I'm so confused!!

Hello all this is new for me. I have a bmi of 42 with no other issues. I have started the process of getting wls. I was thinking of getting the RNY until I went to my dietitian. She stated that I probably would not qualify for the RNY just from a high bmi and I should look into have the lap band. When I first thought of wls lap band was the first that came to mind. But after reading blogs I am not so sure. Can some please give me some help here. Thanks!!!!

The band is the least effective surgery available, with the most post op problems. 

A BMI of 42 qualifies for ANY of the WLS available. Personally, if I only needed restriction, I'd get the sleeve, but I knew I had metabolic issues and my system was very efficient, so I got the DS which combines restriction with malabsorption. The RNY has both restriction and malabsorbtion, but also has the possibility of dumping, reactive hypoglycemia, stuck foods, stoma getting stretched or to tight, as well as an unscopable blind stomach, and you're unable to ever take NSAIDs for pain again. 

The DS has the best stats for weight loss, weight maintenance, and post-op lifestyle, but if I couldn't commit to the vitamins, then the sleeve would be my second choice. And those are the only two surgeries I'd even consider. 

I don't know what your dietitian was thinking. Nuts and dietitians don't have good reputations around here, for giving advice just like that.

Your BMI qualifies you for any weight loss surgery and there are FOUR types.  Good for you for coming here to start doing some research.

The lap band is the worst of the surgeries by all science.  It has the worst results and the most complications.  Just visit the failed lap band forum or the revisions forum.  I wouldn't wish a lap band on my worst enemy.

The RnY is the most common surgery.  But after 2-3 years the malabsorptive part stops working so you will have to diet for the rest of your life or you will regain the weight.  You also will lose the function of your pyloric valve which regulates how your stomach empties into your intestines.  Without a pyloric valve you run the risk of serious complications including reactive hypoglycemia which can be disabling and dangerous.  You also can never take an NSAID again.  Not a surgery I wanted, for sure.

The sleeve is a newer procedure so the stats for long term results are still pending.  If you want a restricitve only procedure this FAR outweighs the lap band.

The DS has the best science for all the things they study in wieght loss surgery except for resolution of GERD.  The best weight loss, and most importantly the best LONG term maintenance of that loss.  It has a good quality of life in terms of what you can eat (low carb, moderate fat, high protein). I had a BMI of only 39 when I started the process to get my DS). 

Decide on your surgery type FIRST THEN pick a surgeon.  Not all surgeons do all four surgeries and you don't need any nutritionist or dietician telling you what kind of surgery you want.  YOU decide based on your own research.

Take your time.  Read all the surgery forums here.  Read the revision forum and the weight loss surgery failure forum especially.

I have studies comparing the different types of surgery if you are interested.  Just PM me or respond to this message.

~Becky

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EN: This one, http://vsgfaq.wordpress.com/ ?

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Sublimate on the VSG board has assembled this helpful site about sleeve FAQs.

and here's the post that usually accompanies it:

Welcome to the VSG board!  The veterans of this board want to share a few links with you that will answer common questions and get you started on the way!  We will add to and update this list frequently, so if you see this re-posted, please check it again as there may be updates.

These links represent questions we see frequently and tend to have thorough responses to answer those questions in the thread.  If you read these messages, you’ll be much more knowledgeable about what you are likely to see during your VSG experience.

Veterans, if you would like to add to this list, please PM me.  Feel free to copy and paste this message and link to the FAQ elsewhere or send to others to help answer questions for new members.

FAQ:
 

http://vsgfaq.wordpress.com

If you have a question or need information, before opening a new thread, try the "SEARCH" box at the top right hand side of the page.  This is a quick and easy way to get an answer to many questions because many questions have been asked and responded to before quite thoroughly.  

Hope that helps!

 While I agree that the lapband is not the way to go, my experience with RNY has been very positive.  With RNY I pretty much eat anything I please and don't gain weight.  I don't eat much of what I please because I have restriction and in my case at four years old I still have malabsorption.

The VSG is currently taking the place of the lapband as the surgery of the day.  There are not long term studies on it yet.  There is no malabsorption, so the only way to lose and maintain weight loss with VSG is by limiting the calories that go in.  

That is fine in the beginning when the pouch or sleeve is smail, but after a year or so the pouch and sleeve stretch and it is easy to eat too many calories.

If I absorbed everything that I ate, I would be obese again.

I realize that people have reactive hypogylcemia, dumping and regain with RNY.  There are also people like me who have good results and none of the problems and complications.  That malabsorption is nice to have.

I had a BMI of 39 and qualified/no other health issues

Your dietitian should not be giving advice re: any medical procedure, including WLS.

I totally agree that you should look into all the surgeries and make up your own mind.

I've been happily RNY, but if I'd been able to exercise an option I would probably gone
for the DS or VSG, simply because of the fact that the pyloric valve was left in the
equation.  Since it wasn't covered by my surgery, I took what I could get and blessed
myself for my good luck.

If there's one thing you'll find as you go through this process, you rapidly come to find
that you are more and more willing to be your own best advocate about your life and
health decisions, and less and less willing to just take someone else's word or decree
about anything at all!!  This can be a real eye-opening, liberating (and scary!!)
experience!  It can also be a big part of changing your entire life!

Good luck!