Sleeve or Bypass? That is the question.

[miss_malone]

So I have my surgery date confirmed (Jan 8th) and it looks like my finances are sorted.

Now I have to decide Sleeve or Bypass.

I started out thinking Sleeve, but as the weeks have gone by I have moved into the Bypass camp.

I think ultimately I feel like I need as much help from my 'tool' as I can get. I'm worried that the sleeve won't be quite as effective as the bypass and don't want to spend so much money and find in a couple of years that I need to get the sleeve converted to a bypass anyway.

I weight 23 stone at this point.

I feel like with the bypass I will have the added 'help' of needing to avoid dumping and this being and extra 'tool' that i wouldn't have with the sleeve, and the same goes for malabsorbtion.

Thoughts???

xoxo

 

[lyzzyanne]

You will get all views on here!!!

I went for the bypass as my surgeon said it was the gold standard, been around and proven for the longest and the one most likely to clear up my recently diagnosed diabetes.

I don't regret it for a moment, I have had dumping but it really helps me keep on track, I am sure its the malabsorption that is helping my weight loss.

 

[Mazza]

Talk it over with your provider but ultimately its your decision. Based on your eating habbts etc they can advise which they think would be best.

Not all bypassers dump and some sleevers do.

Good luck and I'm sure you will make the right decision for you x

 

[Sharonimo]

I feel like with the bypass I will have the added 'help' of needing to avoid dumping and this being and extra 'tool' that i wouldn't have with the sleeve, and the same goes for malabsorbtion.

As Mazza says not all bypassers dump .... and some sleevers do.

I am a sleever who dumps badly (have mentioned it on various previous threads).

I also started out at 23.8 stone and am now 15 stone 11 lbs (nearly 8 stone lost).

There have been a *few* times that I have wished I had a bypass -- mainly only when I was having a bad stall last month hovering around 16 stone 2 (plus or minus a pound or two either side of that) ...... until it finally shifted below 16 stone this week ..... then all the thoughts of "Oh wish I had had a bypass and had the malabsorption NOT absorbing all the calories for me" have entered my head ..... but I know deep down the reason I was stalling (too much stress was leading me to bad habits and picking at snacks again).

Most of the time I am glad I had a sleeve, even tho I know my weight loss will ultimately be slightly slower than bypassers and it will take me until at least April 2013 (one year post op) to reach my goal weight of between 11 - 12 stone.

 

[HoPe*87*]

I'm a sleever and do dump!! Like others have said u need to work out wot is best for u. Sleeves can loose just as much weight as bypassers. I started at 18.9 day of my op I was 16 and today 8 and a half month post op I'm 9.8!!

Good luck in wot ever u decide to do xx

 

[miss_malone]

Hi Guys, Appreciate your advise, it is really helpful to get input from people who have already had surgery or made this decision.

My surgeon is very much leaving it up to me. He has a preference for the sleeve because he prefers to do them and feels outcomes of both are similar enough that the sleeve is better because it avoids malabsorbtion and is less high maintenance after surgery because of this.

I have a few weeks to think about it anyway so I'll wait a while before making the final decision.

 

[ThinnerJemima]

I have a band, but it's not working out for me.

I've been looking at the upgrade options and have been through sleeve and bypass, recently I've been getting to grips with the Duodenal Switch as my favoured option.

 

[stuckinafatsuit]

Hi
Its a really hard choice, i was given the choice of both and its only because im such a chicken i had the sleeve!
I have lost 8 stone with it so its working well for me and i was 23.1 stone.
Whats your reasoning behind thinking it wont be as successful?

Kim

 

[incognito_46]

It's a personal thing I think. I couldn't afford the Bypass hence I went for the sleeve. I am curious though. What is dumping? What does it feel like please?

 

[Wonderlust]

I wasn't given the choice and had a sleeve.

But the surgeon is sure that I will be back to have the sleve converted to a duodenal switch when the sleve stops performing as well.

So far I am very happy with my Sleeve and the losses have been excellent.

 

[Mazza]

Yep the sleevers on here are really showing us all hows its done!

There are some truly inspirational success stories

 

[Beckiboo]

Hey
I am faced with same decision. Though am now leaning to the bypass.
I have a band currently, which needs to come out, so am having a conversion.

When I first started researching, I was adamant I was going to have the sleeve as it didn't seems quite so drastic. When I saw Wendy at my consultation, she raved about it.
However I had also seen an NHS doctor who said I should have the bypass.
The sleeve has not been around as long and therefore its results are not as well documented.
Another thing that worried me is that people have ops converting the sleeve to the bypass. If the sleeve worked why would this be needed? I do not want another op
My worry about the bypass is the malabsorption. Will I be able to get the nutrients etc in that I need to be healthy?
When I was talking to Wendy, she looked at my eating habits, and therefore the sleeve was better. I don't have an overly sweet tooth etc.
However when I mention my uncontrollable hunger, she lent more towards the bypass.
The decision is hard!!
I wish you luck in making your decision - whatever you decide it'll be a great start to the new you
xx

 

[BrianT]

Hey
I am faced with same decision. Though am now leaning to the bypass.
I have a band currently, which needs to come out, so am having a conversion.

