Lapband vs RNY

How does a person go about deciding which WLS to choose? OPEN FOR COMMENTS Thanks DollyC

This comes straight from my heart so please take from it what you need.

I believe that each person needs to do their research before having any weight loss surgery. There are several options out there and you are NOT just limited to the band or RNY. You also have VSG and Duodenal Switch ("DS") as options.

Personally, I chose the DS because it leaves my original stomach in tact vs. having a man-made pouch (RNY). I found that the DS patients I talked to in my research phase were all happy with their surgery and had kept the weight off. It has the BEST long-term results. It is an extremely excellent choice for patients with diabetes as well.

There are pro's and con's with each surgery. You will need to make your list.

I also suggest visiting all the local programs so that you get a feel for each program. They all have their unique qualities.

One other thing I recommend is visiting the Revision forum on this website. Very honest information there!

If you'd like more information on the DS, there is a forum here on this site and there is also www.duodenalswitch.com which has in-depth information for you.

Good luck in your decision-making process!

p.s. - also call your healthcare insurance to find out what your benefits are specific to weight loss surgery and what their pre-surgery requirements are.

I'm a revision post - op (a previous VBG and a revision/repair of that VBG).  Revisions are tough to handle and much riskier than a virgin surgery - I wish the DS had been available in the 80s when I started my bariatric surgery quest.  Restriction only obviously wasn't working for me!  I needed the malabsorption component to overcome my overly efficient body.  I refused to take the chance of living with the risks of dumping and didn't want the restrictive component of the surgery be the make it or break it component - cuz I would have broke it!  I didn't want to live on a diet anymore.  Please check out the duodenal switch forum here on OH, and check out www.dsfacts.com for some 'at your fingertips' information about the DS.

I chose the band because I wanted the least invasive surgery available. I was a volume eater and restriction was the right tool for me. It's slower then the other options but I didn't gain the weight overnight so why try to lose it that fast. It also has a good track record for maintenance which is where I failed every time before.
All the surgery options will work if you are commited to it, the hard part is finding the right one FOR YOU.

The key to find out which surgery is for you is RESEARCH!!  Learn all you can about each one and make that list the privious posters mentioned.

Good luck to you in your search for the right path.

Research takes many forms, and one form is certainly to ask other people how they decided.  There are forums on this web site for many of the different surgery types...look into some of those and just read what issues people are having.  For instance, there is a link in the upper left side of this page that says Surgery Types, click on that and it will list many, which you can follow.

Your surgeon can also help you decide by evaluating your life style, personal issues, how much you need to lose, co-morbidites, etc...

Good luck on your journey...

I was asking this question one year ago this month!  :O)
I believe you will know what is just right for you.  Like the others have said, research, ask just like you are doing now and read books and articles.  

I chose the RNY and my two sisters chose the band.  They love their band and I love my RNY!  :O)   It's amazing how I just knew I needed the RNY when the band was perfect for them. 
I chose the RNY because I wanted the dumping syndrome from eating sweets.  I also wanted the malabsorption that came along with this surgery.  I ate sweets many times a day before surgery and was really uncontrollable around sweets and my cravings for them.  I am now 8 months out and I can enjoy a couple bites of sweets, but no more than that. 
Good luck with your decision!

Hi Dolly C,
Since you've asked, I guess I'll give you my two cents here....

I went about deciding which DS to have by learning all that I possibly could about each and every one that was available on the market as it stands today - regardless of what insurance I had at the time, or what the insurance company said they'd cover or not cover.

This led me to my decision to have the DS.

Of course, I, like so many others, have been dieting all of my life. I wanted an end to my diet mentality, and the fight with myself. The only surgery that even came close to building that utopia in my mind was the DS.

For the first year, I was OUT of the DIET PRISON MENTALITY!!! Absolutely eating whatever I wanted (not in high portions because my stomach was smaller, and without the hormone ghrelin raging through my body, my appetite was much reduce). I did eat, though, and more often than not, keeping an eye on my protein grams (always above 100g/day).

Now, in my 15th month out, my weight loss has slowed considerably. Where I used to drop 10 pounds in a month, I'm only dropping 3, if that. So, I have to go back to monitoring my intake, and somewhat of a Diet Mentality. Not that that's bad, it's pretty normal, actually. Taking in protein first, keeping carbs lower than protein, working out at the gym, and keeping my liquids way up. I'm hoping to restart my weight loss at a higher rate, but even if that doesn't happen, I'm okay.

I've gone from a size 34 dress to a size 24 dress in the last 15 months, and I couldn't be happier.

Sorry for traveling down that little tangent...let me get back to my point.

The point I'd like to make most for you is ... learn learn learn. Study study study. Ask QUESTIONS of EVERY PERSON you know that has had ANY FORM of weight loss surgery.

