Trying to decide which surgery is most effective?

The risk of complications isn't THAT much higher than the other surgeries. And if you look at some of the studies that were done, the DS patients in the studies had much higher BMIs than the other patients -- so the patients with higher BMIs would automatically have an inherently higher risk of complications. If you look at this chart (which is based on several academic studies), there are other procedures that have a higher revision/failure rate than the DS.

And "being able to eat more" is not a reason to get the DS. Resolving things like diabetes and hypertension, preserving the pyloric valve, not dumping, not getting RH, having the best chances of keeping the most weight off long term: those are reasons to get the DS. :)

Frankly some tools are better suited to the job than others. There is a certain amount of skill needed to wield those tools. The DS by far is the best most powerful, and allows more leeway for human frailties, to a point.

Yes, the trade off is being smart enough, and compliant enough to put your own health needs first and foremost.. however, the pay off in weight maint, lipid issues, diabetes cure/resolution/maint and such is so much higher..

I have seen more than a few VSGers get into ho****er thinking nothing about supplements and labs, or failure to realize that the surgery is not enough for their needs, and have seen enough DSers face the same issues.

The benefit of one over the other comes down to your own needs, level of compliance and what level of support you need from an anatomical/metabolic alteration standpoint vs just behavioral. And yes, many, many lightweights who get the DS go on to very successful post-op lives.

I opted for VSG, but I am a strong proponent in promoting what is not arguably the most successful weight loss surgical procedure available. It is not the cutters responsibility to maintain ones health past a successful procedure.. it's the patients. If your level of understanding/commitment/compliance is not up to the needed level to keep yourself healthy (a few handfuls of vites a day, adequate protein/fat intake and labs more often than VSGer or RNYers..) then don't go for it. But by all means, anyone opting to alter their guts NEEDS to understand in FULL all the options available to them and choose the one most suited to their lifestyle vs trying to change themselves to the core to fit their chosen new guts.

Thanks for all of your insights!! It is appreciated!