Sleeve VS Bypass

Hi,
I was sleeved in 2011 and then converted to bypass in June this year. I did not have any complications with either procedure, left it to my surgeon which op to have initially, although I was leaning towards bypass because I thought I might need the 'extra' motivation of dumping because of my bad food choices.

I lost 60kgs in the first year of the sleeve, was going great guns, with still more to lose. I thought my habits had changed and that I could handle relaxing my vigilance with food a little - boy was I wrong. I continued to have good restriction, but old habits reared their ugly head.

I regained 30kgs over the next 3 years....

When I returned to my surgeon, he did say that more and more people are returning to convert to bypass, particularly those with greater amounts to lose. (Although there are amazing success stories... I just wasn't one of them).

I had my bypass in late June and have currently lost 33.5kgs - so I am pretty happy.

Dumping certainly does not happen to everyone with the bypass, and some do not have adequate restriction. I had a minimiser ring fitted with my bypass which adds to the restriction, but also helps with no regains in the longer term.

I haven't dumped with the bypass, although I have been pretty careful with my intake. My surgeon and dietician say I need to try a little more variety, and I will, just not yet.

I will say that seeing a psychologist is a necessity as this is such a head battle, and as everyone says band, sleeve and bypass are just tools - not the whole answer. I am working hard to get my head in a healthy space... and that will help my chances of long term success.

You do know you better. You have done some research. You trust your surgeon. Which ever way you go, I wish you all the best. 

**I have also realised that this is a life long battle for me, not a lose some weight and I'll be ok. Vigilance is something I know I will always need to be.

AA - I'm pretty sure dumping is common amount bypassers due to the fact food enters the intestine quicker.

I think after all my dribbling, Strange said it all better than I did.. I want it done once and for all, so a little harsher restrictions straight off the bat isn't going to be any extra annoyance. What if I fail my sleeve and do some sort of damage.. so they won't bypass me?
And as you said - I don't need the thought in the back of my head that I have a back up!

Strange - my surgeon seems fair against the band, and I am 30 with no health complications at all. The stats haven't been great for the band long-term and I think he's all but stopped doing them in regular cases. After the people I have known with it, and the horror stories I have heard from almost everyone I have been in contact with, I wouldn't consider it.
I'm going to see my surgeon again soon to have The Discussion. I need something permanent that I can't fuck up!

Hi Katey, 

I'm thinking the same thing as you. At the appointment with the surgeons assistant, he talked about all three options - I immediately said no to the band as it wouldn't work with my lifestyle (I move around  quite a bit). I'm still on the fence between sleeve and bypass.

For me, the bypass sounds like a good idea for many of the same reasons you mentioned - I don't eat massive amounts, just lots of the wrong food - I like the idea of dumping syndrome to motivate me away from the sweets. I'm also most concerned with the long-term outcome - my goal is to lose at least 75% of my excess weight and maintain that for life, there is good evidence that this is possible with the bypass....the evidence isn't quite there yet for sleeve. 

Although I like the idea of having sleeve first and knowing there is a backup plan (bypass later) if I fail...I also don't want that backup. I think it will be a disincentive for doing my very best. Also, complications are more likely with a revision surgery so I want to do this once and do it right. 

I have to wait till Jan next year to see the actual surgeon to discuss my options, but the assistant I saw said he'd prefer I have the band seeing as I'm relatively young (36) and don't have any co-morbidities and if I was sure about not having the band, he thought the sleeve would be better. After explaining my reasoning he agreed I should talk it over with the surgeon. I'll go with whatever the surgeon advises, but am leaning towards the bypass at this stage (if I'm given the choice).

Kate, you have done the research, does dumping happen for every person with the bypass? I understand about the nausea as I cannot take pain meds stronger than Panadol because I get massive nausea that even the meds they give for chemo patients don't stop it.

I have had dumping experience in the past, so I know how unpleasant it is.  Not sure I would go with the bypass, although it wasn't mentioned to me. Not sure even now if I stopped losing weight or started gaining again that I would go to the bypass, even though I do suffer reflux. Might think about it if the reflux is not responding to the meds though.

Talk to your surgeon and see what is recommended, after all it is your body and you know yourself best.

Either way you are always welcome here

KateyOverWeighty wrote:

Sammy - I read that to avoid malnutrition, you have to take your nutrients and vitamins every day, and have regular vitamin shots. I don't have a spleen, so I have to have regular shots for various things anyway, so that's one thing that wouldn't necessarily affect me. I also take pills every day!
Why didn't you want a malabsorptive procedure? Because it leads to malnutrition?

