Please be careful in starting a thread like this - these types of discussions often end up in bickering about whose surgery is better because everyone wants to defend their own personal decisions. I responded in the other thread about why I chose the DS, and I will leave it over there.
My advice when choosing a procedure for yourself (or choosing wehter to have any WLS at all) is to ask yourself the following and be 110% HONEST with yourself:
Why am I obese? Is it overeating (and why - emotional, compulsive, seemingly insatiable hunger, etc.), grazing on junk food, medical issues...?
Am I willing to take vitamin/mineral supplements multiple times a day for the rest of my life?
How have I successfully lost weight in the past (if at all)? Was it via calorie restriction, low-carb eating, lots of exercise...?
What comorbidities do I have or am I prone to that I may hope to resolve by having WLS?
What would I consider "success" after WLS? Losing 50% of my excess weight, 70%, 100%?
Will I be proactive and educated enough about my chosen procedure to be able to confidently explain it to medical professionals who may not be familiar with it?
What are my current habits/lifestyle aspects that I am 100% unwilling or unable to change? Can those be worked into a successful part of a post-WLS lifestyle?
Different answers to different questions will likely lead you toward different surgery types (or none at all).
Sorry I didn't think about the possibility of bickering. I hope people would be able to answer honestly and let others do the same as everyone's experiences and lifestyles are different so they will obviously have different opinions on the surgeries.
I'm a bit concerned as I've been hanging around the forums for the clinic I'll be going to (the one that is covered by my insurance). From what I can tell they deal mainly in lap band and bypass but not so much the sleeve and other options. I think they DO do them but they push more for either lapband or bypass.
When I look at the options, I feel like the sleeve is what is best for me, as it's sort of middle of the road. I don't know if I feel like the lap band suits me but the thought of the bypass scares the crap out of me as it seems like the most extreme option.
I lost 85lbs over the last few years, mostly through a very strict low carb diet, which worked great but turned out to be not very realistic long term. I eventually cracked and have gained back about 30 lbs of it.
My problem is emotional eating (as I have explained in the other thread, the re-gain was due to my stress and emotions about my failed fertility treatments) I will often not feel like cooking and we just go to burger king or have a ready made lasagna that we pop in the oven (which FEELS like the devil's food after having been on low carb for so long). I can also sit in the evening and plow through an entire family pack of Maltesers.
I LOVE sweets... chocolate, ice cream etc.
Health wise I'm rather lucky compared to a lot of stories I've seen. I was developing type 2 diabetes but I wiped that out during my previous weight loss and even though I've regained a bit and have not been eating well my sugar has still miraculously stayed at a regular level.
I don't have high blood pressure or high cholesterol, I am not on any medications...
Other than my fertility issues and the emotional eating that has resulted of that (compiled by the fact that I am an expat living in a foreign country and there are also emotions like homesickness, culture shock etc that have contributed) I'm not suffering tremendously from my weight.
I have all the normal things, like I wish I fit into smaller clothes, felt more energetic, didn't sweat so much or my legs didn't hurt after a day out shopping, all the normal stuff overweight people hate, but no I don't have any major medical life threatening issues.
As for how much I want to lose, I want to lose as much as possible. I'd like to see myself at a normal weight before I start IVF, and I want to ensure that I have the best possibility of success and then the most healthy pregnancy possible if I am lucky enough to have one. So for me it's important that I get as much of may excess weight off as I can.
I'm not sure I have any lifestyle things I'm not willing to change. I am in my 30's living in a big city so most of my social circle spends their time doing lunch, going out to dinner etc, so I will have to either sit and not take part for a while or just avoid it, but I did that when I was on my low carb diet as well.
I really appreciate any help in helping me whittle down where I fit in the weight loss surgery scope because I keep reading and re-reading all the info on the different surgeries and I can't, for the life of me, figure out which one is best for me
I initially wanted the sleeve, but it wasn't an option for me as I had GERD issues in the past. My doctor really thought the bypass was the best for me and I mostly agree with her now. My insurance would not cover the DS, nor did the center I attended perform it. I have mixed feelings about the DS. On one hand, I love how the stomach remains intact and it would have addressed my issues with volume eating. On the other, I dislike most meat products and I don't know if I would have been able to get my protein requirements in on a regular basis.
I choose the lap band because it seemed the safest to me. I watched a few friends mothers have the gastric bypass and it seemed like **** for them. I liked the fact that it could be unfilled if needed and it wasn't messing with my insides to much.
I choose it after I passed 300 lbs and had major surgery. I almost died due to a cancer scare and I woke up from that surgery and said enough is enough. I'm not going to be able to save myself alone. I was all ready approved but kept putting it off.
