Okay, here's what I don't get...

I'm sure malabsorption was at work even early out.. you had a double whammy, tiny quantities that were not fully absorbed. The sleeve (statistically) loses slower than the DS. I fully expect I will take near to or over a full year to get to goalish range.

I've lost 50lbs in 5mo and 1 week since the sleeve. That's about 46% of my excess weight (109lbs) gone so far from surgery date till now. I had 125lbs to lose to get me to a normal BMI when I started this thing (from 280 to 155.) I worked on some lbs prior to going under for the sleeve.. so my losses out the gate were naturally a little slower. Comparing EWL% is much more accurate than looking at just pounds lost.

So many factors, but whether she's at goal or not- I'm sure she will be feeling much better with a good chunk of weight gone vs not. Will she hit goal? Who knows. Does she need malabsorption? With 200lbs to go, I'd consider it for sure. With just the sleeve, the first year- yes she will lose a significant amount regardless, unless her metabolism is really messed up, or she eats around it.. but getting to or staying at goal, that's another matter.. Some will, some won't- that's just stats. You know the stats for the DS.. is she against it?

She will not stay on top of her doctor(s) regarding her special post-op needs.

Like...my hematologist wanted to make sure my anemia was due to my genetic thing and not a bleed.  He was all excited that he was going to have me do a "swallow the camera" thing.  He left the exam room and I stuck my head out and yelled, "How are we going to get that camera to do a U-turn to go up the other limb?"

He stared at me for a second and then said, "Oh, ****  I'm the doctor here...I'm supposed to figure that out.  Sorry...endoscopy and colonoscopy for you."  My sister would never have thought of that and if she had, she'd assume that the doctor was smarter and had already considered all of that.

Same with time-release meds.  I have to stay on doctors about those because they just don't have time to dissolve in my gut.  My sister would never question her doctors.  She'd have to take me to all her appointments and I already have to go to all of our mother's appointments!!

She says...and she's right...that she's just not a good candidate for a malabsorptive surgery.

Gotcha! I understand.. I'm fine with saying yes, no or wtf??? to my drs.. but regardless, I hate going to them for any reason. I avoid it unless I have to, so that was one consideration among many I had when comparing the two so I get this. 

I think the sleeve gives so much of a varied result in how much weight loss because not only are all the patients are different in their own way and medical issues, but then add that to the issue that so many drs have their own version of how they do the sleeve, and then so many programs and nuts have their own food plan and different calories limits..

I think that is way more noticeable today than it was when i was first sleeved.  when i was first sleeved, we had patients with sleeves ranging from a 32f to a 42f and the difference in the amounts that were eaten were minimal if noticeable at all, even today the then 42f patients seem to be eating similar amounts to the 32s

what i have noticed more recently is that alough most surgeons do not use over a 40f anymore the amount of food eaten is sometimes more than a few ounces different and can be double of what i was able to eat at the same stage,  i have even seen people being able to eat double what i can eat now at over 2ys  but they are only 1 month out. so the sleeve is definatly not standardized

since i have been on the boards i have seen many many people lose 100lbs in 6 months or less and although she may not get to goal in 12 months  she would definatly be feeling alot better and moving around alot better..

Your sister most definitely could be feeling awesome by then!  I lost a little over 70 lbs in the first 3 mths..100 lbs at 5 mths..and now 151 lbs at 16 mths postop.  I started at 354 lbs..size 32 jeans..now i'm 203 lbs so far..and a size 14 jean and L/XL tops.  I am still losing, normally just one week a mth..about 5-7 lbs.

I think your sister could do very well with her sleeve.  My surgeon used a 32 bougie..and from what I hear..he makes them 'nice & tight'..i still, at 16 mths can only eat 2oz of meat for a whole meal..nothing else.  I can just now eat 1 scrambled egg. 

I think that people will get OUT of a sleeve what they are willing to put INTO it. (Or, not put into it, hahaha!)

I think that someone that uses a great surgeon, and is willing to commit to the eating plan (especially the carbs under 40 part) will be successful. HOW successful will likely depend on working out, etc.

Here's what MY surgeon would say on the subject...

My surgeon's statistics show excess weight loss of nearly 50% at 3mos, 80% at 6mos, and "goal" by 1 year. He defines "success", however, as losing at least 75% of excess weight with a sleeve, and keeping it off (at least 75% of excess weight) for 5 years.  These statistics are based on activity 3+ times per week, and NO carbs other than what would be found in dairy, yogurt, or early out while on mushy foods (the only time he allows potatoes, cream soups, cream of wheat).

The difference in that number being 75%... 50%, or 100% all depends on diet and exercise.
According to my surgeon, carbs/sweets/sliders are probably the factor in weight gain and/or failure to reach goal.

 **See gintobthin's post just before yours...  There's a prime example of what your sister could have in half the time you've promised her.  

 Hi Sue,

  I say she has fantastic chances at getting to goal. I say this because if she is so diciplined as to stick to her "what to-do" list...which is hard...then all she needs is the tool that will help her stick to her "what to eat" list. And the sleeve is the perfect partner in losing weight by eating right and excersice. Mind you, I only did 15 minutes on the treadmill when I first started excercising. It's progression that counts and something is better than nothing. I say she has nothing to lose but weight!

Blessings to you and yours,
Jenny 127lbs lost