Comparing WLS

I just found out that my insurance has changed and will now cover WLS at 90%.  So, I'm seriously starting to look.  My questions are, what are the pros and cons to the different surgeries?  Which one is the safest, most effective, etc.  I don't know that I care about the fastest.  I am an over-eater.  I don't know that I'm an emothional eater.  
I'm leaving towards either the sleeve or Lap-band.  Can someone share the cost of these surgeries?  I will be going through an insurance company so I know it will be more than going to Mexco or being self-funded.

Thanks!!!

If you're looking at a restrictive only procedure, please, please, please go with the VSG vs the Band. There is less risk of mechanical failure and you'll feel a consistent level of restriction where it can vary day to day with the band.

You don't mention how much weight you're looking to lose or if you are hoping to resolve diabetes, if so I'd opt for the DS.

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Please don't get a Band. If you think restriction alone will do what you need, get a Sleeve.

Your profile doesn't mention any co-morbs, or your BMI. If your BMI is much greater than 40, or if you have co-morbs, especially metabolic ones like diabetes, high cholesterol, PCOS, insulin resistance, etc., get a DS. The DS has the very BEST long-term, maintained weight loss, AND the best stats for resolving or preventing metabolic disorders like diabetes and high cholesterol.

The 'safest' is probably the Sleeve. The 'most effective' is undoubtly the DS. Either of them will restrict your ability to eat much AT ONE TIME, but neither of them will keep you from grazing. (However, most DSer DO graze---it's pretty much the post-op eating plan for the DS, as long as you graze on high-protein, high-fat foods.)

You can learn more about the DS here: www.dsfacts.com and here:www.obesityhelp.com/forums/ds/ You should also check out the Revision forum, here:www.obesityhelp.com/forums/revision/. And last but not least, read this thread:www.obesityhelp.com/forums/ds/4438047/Calling-All-Revisions/ #36692073

What's the difference between the sleeve and DS?
I want to lose about 100-150 lbs.  My BMI is around 48...the last time I looked.  I don't have any known co-morbs but I haven't been to my dr. for a few years.  (no judging..lol)

In the DS, there's an intestinal bypass---in the Sleeve, the intestines aren't touched.

With the Sleeve, there's no malabsorption, just restriction, and no re-setting of the metabolism. In the DS, there's quite a bit of malabsorption---DSers absorb about 50% of the protein we eat, about 60% of the complex carbs, and about 20% of the fats. (Everybody absorbs nearly 100% of simple carbs, like sugar and white flour.)

With a BMI of 48, *I'd* definitely go for the DS. I had my DS nearly eight years ago, and I couldn't be happier. I live a wonderfully 'normal' life, eating around 2500 calories a day but absorbing roughly half of them. I eat a high-protein, high-fat, moderate-carb diet, and I've had no regain. I've had no complications, no food intolerances, no 'forbidden' foods. I do take vitamin and mineral supplements four times a day, but I find that much preferable to the medications I was taking pre-op. (*grin*)

Some co-morbs are things we don't really think of as being co-morbs---arthritis, asthma, sleep apnea, GERD, PCOS---but they really ARE improved or even resolved by significant weight loss. In my case, I was never diabetic, but diabetes runs in BOTH sides of my family---I figured it was just a matter of time until I became diabetic. That's one reason I chose the DS---since it cures diabetes in better than 98% of the diabetics who have it, I figured I could count on it to keep me from ever becoming diabetic. (It's so effective, surgeons in Europe have been doing it on NON-obese people for years, with wonderful results. Clinical trials on this started in the US a couple of years ago.)

The DS is also WONDERFUL for treating high cholesterol, since it causes us to malabsorb around 80% of the fat we eat. Mine's gone from 232 pre-op to 112 post-op---and I eat a LOT of fat. Real butter, cream, well-marbled steaks, sausage, cheeses, BACON---for the first three years post-op, I think I ate bacon for breakfast 6 days out of 7. I CRAVED bacon!

"and no re-setting of the metabolism."

That's not really true. The VSG is more metabolically active than RnY. Instestinal bypass is not the only way to re-set the metabolism. There are hormones involved and VSG impacts them greatly.

I suppose that's true---removing 85% of the stomach certainly affects some important hormones. Do you have links to any studies on this? I'd love to read them!

I've got some links on my blog... (I'd go look them up but I'm packing to leave town and was supposed to be in bed 30 min ago. LOL)

Some examples: in some studies, sleeve patients have a lot less ghrelin than RnYers. In some other studies, diabetes resolution is siimilar and the study authors speculate that VSG is providing a metabolic effect that is not yet understood to have those sorts of results. In fact, a lot of the studies I link to talk about this ... that sleeve has some sort of metabolic impact that makes it perform better than expected when it comes to weight loss and co-morbidity resolution.

There's another hormone that's impacted too. Not leptin but something else. I'll try to look it up when I get back.

My surgeon says that DS is the most metabolically active, then VSG, then RnY.