the choice isn't always easy -and i know you've been thinking about this for a LONG time. You're sort of comparing apples and oranges. the sleeve is a restrictive procedure, and the bypass is a restrictive+malabsorption procedure. As Jane noted, you get all your nutrients [and all the calories] with the restrictive procedure, and malabsorption of nutrients [and calories to some extent] with the bypass. and the risk of dumping.
with the sleeve, you keep your pyloric valve, and with the bypass you don't. this has implications for food getting stuck, and for dumping.
initial weight loss tends to be faster with the bypass, but after a year or two, the losses are about the same.
ifyou don't get the weight loss you want with the sleeve, you can have a malabsorption component added to it [either a duodenal switch or an RNY], if your insurance will cover a second surgery.
it's really up to you and how you want to live for the rest of your life, and your age, and your health. As Jane said, your surgeon can provide some insight and guidance here.
gotta tell you, though, that if the sleeve had been available way back when, i would have given it very serious consideration. Might not have chosen it, but would have weighed it as one of the final two choices.
Start your day with a smile, and get it over with.
Keeping it off is a hundred decisions a day that help you maintain what you achieved. And that's the hard part. - L Sanders
start: 506 [Sept 2001]
weight at gastric bypass [Jan 29, 2002]: 409
current weight: 225
weight for plastic surgery: 200
final goal: 180
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