Sleeve, RNY or Duodenal switch-which is better for a binge eater who has to lose 150 pounds

Just interested in hearing everyone's feedback on their experience with their particular surgery. I'm a 5'3, 300 lb woman who needs to lose about 160lbs to get at a healthy weight that will eliminate risk of diabetes, high blood pressure..etc and I'm trying to figure out which surgery is best.  I am not a grazer and I tend to eat 1-2 big meals a day right now-I love carbs.  I was thinking of getting the DS or sleeve but after going to hear the surgeon at the weight loss surgery group speak I'm now more confused than ever.  The doctor seemed against the switch because of all the viatmins one has to take, malabsorption and risk. They do perform DS at his practice so it's not like he's against it because he doesn't perform it. He was steering me towards the gastric bypass as he felt it was safer and would allow me to lose most of my weight. He didn't seem to think the sleeve would get me to the weight I need to get to in order to eliminate high blood pressure etc.  It's confusing because I have friends of friends who have developed passing or who have osteopenia with their gastric bypass and can't take anti-inflamatories etc...so I was moving away from gastric bypass but now I'm just not sure what to do. 

Are there any surgeries that will allow me to eat most foods but just in smaller quantities. I have heard that with each surgery comes certain restrictions. I don't mind restrictions but I don't want to be stuck eating only chicken all day. I want to be honest with myself here. I suck at dieting and have little will power at the present moment.  I can't even imagine myself being successful at this because I have lost and gained weight back so many times. When I hear the doctor say you have to stick to your diet once you have the surgery, I'm not sure what to think because I have never been able to stick to a diet before the surgery so how will I be able to do so after. If I was able to stick to a diet I wouldn't be in this position to begin with. I'm just wondering if you all felt the same way before your surgery. 

VSG, RNY and DS will all allow you to eat most foods in small quantities.  At least, most people with those surgeries are able to eat most foods.  Some people with RNY get sick if they eat large amounts of sugar, but not all do, and even those that do can eat small amounts of sugar.

I could never stick to a diet pre op because I would get hungry.  But now I get full on a small amount of food.  I eat about one cup of food and am full.  My RNY allows me to be satisfied with small portions.

However, my surgery doesn't force me to make good food choices.  I can't eat a lot of sugar at one time, but I could eat one cookie every two hours all day long if I wanted to.   My surgery doesn't keep me from doing that.  I have to choose not to do it.

Thanks for sharing Kelly. Have you had any problems with hypoglycemia at all? I have heard of some folks passing out because of reactive hypoglycemia. Does the malabsorption part of the RNY help you at all or is it mostly the the small stomach that does? Did you have any complications with the RNY?

Please keep in mind that any of the wls are tools to help us.  We still need to make healthy food choices each day for the rest if our lives.  The good news is that you should feel full with less food.

Judy

You already know what I think. (*grin*)

I eat any food that I choose to eat. There are some things that I liked pre-op that I don't much care for any more. (Surprisingly, cake is one of them!) And there are things like now that I didn't like pre-op---like deviled eggs and cole slaw. I do not AT ALL feel like I'm sticking to any sort of 'diet'.

I was never good at dieting either.  It is just so much easier to diet now, because I have no hunger, a small amount of food fills me up and sugar or fat make me feel bad.

I weigh every day so if I do go on a "diet" it is for one or two pounds and after a week or two that is gone again.

Before RNY I had a stomach the size of a two liter bottle of soda. That stomach could easily stretch to hold about double that amount of food.  After surgery my stomach was about the size of the bottlecap on that soda bottle.  Now it is grown up to about the size of a large egg. It takes very little to fill it up.

I eat small meals about six times a day and am never hungry.  Malabsorption helped me lose weight quickly and easily and the good habits I learned after surgery help me to keep weight off.  Once the weight is gone it is easier to keep it off. 

The DS is probably your best choice.  You can eat a lot more food.  I stay at about 1200 calories a day and go down to 800 when I want to lose a few pounds.  With DS you can probably be comfortable and maintain your weight eating 2500 to 3000 calories a day.  With RNY and sleeve you have to eat far less.  DS malabsorption does not go away.  If I were doing this over I would chose DS.

Hi,

Thanks so much for your response. I was wondering why you mentioned that if you had to do it again that you would have chosen duodenal switch. What are the factors that cause you to feel this way? ..if you don't mind my asking...ONe of my concerns is getting a sleeve or RNY and regretting it...All the surgeries have their pros and cons. Just wondering what the pros and cons of the RNY are. Thanks so much!

I meant to type sleeve.  I would love to have my old digestive system intact and not have the bathroom issues that happen with gastric bypass,  Gas, constipation, dumping, diarrhea are all parts of my RNY that I believe would be much less with a sleeve.  My experience may be different than others.

Hi,

I have to say that the real battle is not the size of the stomach but in the mind.  It is important to get the support you need prior to your decision.  Learning to have a healthy relationship with food, portion control and to gain the tools necessary to overcome the challenges  you will face.  It's always good to talk to someone who has knowledge of food addictions and eating disorders now and not later.  You want to set yourself up for success not failure. 

It is a good idea to continue to research all the surgical options out there.  As stated by another member, all of them are tools not cures.

Good luck!

No matter what surgery you decide, please give yourself the gift of associating with a counselor who specializes in eating disorders.  Boy oh boy, I can't stress that enough to people who are exploring WLS.  Simply put - "you gotta do the head work!".

All the best to you, Sandie