I had VSG because I had been leery about some of the issues that may occur with RNY such as slightly more risk of issues immediately following surgery, malabsorption of vitamins/iron, and ulcers. My BMI was about 39, so I didn't really consider DS as an option. I did a lot of research/reading on my own then saw a couple of surgeons. The one I chose felt that I would do well with either and said that people who are motivated can lose just as much weight with VSG as with RNY. In early 2016 they were seeing a big shift from RNY to VSG and in fact a very large percentage of their surgeries these days are VSG. One other advantage to VSG is that it can be converted to DS later. So I somewhat let my intuition be my guide at that point and went with VSG which I haven't regretted yet.

Here's a summary of what my surgeon told me, and the research I did. However, that was two years ago, and in the meantime there is probably new research that your surgeon can advise you about. But here are some of the types of things you will want to consider.

What's best for you will probably depend mostly on any other medical conditions you have, and how much weight you need to lose. For example, if you have acid reflux, it may get worse with VSG, so RNY may be a better choice. If you are diabetic or pre-diabetic, RNY may be better than VSG. If you have a very high BMI, you may be better off with DS.

For people who don't have conditions like that, VSG is typically recommended. It is the least likely to affect vitamin absorption or cause digestive problems. If needed, it can be revised to RNY. The difference in weight loss between VSG and RNY is minor; the amount you lose will depend mostly on you.

In my own situation, my BMI was 46. I was leaning toward RNY because I thought it might help me lose more weight. However, my surgeon suggested I consider VSG instead, because it was the least likely to affect my quality of life. I'm mathematically savvy, and when I read the research papers I concluded that the slightly higher weight loss that RNY patients reported wasn't really significant. So I ended up choosing VSG. My BMI is normal now. I'm still losing, because I want a bit of a "safety buffer".

Whatever surgery you choose, best of luck to you!

It's been a little while since I've posted. What a ride it's been! Ironically, I put off having VSG the first time because I was convinced I was going to have to flee the country after my last election, and that my food choices would be limited. How bizarre to be in a pandemic, confined to my house basically, with limits on what food I can obtain! :D In all seriousness, I'm doing pretty well. I had to have my gallbladder removed last week, semi-urgently which was an adventure, but I'm doing well. I'm down over 100lbs in just over 6 months, which is surprising but awesome. I hope everyone is doing well!

I would be interested in this as well

I have also fallen off the wagon and have been so sad. I've lost about 60 pounds since my sleeve two years ago but haven't been able to get down I am looking for support and to get back on track