Newbie....would love some input..confused more than ever

I have been looking at wls for months now, and the more I look the more confused i get on which surgery is best for me....I have asked doctors and everyone gives a different decision....help please

I have a BMI of 34, about 70 pounds to lose...I have yoyo'd my whole life with weight....and I just need to make a decision...I was planning on having weight loss surgery in Mexico as insurance will not cover me.....

I have been looking at RNY, DS and the sleeve...can someone shed some light on how you can to the choice you made....and are you happy with the results etc.... Trust me I have read on them but I want to make the right choice, not the cheaper choice etc....I just want to hear some feeback from real people telling me there thoughts....


Any info you could give me I would be so grateful....

Hi, I don't know for sure but I thought your bmi had to be 40 or higher to be a candidate for wls.

For most insurance companies it is a BMI of 35 with co-morbidities or a BMI of 40.  She stated she was self-pay in which case a lot of doctors will do it with a BMI of 30 and over since then you are technically obese. 

OP-  There is a lightweights board here on OH http://www.obesityhelp.com/forums/wls_lightweights/ They may have more information for someone starting at your BMI. 

With my insurance my options were the LapBand, VSG or RNY.  The LapBand was a no go from the beginning.  I've done a lot of research and the long term results with the band are dismal.  There are so many people on this site alone that have been revised from the Band to another surgery because it doesn't work.  I also hated the thought of a piece of plastic wrapped around my stomach and the port under my skin.  Also, the band is easy to eat around.  I was worried if I had something that made cheating easy that I would cheat.  

I decided against the VSG solely because the RNY helps to cure comorbidities such as diabetes and high blood pressure.  I was pre-diabetic and I had high blood pressure all at the age of 27.  Since my surgery I have no problems with my blood sugar and I've been off my blood pressure meds for a couple of weeks now.  I also wanted the malabsorption that comes along with the RNY.  I don't mind taking vitamins the rest of my life. It seemed to me that the malabsorption that lasts about the first 18 months would be helpful in getting to my goal.  I'm considered a lighweight with a BMI just under 40, but I still wanted the surgery that would help me to lose the weight and keep it off.  In my case I felt the RNY was right.  

Only you can decide what surgery is right for you.  If you have chronic health issues and need to take NSAIDS then I would go with something like the VSG.  That is my main complaint about RNY , not being able to take NSAIDS for pain.  There are other pain meds out there though that work almost as well and don't cause ulcers.  

I've only recently started to learn about the DS.  So, I don't know enough about it to offer any opinion on it.  It isn't something I researched because it wasn't an option for me.  

Good luck to you in whatever you decide!  You've already made one of the hardest decisions, deciding to have WLS.

 With your low BMI I would consider the sleeve as being the safest if your only problem is volume eating.  If you have co morbidities such as diabetes or high blood pressure or you are metabolically challenged then you are going to need the extra help of malabsorption.  The RNY will give you some malabsorption, which will help you get the weight off but after about a year or so the body adapts and no longer malabsorbs as much food, although vitamins will always be malabsorbed.  All you would be left with at that point is restriction.  The DS will give you life time malabsorption but you have to be very diligent with your supplements as they are malabsorbed more, too.  It also has the best stats for maintaining the weight loss and resolution of comorbidities.  It may be a little overkill but there are many lightweights who have had the DS.  You could get it customized so that you wouldn't malabsorb as much.
If you do go to Mexico for a DS there is only one I heard that is experienced enough to do it.  I think his name is Ungson.  You want to have an experienced and capable surgeon do this surgery for best results.

 You do not have much to lose and I am assuming no co-morbidities since you didn't list any. Elect for the safest, least invasive option.

If I had been in your situation, I probably wouldn't have been looking into WLS at all, but if I did I would go for VSG. You do not require malabsorption, so don't assume the risk of it. 

I can't help you on the Mexico front.  I know there are some that have had great experiences.  Not something I would choose.

I would say since you are a 'lightweight' go for the sleeve.  One of my coworkers opted for the sleeve (I had RNY) and she has had a slower weight loss, but that is what she wanted.  Just food volume restriction.

Sarah

thank you for all you help, i do have risk factor for diabetes and high blood pressure....and i have been told by more than one doctor i need to lose weight or i will end up with diabetes because it is so in my family...I just lost my father to diabetes complications......I have struggled with weight my whole life..I would lose and then gain...most of my family has......I just want to make the right choice...I know everyone is different I just want to make sure that i am making the right choice for me.  I have friends who have done both sleeve and bypass and they have been successful...so i was confused...as i have just recently heard about ds....

I know that i need help to lose the weight, i have no problem exercising...but over the last couple of years(since children) my weight has been getting more and more out of control....

Thank you again for all your help....

I wouldn't go for DS. It's a good surgery, but you do not need it. I considered it as I was over 60 BMI. If you only have risk factors, no actual cormorbidities, and are at your weight, go VSG. It's safer, wll work well for your specific needs and will be less expensive overall.

At your BMI, you really don't want to even consider DS -- it is most commonly done on patients with 200lbs or more to lose. At your weight, DS would most likely give you quick trip to malnutrition and vitamin deficiencies.

That leaves RNY or the VSG. With only 70lbs to lose, VSG might be your best choice. It preserves the pyloric valve, you can take NSAIDs after surgery, and it restricts your food intake like the RNY. With less weight to lose, you may not really need the malabsorption of the RNY.

An advantage of RNY are that it does a better job of reversing diabetes than VSG, but if you're still pre-diabetic that might be a non-issue. It also reduces or eliminates reflux. And just in case something truly awful goes wrong with your pouch, your trusty remnant stomach is still in your abdomen and could be hooked back up.

My insurance covers all 3 surgeries. I chose RNY because: 1) my doctor thought I wasn't heavy enough for DS (I had 140lbs to lose when I started the journey.) Also, he doesn't do many DS surgeries and the number of procedures a doc does has a huge bearing on their complication rates. 2) I had terrible reflux. I would have done RNY for that even if I never lost a pound, and 3) I felt  the temporary malabsorption in addition to the restriction of the RNY would give me the best chance to lose my excess weight.

I'm very happy with the results of my surgery. My recovery was smooth and problem-free. I have not had any complications. I haven't had any problems eating or drinking and very few issues with tolerating foods.

My only regret about the surgery is that I didn't do it years ago!

Good luck with your decision!

Thank you...the more and more I look into it I am thinking that RyN is what i will be chosing.....because of the diabetes factor....I just lost my father to it....and the nurses the whole time i was in the hospital with him, kept telling me to lose the weight or I would end up with it...I was gustantional diabetic with my pregnancies so that increases my chances as well.....

I am so scared  I am thinking of surgery July 1st...I am ready for a chance but scared to death of the surgery....

Thanks for all your help...