I had gastric bypass in 2008 and was very successful, the sleeve was not an option at that time. I had too much weight to loose for the band. My 23yr old daughter struggled wt obesity her entire life now she also has many medical conditions due to the access weight. She must loose at least 60lbs and her bmi is over 35.  We can use some help deciding what would be best for her surgery wise.  The gastric Bypass or The Gastric Sleeve (where I have heard many people are not always as successful?) So if you have any comments good or bad or indifferent please feel free to comment.  We  would appreciate any and all information possible. Thank you all for your time.

I recently had RNY. My doctor indicated it is the best choice for anyone with diabetes-related medical issues.   If that is one of your daughters problems then that may be best. Your doctor can help a lot with the decision. 

What I have seen over the years...If you are young and have 60-100 pounds to lose the sleeve is better.  Years down the road you can convert to the RNY if necessary.  If you are say over 50 years old, and have over 100 pounds to lose, either the RNY or the DS would probably be the way to go.

This is something that is a very individual decision. If your considerations are down to bypass or sleeve (have you looked into the duodenal switch?) then I'd suggest that you spend some time reading through the forums dedicated to those surgeries to get a little better of what your daughter may be facing. There are many factors that can influence the choice: If she is a volume eater, then the sleeve may be a better choice for her. If she makes bad food choices (which she'll have to change no matter which surgery she gets, to be honest) then the temporary malabsorbtion of the bypass may be better. If she takes NSAIDs for any chronic pain issues, it's back to the sleeve (NSAIDs are not a good idea for people with the bypass.) If she's not likely to be compliant with a supplement regimen and monitoring of her labs for the rest of her life then the sleeve is again the better choice. If the initial boost to weight loss that the bypass causes by virtue of the malabsorbtion would help her with the mental and emotional changes she must make to be successful, then go for bypass. If she suffers from GERD or heartburn at all at this point, the sleeve is not advisable as it often makes those problems worse. Long term success rates for sleeve and bypass seem to be very similar, keep in mind. Also, the very best input you can get may be from a qualified surgeon who performs both surgeries. He or she is in the very best position to advise you.

I can say that although I'm a newbie at four and a half months out, I'm very happy with my RnY bypass and the results it's given me so far.

Good luck to you and your daughter.

I would go for a sleeve.....keep a functioning pyloric valve!! Read this...................

New Data on Weight Gain Following Bariatric Surgery

Gastric bypass surgery has long been considered the gold standard for weight loss. However, recent studies have revealed that this particular operation can lead to potential weight gain years later. Lenox Hill Hospital’s Chief of Bariatric Surgery, Mitchell Roslin, MD, was the principal investigator of the Restore Trial – a national ten center study investigating whether an endoscopic suturing procedure to reduce the size of the opening between the gastric pouch of the bypass and the intestine could be used to control weight gain in patients following gastric bypass surgery. The concept for the trial originated when Dr. Roslin noticed a pattern of weight gain with a significant number of his patients, years following gastric bypass surgery. While many patients could still eat less than before the surgery and become full faster, they would rapidly become hungry and feel light headed, especially after consuming simple carbohydrates, which stimulate insulin production.

The results of the Restore Trial, which were published in January 2011, did not confirm the original hypothesis – there was no statistical advantage for those treated with suturing. However, they revealed something even more important. The data gathered during the trial and the subsequent glucose tolerance testing verified that patients who underwent gastric bypass surgery and regained weight were highly likely to have reactive hypoglycemia, a condition in which blood glucose drops below the normal level, one to two hours after ingesting a meal high in carbs. Dr. Roslin and his colleagues theorized that the rapid rise in blood sugar – followed by a swift exaggerated plunge – was caused by the absence of the pyloric valve, a heavy ring of muscle that regulates the rate at which food is released from the stomach into the small intestine. The removal of the pyloric valve during gastric bypass surgery causes changes in glucose regulation that lead to inter-meal hunger, impulse-snacking, and consequent weight regain.

Dr. Roslin and his team decided to investigate whether two other bariatric procedures that preserve the pyloric valve – sleeve gastrectomy and duodenal switch – would lead to better glucose regulation, thus suppressing weight regain. The preliminary data of this current study shows that all three operations initially reduce fasting insulin and glucose. However, when sugar and simple carbs are consumed, gastric bypass patients have a 20-fold increase in insulin production at six months, compared to a 4-fold increase in patients who have undergone either a sleeve gastrectomy or a duodenal switch procedure. The dramatic rise in insulin in gastric bypass patients causes a rapid drop in glucose, promoting hunger and leading to increased food consumption.

“Based on these results, I believe that bariatric procedures that preserve the pyloric valve lead to better physiologic glucose regulation and ultimately more successful long-term maintenance of weight-loss,” said Dr. Roslin.

I think the choice needs to be indicated by the individual and health issues and comorbidities. I had to do my RNY because of my severe GERD, and I do miss NSAIDs. 

I also think your daughter's choice needs to be made working with her Bariatric surgeon- here we aren't professionals, and have only our own experiences and opinions, plus we are only strangers to you. Our personal experiences and opinions can be helpful, but they aren't a good basis on which to choose permanent body changing major surgery.

I also would suggest your daughter needs to do her own research. I understand your concern for her, but it is her body and choice as to what to do with it. Also, if she does her own research, she will be more invested in the results.

Congratulations on your success! I always love hearing long term success stories- they give me hope and inspiration.