Roux-en-y vs. Sleeve

Hi All! 

I need some input.  I've been researching WLS on and off for about 14 year (yes, seriously) and I'm finally ready for surgery. But I can't decide which one would work best for me RNY or GS and that's where I need your help.  I'm highly analytically and I've visited with 3 top surgeons, researched both surgeries for hours, attended 3 nutritional seminars, 2 support groups, 1 4 hour in-person seminar and taken several online WLS classes in preparation, read as many clinical trial results as I can find, (Basically over-analyzed it) and now in the anxiety of having to make a decision & overwhelming myself with data... can't make a choice.  --And Yes I know it's just a TOOL, but just as you would want to select the right tool to build a fence.... I want to pick the right tool to help with my WL situation. 

Before replying... Please allow me give you a little background... about me.  (Maybe it'll help) 

I'm a 34 yo F 5'10" tall with a current BMI of 37-38, with several co-morbidities (Hypothyroidism, Hypertension, Sleep Apnea, and my blood sugar and cholesterol numbers are increasing year over year.)  My weight battle started when I was 17 and was diagnosed with a pituitary brain tumor & subsequently I've Yo-Yo'd up and down 4 MAJOR times (over 100 lbs each time) in the past 17 years.  HW 286 LW 151.   (BTW the tumor is gone, but my body chemistry has changed forever.)   Like many of you, I have portion control issues, and if I had the worlds best self control I wouldn't have let myself get fat AGAIN, so let's be honest... the idea of a Big Mac and Fries or the like is really tempting.  With either the RNY or GS portion restriction should help, but with the fact I've failed at maintaining a low healthy weight 4 times before & I know what's healthy to eat and how to exercise... I'm worried I'll fail again and need to pick the right tool for the job.  

So again my question to you... taking away all the extraneous issues (cost, surgery time, recovery time, time off work, invasiveness)  Long Term what's your thought on what might be the best surgery?   (Note: RNY and GS are the ONLY 2 procedures I'm considering.) 

Thank you in advance! 

The Yo-Yo-Girl

I swear by the RNY. Had it three months ago and im doing great. I know the sleeve isn't good if u have acid reflux and the like. My friend had the sleeve 8 months ago and shes doing well, lost 90. Shes had more issues tolerating food then me but that could just be her individual situation. I think most rny patients complain about taking all the vitamins and such but I really dont have a problem with that. Both rny and sleeve have had issues getting a protein drink they can tolerate. I found I can only take low carb soy protein because im more sensative to lactose now. I guess you should consider the long term lifestyle.  I think thats where the biggest difference is. With sleeve you dont have malabsorbtion in the future but that also means you absorb more calories. 

Yes it does depend on some things. They do say if you have reflux the sleeve can make it worse. Mine actually went away. Also if you ever think you will need NSAIDS in the future you can take them with the sleeve. Some people want malabsorption so they get the RNY. I did not want that I just wanted a smaller stomach and loss of hunger, which I got. Some want the dumping syndrome but I have read only about 30% of RNY patients actually get that. So I would suggest maybe you ask on each respective boards why they choose the one they choose you may get some ideas of what may work for you.

Thank you! 

As for Acid Reflux I don't have any issues, so I can take that out of the equation too.  I realize it'll really just boil down to making a decision.  As much as it would be nice to be able to have a cheat here and there... a cheat here and there resulted in a 20-30 lb weight loss, which resulted in a little depression, which resulted in well... you called it, more eating and on and on.  Which means I need the benefits of the malabsorbtion & the "punishment" if I do cheat.  However, one of the MD's warned me of having to eat like a diabetic for the rest of my life without the disease & may have severe allergic reactions to any sugar after the RNY.  So... The bigger issue, is the long term effects.  Pills/vitamins don't bother me; I'll just replace the medications with vitamins, so that's not a concern.  :)   My concern is the potential complications with either, but I'm in hopes since I'm taking care of it while I'm still in the 35-40 range that my complication rate may be lower.  Since I'm a newbie to the site I'm not sure how the forums work, so thank you for your replies.  I'll also try posting in each of the prospective boards.

Have you found any studies which listed complications by BMI at the time of Surgery? 

Where did you find the 30% statistic? 

it is just common knowledge. if you find the website of american bariatric surgeons they have all kinds of data. also the malabsoprtion of food goes away after 2 to 3 years. that is why regain is common at that time. i like the removal of hunger with my sleeve. 

You need to read up on reactive hypoglycemia, too. I personally think there's a reason you should keep your pylorus intact.

Well, since I've had the RNY - I can only speak to that procedure.  BUT, I have not had a Big Mac or French Fries in over 5 years.  As a matter of fact - even the thought of greasy foods makes me nauseous.  Is that a product of my RNY?  I don't know for sure.  I just know that fried foods have no appeal to me whatsoever.

I also cannot tolerate pastas or breads - so as a former bagel freak - I've not had anything like that in over 5 years as well.  Oh, and I can't tolerate pizza either.  And you know what???  I'm grateful that I can't tolerate those things - and I consider it a gift!

Good luck in whatever you choose - you've certainly done your homework

Sandie

Thanks Sandie!

I think I've done too MUCH research!  LOL.   I may need exactly that... the inability to tolerate those foods, but the fear of additional complications has me a little worried.    Is there anything you regret about having the RNY?

Oh gosh - are you kidding me - I've said this a million times before on here - but I had acid reflux so bad that I'd wake up in the middle of the night gasping for air because I was choking on acid.  RNY cured that immediately for me.  I did have a complication (small bowel obstruction) that required surgery - but that was a mere "bump in the road" actually. 

So far - I've not had any regrets whatsoever!  WLS saved my life - I am sure of it.  And everyone's story for each WLS will be a little different from someone elses.  You have to decide which fits best for your lifestyle and needs.  (as long as it's not the Band - and I only say that due to the feedback people on here have posted; you just gotta do what you gotta do, girl!)

Sandy you said that quite well. It really is such a personal choice. Plus we are all going to be somewhat partial to the one we got. I always say it is like asking a bunch of motor heads what kind of car to buy, every single one will say a different car. It really is what best fits you. I am doing well with the sleeve but someone in my support group is struggling at only a year out and may need a revision so it all depends on us.