RNY or Lap-Band?

Hello all! I'm new to the site and looking for some advice from those who have been in my shoes. I am currently in the hoop-jumping phase of getting WLS, but I am now having a difficult time deciding which procedure to have done. I initially was interested in Lap-Band, but I'm not sure I have the will power to always turn down the sweets. They are my only weakness, the rest of my diet is pretty healthy. My surgeon also told me studies show that people who have the RNY on average lose and keep off more weight than those who have LB. I guess I should include a little bit of info about myself here too and let you know that my BMI is 59.8 and I have 226 lbs to lose to get to my ideal weight.

Basically what I want to know is what kind of surgery you had and why you chose it, if you have any regrets, what they are, and about your general experience. Any other information you might think is helpful would be appreciated as well. I am by no means basing my decision solely off of what is discussed here. I'm talking it all over with my family and will go from there. I have a very real fear of the RNY since my paternal grandmother passed away from this very surgery. I find comfort in the fact that medicine and technology has advanced so much since she had it in the 1970's and the fact that I am young and, other than being obese, very healthy.

Thank you for all of your responses!

There are two OTHER forms of WLS that you should also research---the Vertical Sleeve Gastrectomy, often just called the Sleeve or VSG, and the DS, or Duodenal Switch. Given your BMI/excess weight, I strongly urge you to really consider the DS. Not only does it have the VERY BEST long-term, maintained weight loss (especially for those of us with a starting BMI greater than 50), it's also the very best at resolving or preventing co-morbs like diabetes and high cholesterol.

I chose the DS, 7.5 years ago, and I couldn't be happier. With my DS, I still have a fully-functional stomach---just a MUCH smaller one. I also have an intestinal bypass which causes permanent malabsorption of CALORIES, especially those from fat. (The average DSer only absorbs 20% of dietary fat. This is why we eat high-fat foods but have amazingly good cholesterol levels.) However, this also means I have permanent malabsorption of certain vitains and minerals, so I will ALWAYS need to take supplements. This is also true of the RNY---but the RNY does NOT cause permanent malabsorption of CALORIES.

My general experience has been...a normal life. A much more normal life than I ever had, pre-op. Before my DS, I was ALWAYS hungry. Even when stuffed, I always wanted at least ONE MROE BITE. I did not know what 'full' felt like. Now I do---and I get that way on a 'normal' amount of food. Less than 'normal', if you consider restaurant portions 'normal', LOL!

There are NO 'forbidden' foods for me, sweets included. However, pre-op, sweets called my name CONSTANTLY. Since surgery, I can take 'em or leave 'em. Sometimes I take 'em, sometimes I leave 'em. (*grin*) I eat 2500-3000 calories a day, primarily from high-protein, high-fat foods, and because of malabsorption I only absorb about half of them. I'm effortlessly maintaining my weight loss without counting calories or, really, denying myself anything I really want.

I can't say it enough---this is the most 'normal' I've ever been. I started gaining weight when I was FOUR. I went on my first doctor-supervised diet at NINE, and my first diet pills at ELEVEN. I dieted, largely unsuccessfully, for more than 35 YEARS before I had my DS. The last 7.5 years have been BLISS, compared to dieting. I no longer feel any guilt about what I eat, I feel no need to punish myself with the diet mentality.

I'm FREE at last.

Did your surgeon discuss the other two surgery types with you?  Honestly, with the amount of weight you need to loose the only surgery you should consider is the DS. 

Please educate yourself on all four surgery types.  Read all the surgery type forums here on OH, and check out www.DSFacts.com for info on the DS.  And also read the Revision forum here on OH where folks with failed surgeries are looking for their second (or third) surgery.

Chose your surgery type first, then chose your surgeon.  Not all surgeons do all procedures.  If a surgeon doesn't DO a procedure he isn't likely to recommend that procedure.

And whatever you do don't get a lap-band.