Cee - The big thing for me is I think I need the type of foods I can eat restricted, not just the amount. Quantity is a problem for me but if I can still eat naughty food, I will, and in ever increasing amounts. I think I need dumping syndrome to kick my ass all over the shop. I have spent 20 years eating what I want. I need to be as restricted as possible and punished hard when I do the wrong thing. I have always felt that over any pain I have endured, nausea is the worst feeling in the universe. I was actually disappointed when my dietician said that dumping syndrome wasn't so much a problem with the sleeve!

LMW - what does your name stand for? For some reason my initial thought was 'Love My Weight' which by a logical guess would be wrong!
I will go stalk a bypass forum... 

Money aside... if the sleeve fails (or I fail the sleeve) it can be upgraded to a bypass. If I fail a bypass................. :(


I think I will leave it down to Dr. Greenslade's advice. I don't want to start this journey by expecting the worse from myself but I am also a very practical person!

I didn't want a malabsorptive procedure because I just simply don't like the idea that my body would not be absorbing 90% or so of the food I eat. I'm not really a fan of having to go and get shots for vitamins - currently I just take 1 multi a day, which I did pre-sleeve anyway. I like having normal digestion, normal absorption.

But we have different issues with food it seems - I didn't eat a huge amount of junk food, or really binge eat - I have always eaten quite well, it's just the sheer volume of it. I just needed to control my portion sizes. Me being so short (160 cm) I really only need small amounts of food to maintain a healthy weight, so that's what the sleeve helps me to do. But if you feel like a bypass will help you get control of your fatty / sugary cravings then great - that may well be the best option for you!

It really is a huge decision! Certainly listen to the advice of your surgeon, and also talk to a dietician too - they will really be able to give you good advice based on your particular circumstances. Good luck!

KateyOverWeighty wrote:

Sammy - I read that to avoid malnutrition, you have to take your nutrients and vitamins every day, and have regular vitamin shots. I don't have a spleen, so I have to have regular shots for various things anyway, so that's one thing that wouldn't necessarily affect me. I also take pills every day!
Why didn't you want a malabsorptive procedure? Because it leads to malnutrition?

Cee - The big thing for me is I think I need the type of foods I can eat restricted, not just the amount. Quantity is a problem for me but if I can still eat naughty food, I will, and in ever increasing amounts. I think I need dumping syndrome to kick my ass all over the shop. I have spent 20 years eating what I want. I need to be as restricted as possible and punished hard when I do the wrong thing. I have always felt that over any pain I have endured, nausea is the worst feeling in the universe. I was actually disappointed when my dietician said that dumping syndrome wasn't so much a problem with the sleeve!

LMW - what does your name stand for? For some reason my initial thought was 'Love My Weight' which by a logical guess would be wrong!
I will go stalk a bypass forum... 

Money aside... if the sleeve fails (or I fail the sleeve) it can be upgraded to a bypass. If I fail a bypass................. :(


I think I will leave it down to Dr. Greenslade's advice. I don't want to start this journey by

Haha nah I was so excited/stressed when I joined the forum I just couldn't think of a witty name, it's just my initials😉 Although Love My Weight could totally work for me now! Am so happy with my sleeve and how it's helping me on this journey.

For example I am an emotional eater prone to bingeing and I am being put to the test at the moment because I've just been made redundant two weeks ago. I still have to go in to work till December, which is turning out to be rougher than I thought. I can honestly say that although I have eaten a few things I do regret ie I wallowed a bit yesterday with a mc flurry (had to stop halfway because I just can't eat a whole one) and later a 45g pack of chips. Previously I would have probably eaten 2 quarter pounder meals and the mc flurry in about an hour then gone looking for more. Overwhelmingly I still feel like I need to eat my protein instead of rubbish and I'm straight back on the horse  because the idea of having something off plan today is making me feel a bit ill.

Haha good.... If I was banned I would create a stalker account anyway just to keep track of you ladies!  

KateyOverWeighty wrote:

I know me better than anyone.
 

What do you guys think? Would I be disowned from the GastricSleeveSupport.com forum if I have bypass instead?! L
What have you heard?

(a) There you go - you know you better than anyone !!! I certainly do not have an answer, Katey - like Sammy, neither the band (just couldn't cope with the plastic bits lol ) nor the bypass (I'm not big enough) re a consideration for me, so I'm in a different position to you. The best thing you can do is research, which you don't need to be told, 'cos you've done bucket loads , and discuss with your surgeon to wok out what's best for YOU.


(b) Ummm NO !!! I would hunt you down & find you  - I want to hear how this journey continues !!!

Sammy - I read that to avoid malnutrition, you have to take your nutrients and vitamins every day, and have regular vitamin shots. I don't have a spleen, so I have to have regular shots for various things anyway, so that's one thing that wouldn't necessarily affect me. I also take pills every day!
Why didn't you want a malabsorptive procedure? Because it leads to malnutrition?