I made the right decision. I would so it again in a heart beat. I think I would deal with my food issues a little deeper before the surgery but it saved me and I would never trade that.
Good luck with the choice. It's not easy.
we don't allow much bickering over whose surgery is better or worse or right or whatever. there are VERY good reasons to choose one surgery over the others, but there IS no one size fits all.
having said that - i had been considering the lapband, but i ended up in the hospital for 5 weeks, and then a nursing home for 3 with hypoventilation - when i was discharged on oxygen, i was finally able to keep the appt with the surgeon [originally scheduled for 2 days after the admission!]. Back then - 10 years ago - the choices were lapband or bypass. the others were considered too experimental.
my surgeon told me that my only choice was the bypass because the lapband, although effective, would not help me lose enough weight fast enough to save my life.
so, here we are!
IF i had it to do all over again, and IF i had the time to lose weight more slowly, i would give some serious thought to the gastric sleeve - the diabetes resolution/prevention data are pretty darn good, and a malabsorption component can be added later if it's needed. or it can be done NOW with a DS or even an RNY. there's something about keeping the pyloric valve that seems to be involved in helping with the diabetes.
If your primary issue is emotional eating, as you mentioned, then the surgery type has little to do with the long term outcome. I think you'll benefit much more from counseling/therapy to dig into why you turn to food and how else you can deal with your emotions. I'm not sure what the usual counseling is that would accompany WLS where you are, but I know here, there is usually a required psychological evaluation prior to surgery, and some surgeons/facilities also require additional pre- and post-op counseling, which I think is SUPER important for most WLS patients, and I wish it were more common. There is no surgery that will keep you from turning to junk foods in moments of weakness, such as ice cream, milk shakes, candy, etc., as these are "slider" foods that don't stay in the stomach very long (flow right through a band or RNY pouch, and don't stay in a sleeved stomach very long because it turns to liquid so quickly). With the RNY, there is a chance you could have dumping syndrome, which many think will make them not eat junk, but I know from talking to them that many of them do it anyway and just "plan" their indulgences so the dumping episode doesn't interfere with other plans. (And only about 30% of RNYers dump in the long term, so it's not really something to count on, anyway.)
Yeah I have already set myself up with a psychologist outside of the whole WLS thing, I am also seeing a dietitian already. I am an emotional eater in the sense that I am either ON or OFF a diet. I have a very hard time not seeing it as black and white.
For example, when I lost the 85 lbs I was MILITANT about my low carb diet. I did not take even one step outside of that particular diet I was following. I went all over the city to supermarkets to find one that had ground beef and bacon without dextrose in it (it's harder than you think! haha) I cooked entirely from scratch for a year and never went out to eat once etc.
In December all within one week I had my gallbladder removed and started fertility treatments. It was incredibly stressful. Once the treatments started and I had to give myself the hormone injections every day, the cravings started and I had NO Idea how to deal with them. The diet I followed didn't allow any sugar whatsoever. It programmed me in a way, to feel like anything I did wrong would be an out and out fail... so when I did finally crack and give in I just kept going. It was like "Oh dammit I already ruined it so I may as well have <enter forbidden craving food here>".
I am definitely an emotional eater but more in the way that it sets me off track. The day where I go to Burger King and then whoof down a bag of maltesers are pretty slim, but rather some of the things I eat are quite normal to others (like having spaghetti and meatballs for dinner) but after having been on that diet for so long made me feel like even though it was a normal portion, it was the devils food so I was pigging out.
My main problem right now is time. I don't have the time to sit around and see a psychologist and work though everything and THEN lose the weight. I have 2.5 years before they will not do IVF anymore (they won't do it after 40 here in Holland) and with each year that goes by my chances are cut in half.
So I need something that is going to help me get weight loss quickly, WHILE I work on these things, know what I mean? My doctors, my dietitian, my gynaecologist, everyone is in agreement that WLS is my only hope at the moment and I agree with them, but I need to figure out which one will suit me best.
I know once I have the surgery and start seeing the scale moving in the other direction and start moving towards my goal again I will feel better and be able to do whatever it is I need to do, and with the help of the psychologist (as well as the one I will see from the WLS clinic) I will have time during the process to deal with the food issues.
I just need to figure out which surgery is what I want to live with long term.
while i am all for dealing with food demons BEFORE surgery, i've realized [the hard way!] that there are many, many lessons that still have to be learned. I had dealt with MANY issues before surgery, and thought i was ready, but OMG!!!
