By all means research the DS. It has the best long-term, maintained weight-loss stats for patients of any size, but especially so for those with a BMI greater than 50. It also has the best stats for resolving or preventing co-morbs like diabetes and high cholesterol.

The DS has a Sleeved stomach, plus nan intestinal bypass similar to, but more aggressive than, that of the RNY. With the DS, you'll always and forever malabsorb calories, as well as certain vitamins and minerals. (With the RNY, the malabsorption of certain vitamins and minerals is permanent, but the malabsorption of calories is not. If you need malabsorption, you're going to need it forever.)

Wow four months and 100 pounds to say I am happy is an understatement! I still have a long way to go about 200 pounds worth to hit my goal! I feel so accomplished and yet I am where a lot of people start their journey. Feels a little overwhelming. I still struggle to eat and drink enough. I average about 500 calories and about 32 oz of fluid a day. Not enough, I know! Working with my surgeon on this. I have an endoscopy scheadules for January 14th to stretch out any areas that are too narrow. Last night I decided to try some curry ate just the broth... Not a good idea I was miserable! Came home crawled into bed and slept it off! First time I've eaten too much! Lesson well learned! This has been by far the hardest thing I've ever done but  I would do it again in a heart beat there are so many things I can do now that I couldn't at 500 pounds! I can walk around a store and enjoy looking! Personal hygiene; well let's just say, I'm capable of taking care of that area now!(sorry if that's TMI) i am still struggling with my lower extremity lymphedema. In some ways it seems worse; not sure my legs are bigger but my gait is all off. I can walk more but I look like frankenstien as I do it. Lol I also have numbness in my legs and lower abdomen that the surgeon thinks may be related to the rapid weight loss. He admitted that he's not sure about this. So it's "wait and see" my goals for the next four months include joining a gym and going. Getting some PT for my legs and improving my diet in respect to protein and liquids. I am so blessed to have this opportunity to reclaim my life! Hope everyone has a wonderful season and may all your dreams come true

It's not mandatory.  A lot of people at very high weights do well with just the VSG - it became a stand alone procedure when individuals had it first and then did not do the DS.  Everyone's metabolism and habits are different.  It is also true that many of us struggle with eating, and the DS has a metabolic benefit in that you can eat more and not gain as easily.  

I might need it simply because of statistics; my highest weight was over 700 pounds.  I got down to 430 on my own and that was my weight June 1st.  I was 400 on surgery day, on the 22nd.  Statistics simply are that I am at risk of regain than the average WLS patient.  I intend to avoid it with good habits, though, as I really don't care for the vitamin regimen of the DS.  Even so, I also know I have eating issues I work on via counseling.

There are many reasons that the DS is still regarded as the best surgery for very high BMI patients, though, due to the results being far ahead of the other surgeries.  Having said that, there are also DS patients that have significant regain, too.  No surgery will work if you rely on it instead of on changing your habits.

It's nice to finally find a few people here that are/were around my height/weight!  I'm 5'2 and was 431.2 when I started my journey in May, but my first appointment with the bariatric clinic wasn't until 2 days ago.  During the 6.5 month wait for my appointment I decided to get a head start on things and began using MyFitnessPal to track everything I ate and had a goal of 1500-1600 calories.  This worked wonders for me and am now I'm down to 362!  

When I went to my appointment they were so impressed with my progress and knowledge of the process that they fast-tracked me in the program and scheduled me to meet the surgeon on Jan.13th.  I'm determined to get the sleeve, as I don't want my intestines re-routed and have to deal with malabsorbtion the rest of my life.  I'll still have many months of appointments before I can be scheduled for surgery, but it's so great knowing that all my hard work and research is paying off!

If you haven't already, I highly recommend starting a food journal and doing all the research you can on both surgeries and what you can expect before/after.  The more you know going into your appointment, the more prepared and comfortable you'll feel with your decisions! 

Best of luck!

My starting BMI on the day of surgery was 78.7 - today it's 58.3, and I've lost 111.5 pounds since June 1st.  I went from 430 to 319 pounds.  I'm 5'1" and have done really well.  So, the VSG is very effective.  The DS is effective.  The RNY is effective.  Any of them

So, the VSG is very effective.  The DS is effective.  The RNY is effective.  Any of them are effective if you follow the rules. 

Now, for higher BMIs the outcomes tend to be better for the DS that is true.  I think that is a combination of behavior and metabolic differences.  The malabsorption is very good with the DS, and it also has much stronger metabolic changes, though we aren't sure of all the details why.  The VSG also alters metabolic regulation too, though these mechanisms are also poorly understood.  We've only known about ghrelin since 1995 or so, so much of this science is new.

My point I guess, is that any surgery works if you work it.  You have to use the sleeve as a tool and not rely on it - you still have to rely on your choices and judgment.

As for sleeve vs. RNY, that's a conversation to have with your doctor.  The outcomes are more on par with each other, though some studies show the RNY has slightly better results.  I did not choose it because I was concerned about having a blind and unscopable stomach.  I also wanted something I knew was completely permanent.  I wanted the option to take NSAIDs in a pinch, if temporarily.  I also knew I might have to revise to the DS one day, though I've had really good results in just six months, at any rate.  We'll see how things look after a year.