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

I was a major binge eater. It was not unusual for me to scarf down six breakfast tacos.

I had the sleeve, have lost 225 pounds and all of my weight.

Mental health is the real answer here. No surgery will fix that. You can eat enough to gain using ANY surgery. Choose the one you can live with long-term. I didn't like the malabsorption issues of the RNY and the vitamin and bathroom issues of the DS turned me off. And the band, well, just now. That left VSG and I'm thrilled with it.

Hey sleevegirl, 

Thanks so much for sharing. Did you find it difficult to lose the 225 lbs once you had the sleeve-in comparison to prior. ARound how long did it take you to lose that weight and how long have you kept it off? Just wondering how the sleeve is for maintenance.  I have been bouncing between the sleeve and DS. What would you say you eat calorie wise in a typical day? Are there foods that are restricted? Do you take a lot of vitamins? Any complications?  Any input would be greatly appreciated. Just trying to really get a feel of what it's like to have a sleeve. 

Well, seeing as I was unable to lose weight on my own, it was easier with the sleeve, but really... therapy has been SO instrumental in my journey.

I took me just over two years, I wouldn't say I was a "slow loser" but I didn't lose it quickly. Rome wasn't built in a day and it took me 36 years to get that obese :) I just hit true maintenance a month ago, but I've been really easing into it the prior few months.

Take a look at my profile, just click on my username. All the way at the bottom is my weekly/month weigh in amounts. Also, my blog, I blogged pretty thoroughly throughout my journey. It wasn't easy.

I now eat about 1300 calories per day. I'm upping my calories every few weeks until I hit where I want to be maintenance wise. I have some days as low as 700 and some as high as 2000. I'm having some other issues at the moment and to be honest, this really isn't a high priority for me, just maintaining and staying sane is a higher priority.

I DID put myself into maintenance every couple of months for a week or so. I had a long journey and I knew it and I did that for my sanity, I'm sure that's why it took me longer than some of the super losers, but I was okay with that and I came out of it learning about my limitations and what I needed to do for myself.

Only foods I CAN'T eat are carbonated beverages (they freaking hurt, although not everyone has that issue), pasta and breads tend to sit like a rock so I avoid them. Pork chops don't sit well either (although slow roasted pulled pork is great!). I CHOOSE not to eat other foods because they trigger me, though. I watch my carbs because I'm pretty triggery with those.

I take all of my recommended vitamins. Visit CelebrateVitamins.com and you can go through the order builder and get an idea of each surgery and how far out you are to see what you'll need to take (of course, your doctor may have additions/revisions). I still take bariatric vitamins because I know they are made especially for me and my body's needs.

Absolutely NO complications at all, well... I did lose a bit of weight ;)

Really, read through my blog to learn more. I had really good days and really bad days. Losing weight doesn't fix your life, it just makes you skinnier, if you use the tool properly.

HTH. Truly, the surgery type matters little, I believe... YOU have to be fully committed to it and believe in yourself.

Thanks so much for sharing your experience. I think the idea fluctuating between losing and maintaining is really a great strategy. I have done that in the past when I was trying to lose weight and I found that it took some of the stress off and the feeling of restriction away and prevented binges.   

if you need to take anti-inflammatories "NSAID'S" you don't want the RNY. It's off limits forever for the RNY. I am never allowed steroids either such as prednisone but my surgeon has other reasons for that too. I am at high risk for an ulcer since i have gastritis "inflammation of the stomach". My guess would be the sleeve for your NSAID's and maybe DS for being able to eat more. You will have a VERY hard time though finding a DS surgeon they are very limited. RNY offers lots of restriction but you won't be able to eat much especially the first year out. 

It's not "VERY hard" to find a good DS surgeon. They're scattered all over the country. You just have to be willing to travel.

I am 18 months out which I feel is almost too early to declare success. I have been in maintenance since Feb 2013.  Iost about half my body weight - currently weigh around 155.

I had the lapband which was a disaster, revised to the sleeve which has been a godsend. Now, I realize that I had to really work it too, so don't think it was easy.

The key thing for me was getting the education to go with it. There are sleevers who don't do that well with the weight loss - could be surgical technque I am not really sure.  I always felt that the DS was the only ohter choice for me after the sleeve but now I am looking into plastic surgery. I have been told by two surgeons that the complications risk is higher with DS patients and I guess that is because of the malabsorption/vitamin issues?

Surgeons are *probably* talking about surgical risk, and---there's no real difference in surgical risk between the RNY and the DS, when performed by the same surgeon on patients with similar BMI and health issues. In the past, the DS was 'reserved' for heavier, and therefore generally sicker, patients---so the complication rate was accordingly higher. Since the DS has been made available to lower-BMI patients, the surgical risks are pretty equal.

Now, as for long-term complications---yes, the DS is the form of WLS that demands the most vigilance about vitamins and lab work, since it has the highest degree of malabsorption. That said, over the years I've seen far more RNY patients end up with really severe supplement-related complications. I suspect that's because the RNY has its own unique supplement needs, BUT RNY patients tend to get less pre- and post-op education about this. Any DS-related boards I've ever been on really harp on how important daily supplements and regular bloodwork are---not so on RNY boards.