I'm still learning. the first really big lesson i had after surgery came about 2 weeks afterwards. i realized that i was using food to 'ground' myself! and the longer i was unable to eat, the more anxious i became, until i realized that strongly flavored tea served the same purpose.
all this to say - you're not going to have the emotional issues solved before surgery. but you CAN work on figuring out your triggers, developing some coping mechanisms, and recognizing -calmly, without hysteria or anxiety - when some other issue is raising its annoying little head.
I chose to have GBS because I needed to lose more then 100lbs (lapland's average was less then that) and I needed the kick in the pants with the "dumping syndrom" to help me break my carb addition. I had friends that had the DS and I felt it was too dangerous (at the time, it wasn't as sophisticated as it is now).
My counselor and I worked on why I ate emotionally for a year before surgery and 6 months afterwards, but still when it came down to it, I had a hard time not being able to overeat. Without counseling I don't think I would have been as successful at losing weight and keeping it off (to some extent) but it was still difficult. It was like when I quit smoking cold turkey and I had to find other ways to keep my body happy.
Good luck! Figuring this part out is crucial.
Angela
Last edited by missangelaks; 10-16-2011 at 07:45 PM.
I haven't had surgery yet but here in Canada unless you want to pay privately you are going to end up with RNY as it is the gold standard for weight loss surgery. The do the sleeve if the person is a good candidate (meets certain requirements). It is pretty much the surgeons discretion what he ends up doing in that case. I don't know how many people have DS or lapband, those you'd have to pay for yourself. Anyway I asked for a VSG because of having migraines, I need to be able to take Advil. When I was having a chat with my surgeon he said that the malabsorption from RNY is not as much as what people are told which I thought was interesting. It is quite a process here to get WLS. First your family doctor needs to refer you to the bariatric registry then the referral gets sent to the closest centre that does WLS. Then it goes like this: orientation class, meet with the nurse and nutritionist, meet with the social worker, meet the internist, meet the surgeon, have final nutrition class then surgery. In between all that is blood work, an abdominal ultrasound, ECG, gastroscopy, possibly a sleep study and it can take anywhere from 6 to 18 months. It sounds like a lot and it is but in some ways I think it is good because there is a lot of time to deal with some of these food issues and get on track with some improved behaviours. In the long run I'd have been happy if the surgeon had said no it was RNY or nothing.
good luck tomorrow Jen! and the process you've described is pretty much what we have to endure down here - with the possible addition of a 6-12 month supervised diet depending on the insurance company.
I will bite my tongue and simply say that this is my problem with threads like this: I see multiple incorrect statements/assumptions about various surgery types in these responses. This is why, while it's great to get some opinions, you need to know that is all these are, and continue doing your own research on solid data and facts
Jill, am I correct in my statement that the DS has a higher protein requirement than the RNY? I barely meet my goal of 60g/day of protein now and I mostly consume dairy products and protein supplements. Of course, I also have a stricture, which won't be addressed until Nov 3, so I am having trouble getting anything down, not just protein.
I will bite my tongue and simply say that this is my problem with threads like this: I see multiple incorrect statements/assumptions about various surgery types in these responses. This is why, while it's great to get some opinions, you need to know that is all these are, and continue doing your own research on solid data and facts
I understand, I was asking specifically for people's opinions based on their own experiences. I am just trying to get the best image I can of each of the surgeries so when I speak to my doctor I will know all the things I want to ask him to help us decide together which is the best option for me. I understand that you all have different opinions, it's a touchy subject because everyone is going to think that their surgery is the best option.
I read something the other day that terrified me. The thing about me is that I will research things to DEATH for fear of making a misinformed decision, because I've been known to be somewhat impulsive in the past (like picking up and moving to another country to be with my husband! haha) I want to make sure I get every single scrap of info I can so that in the end I'll be totally at peace with my decision.
So last night I was googling about why NOT to have weight loss surgery (I need to see both sides of the coin, right?) and I found this... darnit it won't let me post links. Look up suesaysthings dot blogspot dot com slash 2010 slash 05 slash gastric-sleeve-story dot html (oh god that's so annoying, the no links thing)
It scared me, I'll admit. I realized that she was right, I've not read anything from people who are that far out from their surgery. Most people on the forums are up to 2-3 years post op and are still in the 'honeymoon stage', and I wonder if there is truth to that 'silence conspiracy' she was talking about. Where are the people who had surgery 8-10+ years ago? Are they out there living their new healthy thin lives or are they out there regretting they've ever had the surgery? What is the majority doing right now?
Is she just fearmongering?? Ugh... it really adds to the confusion.
Why did you choose your surgery?
