going).

 Whenever you begin researching your options, you immediately see "RNY GOLD STANDARD".  . . AND from what I can ascertain its because of the malabsorption issues, and more complicated surgery and the fact that you cannot trust everyone to follow protocol in regards to their nutrition afterwards.  Simply put, for the majority it probably gives you the most chances of weight loss with the least amount of side effects because MOST people are not willing to put in the work of maintaining their own health.  I THINK its considered GOLD STANDARD simply because its the most performed... its a numbers game.

I think I got off text lol  sorry about that.   But just wanted to offer my thoughts on why from the research I've found.  And I also notice can't find ONE SITE that will explain to me why?? Interesting.