Read ALL the ObesityHelp.com message board forums. The DS board, the Main Board, the Revisions board, the Lap Band board, the RNY board, the VSG board. Soak in all the messages and answers to those messages.

If you can, attend a Lap Band surgery orientation or two. Attend an RNY surgery orientation or two. Attend a DS surgery orientation or two.

Use my profile as a place to gather information about the DS if you'd like. It's chock full of good stuff for the beginning learner of the DS.
There are medical journal studies and results posted on my profile, too.

The Lap Band, RNY, and DS work. In my opinion, the DS was the only chance I had out of my obesity prison, and even if I don't get all the way out of this obesity cage, I'm still okay. I've got much of my health back.

My risk of aquiring Type II Diabetes is now minimal. My sleep apnea is almost gone (I was at the highest possible therapy for that). My heart condition has disappeared. I used to walk with a cane, and for one outing prior to surgery, I was actually wheeled around in a wheelchair! I used to take the scooters at the grocery stores because my bones and muscles wouldn't carry my weight without incredible pain. Now I'm free to move about, and I do so with great happiness and ease.

Sorry to go on and on. I just wish for you to find your answer out of your obesity prison, too.

My reasons for choosing the DS:

 

My reason for choosing the DS:

1. The DS allows a person to take NSAIDS (Advil). I need that because of pain associated with arthritis.

2. The DS "forgives" calories. I like food. I like to eat. The DS absorption of calories is like this: carbs = 60-100% absorbed, proteins = 60% absorbed, fats = 20% absorbed. This means, out of a breakfast that I just ate, a four-egg omellette with cheddar cz, prepared in butter and oil, about 700 calories total, I'll only absorb 340 of those calories. And it was delicious!

3. The complications and risks associated with the RNY and Lap Band were not the kind I wanted to have - not that the DS doesn't come with complications and risks - but the risks were different. For example, I didn't want to NOT lose weight. That can happen with any of these surgeries, but the slowest loss seemed to be with the lap band. I would have to rely on ONE PERSON to fill and unfill my band, trying to find the "sweet spot" where I'd continue losing weight. I didn't want to have to go back to the Nurse Practitioner time and again, discuss my food intake, and have her adjust my band with a lecture every time, plus a $215 fee, potentially every 2-3 months as a postop. Nope, not for me. One other example is about the RNY. The RNY wouldn't allow me to take my Advil. The stomach (pouch) is just too small, and fragile for a hard-on-the-stomach med like Advil. My arthritis is still painful to this day, and I'm so glad I didn't have the RNY on this principle alone. Then again, I didn't want my stomach to be sitting in my body, producing acid, and potentially getting stomach ulcers from such later.

4. The DS looked like it had the best outcome for the most people. This has been proven a couple of times by the medical professionals themselves with empirical evidence (see my profile for the studies themselves). Since my body has been an expert at putting on and keeping fat cells full and plump, I needed a surgery that would provide BOTH restriction and malabsorption, and an excellent outcome rate, at over 10 years out.

If you have any questions, please just ask me.

:)
anne s.

I would look at all the aspects of your health.... co-morbidities, weight, age, etc.

Then I would look at your habits and willingness to commit to certain things - band fills (band) vs. taking daily vitamins (RNY)... that kind of thing. Each sugery has their own set of lifestyle changes after the surgery.

I started at 304lbs...and though most people would push the RNY for me, I chose the band. I like the adjustability of it... and being able to get a fill any time I feel like I am falling into overeating.  I was also a VOLUME eater so that really helped. In my opinion, the band takes more self-control... especially in the  beginning... but the RNY takes more self-control after the first year or so... in order to keep the weight down.

Ask yourself:
-Can you handle slower weight loss (band) that will still get you to goal? (though for some, it really isn't all that slow!)
-Can you commit to taking your full set of vitamins daily (RNY)?
-Are you OK with the idea of a fill and getting adjusted (band)?
-Will you be able to make the neccessary changes to your food choices, sugar intake, etc in order not to dump (RNY)?

That is just a few questions of many to ask yourself...

How did I come to the conclusion of the band?

--I wanted slower  weight loss
--I LOVED the adjustability of the band
--I like the learn new habits as I go
--It is reversable if anything goes wrong
--There is a very, VERY morbidity rate and the complication rate is low

So far I am 6 months out and down 73lbs. :-)

Hi Dolly.  We are lucky in MN to have two DS surgeons.  Most states do not even have one.  You have the opportunity to do your homework and choose the best surgery available to you.  Please research all surgeries.  The bad thing is a surgeon who does not do the DS will not give you good information about it.  THey will tell you bad things about it, because they want your money.  Do not take their word for it.....go to a true DS surgeon and get the information for yourself.

Good Luck!!
Jennifer