Here's one surgeon's comments on the Rny, lap band and DS:

www.dssurgery.com/procedures/compare-surgical-procedures.php

And here is why you need to preserve your pyloric valve by NOT having an RnY:

www.lenoxhillhospital.org/press_releases.aspx

And the biggest reason I know of to really research the DS is that the science shows it to be the best surgery in every category that is studied (except for helping GERD).  The reason I chose it was it has the best stats for MAINTENANCE of weight lost and best stats for CURING Type II Diabetes.

PM me if you have any questions!!  Happy researching!!

~Becky

I was supposed to have the RNY, but during surgery the surgeon found that he wouldn't be able to do it lapascopically and wouldn't do an open procedure. He was afraid I wouldn't heal or something. Anyway, he did the lapband and it's a joke. I did lose weight in the beginning, but that's because you are on a really restrictive diet. Hunger is a problem, as the band is a little bit of a restriction, but not a lot. I had a lot of hopes for it and I do tell a slight difference with my eating but it all boils down to will power once again. Something that has a lways been a struggle for me. Knowing portion size and stopping when you get full. I'm sorry that I had it done. I think it was a waste of money. This past week when I went for my appointment, I had gained 6 pounds. He did a fill, but do I feel any different,no. Did the fill make a difference, no. It's me against my old foe food, again.

 Shub:

First off, if you didn't want the band you should never have allowed your doc to do the procedure. You should have found one that would perform the procedure that YOU decided is right for YOU, not what he wants. Since your doctor rammed the band down your throat, you need to get into his office and tell him - forcefully - what's going on, and he needs to check to see that it's positioned right and working correctly. YOU have to be proactive about your aftercare.

You DO know that you probably will have to have several fills - if your doc is giving conservatively sized ones - or a couple of large ones before you will feel any restriction. How many have you had? What's your fill level? Also know that fills do not always kick in right away. I've had some that have taken 2 weeks to kick in.

It's also not a matter of "stopping when you get full." If your band is set up right and you have the right restriction, when your stomach is physically full, you will PUKE if you try to stuff any more food in, because there will be no more room for it. That should happen with ANY restrictive procedure.

Spend a couple of weeks keeping an HONEST food journal of every single thing you put in your mouth, including liquids: what, when, how much, in what order (protein first, etc.) Then you need to meet with him and ask him why - if you are eating correctly and if you are at the correction restriction - you are still hungry and not losing.

I wouldn't say he rammed the procedure down my throat, but since I was sedated at the time and had given permission for him to make a change in procedure if necessary before surgery, I didn't have much choice. I trusted the doctor to know what he was doing. After I had it, I found out all I could about it and the differences between it and the bypass.
I have had 4 fills now with little change in the way the band restricts. I talked it over with the nutritionist in the office before the doctor each time and told them I could eat with no problem. I have never puked after eating too much.
I never saw any kind of info that said I would, so I never questioned why I could over eat after the band was put on.

 LOL - okay, so it wasn't done against your WILL, and what's done is done.

Stay on top of not feeling full. When you're at the correct restriction, you should get full on smaller amounts of food and stay feeling full for a few hours. It sounds to me like you're still not at the right level. 

I've had both the lapband and the RNY now. I had the band first. Gained weight, because the thing kept slippping and they'd empty it and I'd gain. I had an RNY revision on 1-11-11 and have done great! I say stay away from the band

teri

I chose the band for several reasons, but the "make or break" reason was that it was - and still is - the ONLY WLS procedure that does not cut, alter or remove any part of the digestive system. I did not want 50-80 percent of my stomach removed. I did not want to have my intestines cut and redesigned.

I have no regrets about my choice except that I did not have the option to do it sooner in my life. If I had to do it over again now, I will still make the same decision, but the physiological cut-and-paste issues are still deal breakers for me.

If those issues are not that big of a deal for you, then consider all your options, because only you can determine which procedure will give you the best chances of success, based on your own needs, health issues and lifestyle.

 "the ONLY WLS procedure that does not cut, alter or remove any part of the digestive system."

It definitely alters your stomach. Scar tissue grows up around it. This scar tissue will make any future surgeries you may need to your stomach riskier and possibly impossible.

ALL WLS is permanent. Don't buy the "less invasive" and "reversible" arguments for the band. It's a smoke-and-mirrors argument.