Duodenal Switch or Sleeve

Just curious what your thoughts are about the sleeve and long term weight loss success. I'm wondering if anyone with a sleeve has been able to keep their weight off for 3 years or more and just interested in your thoughts in general. I'm trying to figure out which would be the best option for  me. I have to lose 150lbs and have a long history of losing and gaining my weight back. I am also a binge eater-not a grazer- and a carboholic. Any thoughts on which surgery would be better for me? 

You really need to discuss with your surgeon but there are many people on here that have lost that much weight.  My excess body weight was 131.  I am about 23 lbs from that goal.  It will be hard to binge with either one but it is possible.  You should start cutting back on your carbs now because that will make the withdrawals easier when you start your pre op diet and/or the first few weeks after surgery.

You are a self admitted carbaholic.  It will probably be a good idea for you to try and stay away from carbs as much as possible because they could be a trigger for you and the more carbs you eat the slower your progress will be.  If you do not control your binge eating and your carb addicition then none of the surgeries will help you in the long term.

The surgeries are just a tool to get the weight off and it will be up to you to follow your program and change your eating habits for the rest of your life.  If you are not ready to make that commitment and follow it for life then you need to reconsider surgery at this time.

There are people on here that have been able to keep the weight off but some do have to work at it and there are many that have lost at least 150 lbs or more with the sleeve.

Good Luck!

Thanks so much for your reply. I have already started on a low carb meal plan  to prepare myself and am doing okay so far. It's a tough decision because I would opt for the sleeve but I hear a lot about regain years down the line. I would opt for the DS because the weight loss and maintenance is fantastic but I worry about the vitamin deficiency issues and there are just a lot of unknowns out there with regards to possible complications. It's a tough choice. 

I understand that it is a tough decision.  There is not as much data on the sleeve because it is a newer surgery but it is also the first step in have a DS done.  You can regain with any of the surgeries if you don't change your lifestyle and that is what some people just don't get.  They expect to have surgery and that the weight will magically come off and stay off and they don't have to change anything.  I find that to be very sad.  Good Luck in whatever decision you decide. 

both surgeries will work if you follow your plan

 check out the ds forum it works great for many but many people have a lot of problems with gas and diarrhea

 do you like taking handfuls of pills all day for the rest of your life , you will with the ds

 both will limit how much you can eat at 1 time

 the sleeve is a safer surgery ,less chances of leaks , malnutrition, like the rny the malabsobtion  of calories is only temporary, but the malabsorbtion of nutrients is permanent

if you get the sleeve and you need more help it can be revised into a ds

remember all wls are just tools to help you eat better , its up to you what you put in your mouth  

Neither surgery is going to help with carb addiction.  DSers will regain if they eat too many carbs, as well as having gut issues from the carbs.  DS is more forgiving of general calorie intake, particularly from fat and protein.  But, since they have a sleeved stomach, their intake is restricted.  If regain is your primary fear, DS has the best stats for maintenance.  And you pay for that with the most rigorous vitamin requirements of any of the surgeries.  So you have to commit to making your vitamins and annual labs a first priority, no matter the cost.  That's a question you have to answer for yourself - can you stick to the schedule of daily supplements and can you afford them for the rest of your life?

VSG is restrictive only.  It also won't stop you from putting carbs in your mouth, and many carb laden foods are "sliders."  They go right  through your pyloric valve, so you can eat a googob of them.  Yes, you can lose all your weight.  Yes, you can maintain your loose.  But you'll have to adapt to a new way of eating (also true of all the surgeries).

Well, there's the long answer.  The short answer is that either one will work.  But you need to deal with the binge eating issue first, because no surgery will fix that.

My doctor sold it to me this way.  Do the VSG if you don't reach goal (following the plan) we will do a second surgery to make it a DS.

I have lost 150lbs in a year, kinda stalled out right now 30lbs from goal, but I haven't been as good with my plan over the last two months as I should be.  Once I buckle down and put in the effort I'm sure the sleeve will continue to help me loose the last bit of weight along with a healthy dose "of get off my butt"

You wont be able to do large quantity binging after either option, but neither surgery will dictate the choices you make on what you put in your mouth.

That's exactly what I thought of doing-sleeve first then convert to DS- but ins will not cover the second surgery  if I need it and it will have to be out of pocket. In addition, my doc told me that if I did convert to DS and paid out of pocket-$26-30,000+-that my insurance might not cover complications due to the surgery.  I have also heard that folks do not lose as well when they get a two parter. It sounds like you are doing great!  

My biggest concern is regain. I wish there was more long term data out there on the sleeve so I could get an idea of what the % regain was. At least that would give me some idea of what I'm dealing with. 

I think regain is very situational, everyone is willing to tell the story of the person they know that "gained it all back, plus some"  We have to take time before surgery to make major life changes in our relationships with food, and keep those changes even once we hit goal.  No matter what surgery type you pick, if you continue with bad habits or go back to bad habits, there will be regain.

I feel you, sunshine. I'm in the same dilemma. The advice on the forum to you sounds accurate, from all I've read. It might be a case of "there's no RIGHT answer-you make a decision and make it right by what you do afterwards."  I also am concerned about remission for diabetes-I've had type 2 for 17 yrs and am on 2 insulins now.