Cee - The big thing for me is I think I need the type of foods I can eat restricted, not just the amount. Quantity is a problem for me but if I can still eat naughty food, I will, and in ever increasing amounts. I think I need dumping syndrome to kick my ass all over the shop. I have spent 20 years eating what I want. I need to be as restricted as possible and punished hard when I do the wrong thing. I have always felt that over any pain I have endured, nausea is the worst feeling in the universe. I was actually disappointed when my dietician said that dumping syndrome wasn't so much a problem with the sleeve!

LMW - what does your name stand for? For some reason my initial thought was 'Love My Weight' which by a logical guess would be wrong!
I will go stalk a bypass forum... 

Money aside... if the sleeve fails (or I fail the sleeve) it can be upgraded to a bypass. If I fail a bypass................. :(


I think I will leave it down to Dr. Greenslade's advice. I don't want to start this journey by expecting the worse from myself but I am also a very practical person!

Awwww, disowned, can't get rid of us that easy😉 Sorry you're having some sleepless nights Katey.

There are plenty of people in both camps, this journey is different for everyone. The sleeve and the bypass are just tools and you just need to choose the one that is best for you.

Personally I was the same as Sammysleever I only really made the decision to have surgery after I found out about the sleeve. The pros vs cons of the band and bypass just didn't tip the scales for me but the sleeve was the perfect balance. I still don't know if it will work in the long run but I'm really happy so far.

The point is that I felt that the sleeve was the best option for me! I think you have to feel that way about your op because once it's done you can't take it back. You just have to decide which one you feel strongest about.

All the best with the decision and I hope that you can have a chat to some of the bypass peeps so you can get a good idea of how they feel about it.

For starters, you will most certainly not be disowned from the site! A lot of the sleeve rules apply to bypassers as well.

From my personal experience as someone who has had both - I honestly couldn't tell you which is better.

I never "failed" my sleeve. I just had severe reflux from it, which in turn made me regain, and a bypass was my only option to control this.

Invasive wise - bypass is no more invasive than the sleeve. Same amount of incisions. I had the omega loop mini bypass - my recovery time was the exact same as sleeve (actually less, because I had complications when I had my sleeve done years ago).

IF you are a binge eater, love your fatty or sugary foods, bypass is actually a pretty good option. It has forced me to not eat these things... I've had dumping a few times, it's not overly pleasant, but you get over it pretty quickly.

When I had my sleeve done, I never had dumping, and continued to lose weight rapidly, so therefore I was kind of like, oh well, I can still eat shit, not have side effects AND still lose weight.

Now I can't. And my body is so much better for it.

I'm a very happy bypass patient. I've lost very slowly compared to my sleeve, but I also didn't have as much weight to lose.

This is all my personal experience of course, and you need to sit down with your surgeon to weigh up the risks and positives of each procedure.

Good luck

Hi Katey,

the bypass was never a consideration for me (nor was the band) purely and simply because I did not want malabsorption of food and the ever present risk of dumping. I didn't want the risk of becoming malnourished. I didn't want the risk of bowel obstructions.

The sleeve was the best (and only) option for me because I didn't necessarily want to change what I ate - simply how much of it.

Of course there is much more evidence out there for long term studies because the bypass has been around for much longer than the sleeve. 

Keep asking around, obviously there are many, many happy bypass patients and in the end, you have to choose what you think will fit your lifestyle the best.

Good luck!

Hi guys
I laid awake most of last night and have been staring out the window at work this morning, thinking about whether I should ask my surgeon for bypass instead of sleeving. I have been reading articles and statistics and from what I can see, although slightly more expensive, slightly higher risk and slightly more invasive, bypass has been tried and tested and has a higher average weightloss AND stats on long-term maintenance. Over all the disadvantages, that is all that matters to me… to spend this money, to have the stiches, to lose the weight, then fail and have to go for a 2^nd surgery, paying again… would just be devastating to me (and my back pocket). I figure if immediate life after sleeve is going to be a shock to the system, why not shock it just a little more and never have to worry again?
-It’s $500 more with my surgeon than sleeving.
-Statistically, the risks are only higher because it’s more invasive.
-Invasive surgery does not concern me.. I have had my spleen and my gallbladder removed already and so know what to expect.
 
I found a couple of articles discussing the differences… Granted, the author who compared sleeve to bypass chose sleeve as the best one, but after reading his reasoning, I know me better than anyone. The second says that if binge eating is a problem then bypass may be more suitable….

It sounds to be the most ‘idiot proof’ WLS around… and knowing my luck….. gah!
 
http://guidedoc.com/gastric-sleeve-vs-gastric-bypass-surgery
http://guidedoc.com/6-types-of-bariatric-surgery-for-extreme-weight-loss
 

What do you guys think? Would I be disowned from the GastricSleeveSupport.com forum if I have bypass instead?! L
What have you heard?