I don't know which wls is best for me!!!!

I am going through the 6 month pre op weight loss program right now. I am in my 6th month and I need to decide which surgery I want to go with. I was dead set on the gastric bypass because its supposedly the "golden standard" of the surgeries but the more I research the long term effects the more afraid I get of it with the malnourishment and everything. My other option was the sleeve but I'm afraid of the stomach stretching and regaining. I feel like I need the discipline of the bypass but I just don't know..help!!

The RNY pouch can stretch too over time. When they do the sleeve they remove the stretchier part of the stomach, so while it will stretch a little over time it won't stretch alot unless you abuse by over eating. You need to read about both surgeries and go to the forums and read what people have to say about their journeys and then talk to your surgeon, then research both surgeries apart from what OH has on them, then and only then should you make a choice. Be sure you know what is happening to your body. I can't tell you how many people come here and have no clue what is being done to them or what the after care and life is all about. Know exactly what you are getting into!

Do you have a problem with reflux?  That was the deciding factor for me (or rather, for my surgeon).  VSG can make that worse, apparently.

You should also research the Duodenal Switch, the 'platinum standard' of WLS. The DS has the same stomach as the Sleeve, plus an intestinal bypass similar to, but more effective than, that of the RNY/gastric bypass. The RNY's intestinal bypass gives you a lifetime of malabsorption of certain vitamins and minerals, but only about 18-24 months of malabsorption of calories. The DS, on the other hand, gives you a lifetime of malabsorption of calories, especially calories from fat. This is why the DS has the very BEST long-term, maintained weight-loss stats, period.

Things to think about when choosing the best WLS for you:

What health problems do you have, or run in your family? How will each form of surgery impact those health problems, or limit the medications you may need to take for them? After the RNY, you'll need to steer clear of NSAIDs, and you'd be amazed by all the medications that contain them. (Google it!) After the Sleeve or the DS, you can still take NSAIDs. After the RNY or the DS, your dosages of certain medications may have to be adjusted due to the possible malabsorption, but the Sleeve has no malabsorption. If you're diabetic or have high cholesterol, go with the DS---better than 98% of diabetics who get the DS achieve total remission , and it appears to be permanent. And since DSers only absorb around 20% of the fat we eat---no, that's NOT a typo!---we tend to have really good cholesterol numbers, even though we eat lots and lots of bacon. (*grin*)

How good are you at dieting? Do you lose weight easily, as long as you control your portions, or do you struggle for every pound? If you lose weight easily, then a restriction-only procedure like the Sleeve may be right for you, but if you struggle, you probably need malabsorption.

How good are you at taking vitamins? Can you commit to taking them every day, without fail? Multiple times a day? If the answer is yes, then go with the DS. If the answer is no, then go with the Sleeve.

And---how do you like to EAT? All forms of WLS are going to require that you limit your simple carbs. Sad, but true. However, we DSers eat around 2500-3000 tasty, high-protein, high-fat calories every day. (Think bacon, cheeses, nuts, all manner of meats, butter, heavy cream, rich sauces and gravies. Yum!) I can't reliably tell you how RNYers or Sleevers eat, but I can tell you that the DS post-op 'diet' is very liberal, and very tasty.

Remember---WLS isn't magic, and you will be back to 'diet and exercise' at some point post-op. Choose a surgery that allows you a 'diet' that you can live happily with for the rest of your life.

This is a great article that will give you a good background on all of the major surgeries. 

http://www.obesityhelp.com/articles/choice-of-bariatric-proc edure-a-philosophy-obtained-in-20-years-of-bariatric-practic e-2/

vsg is becoming the new gold standard , about the some loss as the rny , almost the same loss as the ds with much less problems , less nutritional deficits, if you get the vsg and don't lose enough the can add the switch , of the ds , you will aready have the sleeve part, or they can convert it to rny  

Well, yes and no...

All depends on whether you have a ONE surgery per lifetime restriction on your insurance policies. And not losing ENOUGH depends on the insurance industry. Even 50% is considered enough. (50% of mine would still make me obese).

Be sure you get the surgery you WANT to begin with as it may be the one you have to live with the rest of your life.

As to converting a VSG to a RNY, WHY?????

There are many VSG patients getting revised to the DS that were told the same malarkey as you were, I'm afraid.  Some have insurance to pay for a revision to a full DS, while others have discovered that their insurance has a "Once per lifetime wls" clause, and are left to self-pay or remain morbidly obese.   

Hello,

Knowledge is power.  The more you learn about each type, the more power you will have to make the decision.  Look at both pros and cons and the long term outcomes of them all.  Search your heart and really be honest with yourself as to which procedure you can live with the rest of your life.

Also, whatever procedure you pick it is just a tool.  You will still need to confront and deal with all the issues that put you into the obese state.  That means a whole body treatment.  A nutritionist, Life Coach and fitness consult may be something you will need to incorporate in your full body recovery.