When I first started researching, I was adamant I was going to have the sleeve as it didn't seems quite so drastic. When I saw Wendy at my consultation, she raved about it.
However I had also seen an NHS doctor who said I should have the bypass.
The sleeve has not been around as long and therefore its results are not as well documented.
Another thing that worried me is that people have ops converting the sleeve to the bypass. If the sleeve worked why would this be needed? I do not want another op
My worry about the bypass is the malabsorption. Will I be able to get the nutrients etc in that I need to be healthy?
When I was talking to Wendy, she looked at my eating habits, and therefore the sleeve was better. I don't have an overly sweet tooth etc.
However when I mention my uncontrollable hunger, she lent more towards the bypass.
The decision is hard!!
I wish you luck in making your decision - whatever you decide it'll be a great start to the new you
xx

The sleeve is sometimes used as a first procedure for those that are super heavy as it allows them to get some weight off first and then they can have the bypass to help with the rest of the weight.
As regards the hunger because the sleeve means that a large part of the stomach is removed the part that tells you you are hungry is no longer there and so the hunger pangs either stop or are so minimal its not an issue, I don't believe this is the case with a bypass, but there are many on here who can put you straight on that.

 

[Sharonimo]

The sleeve has not been around as long and therefore its results are not as well documented.

Here's a few recent results from 3 year follow up sleeve studies:

Obesity Surgery, Volume 22, Number 3 - SpringerLink

Laparoscopic sleeve gastrectomy as a stand-alone p... [Obes Surg. 2012] - PubMed - NCBI

Another thing that worried me is that people have ops converting the sleeve to the bypass. If the sleeve worked why would this be needed? I do not want another op

This is usually only because of 2 reasons:

(1) The patient weighed over 400 lbs to start with and the sleeve was used as a "first stage" procedure to get help them lose between 8 and 10 stone and then a DS (duodenal switch) or bypass was used as a planned 2nd stage procedure to help them lose the rest.

(2) They were a sleever of lower starting weight who did not follow the rules, started snacking too much on bad carbs and ended up stalling and not losing sufficient weight (or they stretched their sleeve due to frequent bad habits, over filling the sleeve etc) ..... and then a bypass was done to aid them on their way ..... however bear in mind simply going thru a 2nd surgery (any 2nd surgery) will involve that patient going on another "pre-op" diet and post op liquid only stage for 4 - 6 weeks ..... and that in itself may be a large part of the reason why weight loss THEN resumes again after the 2nd procedure.

Please see my comment above about the recent period when I was stalling just above 16 stone -- I also thought "oooh, I wish I had the bypass so it was malabsorbing all these naughty extra calories for me" -- but all the naughty extra calories (carb snacks) were *MY* fault and entirely the reason why I was stalling. I don't need a bypass, all I needed to do was go back to basics: 3 meals a day, no snacks, high protein and weight loss with the sleeve resumed again.

See also Brian's (similar) comment in his own diary this week.

The sleeve is *ideal* for people who "only" have 100 lbs or just over 100 lbs to lose (say up to 120 lbs or so) ...... it is not usually recommended for people who have more than 150 lbs to lose as a "one stage" procedure -- but there is plenty of anecdotal evidence that some sleevers can lose between 150 to 200 lbs with a sleeve if they stick to the rules.

I chose the sleeve even though I did initially have more than 150 lbs to lose and I knew there was a slight risk in doing that ..... but I really don't want to have to go through a 2nd surgery, so I will be doing my best to make my sleeve work for me.

My worry about the bypass is the malabsorption. Will I be able to get the nutrients etc in that I need to be healthy?

Yes -- especially if you eat good quality high protein foods and a few veggies ..... if you abandon "the rules" and subsist on low quality carb loaded food (bread, potatoes, pizza, etc) then you may well run into problems getting enough nutrition.

With the bypass it is even more important to "stick to the rules" and concentrate on high protein foods after the op (bypassers are recommended to aim for 80 grams of protein a day and sleevers 60 grams -- that is because bypassers will not even be absorbing all the protein that they consume, so they have to compensate by eating *more* protein and fewer carbs).

 

[stuckinafatsuit]

Hey
I am faced with same decision. Though am now leaning to the bypass.
I have a band currently, which needs to come out, so am having a conversion.

When I first started researching, I was adamant I was going to have the sleeve as it didn't seems quite so drastic. When I saw Wendy at my consultation, she raved about it.
However I had also seen an NHS doctor who said I should have the bypass.
The sleeve has not been around as long and therefore its results are not as well documented.
Another thing that worried me is that people have ops converting the sleeve to the bypass. If the sleeve worked why would this be needed? I do not want another op
My worry about the bypass is the malabsorption. Will I be able to get the nutrients etc in that I need to be healthy?
When I was talking to Wendy, she looked at my eating habits, and therefore the sleeve was better. I don't have an overly sweet tooth etc.
However when I mention my uncontrollable hunger, she lent more towards the bypass.
The decision is hard!!
I wish you luck in making your decision - whatever you decide it'll be a great start to the new you
xx

Hi
I also had a raging appetite and the sleeve has reversed this. The removal of the ghrelin hormone is what sold it for me, i just wanted to feel less hungry without going drastic.

Kim

 

[Wibble]

My main reason for having bariatric surgery was to improve my insulin-resistance that came through being doubly diabetic and overweight and over-eating. Being an insulin dependant diabetic and being insulin resistant are not happy bedfellows. I was going to have the sleeve, but after a lengthy discussion with my diabetic consultant and frantic emails with my surgeon (who was in Spain at the time - sorry mate!) I switched to the bypass as it gave me the best chance of sorting my insulin resistance. And it has done and then some!

 

[Wonderlust]

As stated above, they felt I was too high and risk for a bypass.

At 500lbs I was told that even with the sleeve I had a high chance of mortality, for me it was not an issue as my life was in limbo due to my lymphoedema.

7 months down the line is am over 8 stone down and determined to get to my goal without the need for further surgery.

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