Hello all,

I am 46, pre-diabetic with hypertension and arthritis of both knees, lower back and hips.

I seem to crave carbs all day. I am also hypothyroid with a genetic cause so I don't respond well to the traditional thyroid medications. (Synthroid, Cytomel)

How can I assess which surgery might be best for me? I know that I don't want the lap band but beyond that I am unsure.

I will be self pay as I have no bariatric coverage on my health plan.

Thanks!

I'm not sure how much weight you have to lose, nor do I know what your specific challenges are (are you a volume eater? binge eater? grazer? drawn to fatty foods? etc.), but I will make a suggestion that you research the DS and the VSG, and here's why: NSAIDs. You mentioned arthritis, and with the RNY, it's riskier to frequently use NASAIDs due to the inability to scope the remnant stomach for possible ulcers.

Further, I would personally suggest the DS due to your pre-diabetes since the DS has the highest resolution rate for type 2 diabetes. Again, that is my personal suggestion. Oh, the DS also has the highest statistical rates of resolving hypertension.

My final suggestion is that you do lots of research! I like to start on PubMed and go from there. I can offer you staistics all day long, but you have to know what you can or can not live with for the rest of your life (how dedicated can you be to taking vitamins multiple times a day for the rest of your life? how dedicated will you be to meeting possible protein requirements each day? things like that).

Hi Jill,

I have about 80 lbs to lose and am a carb loader. I suspect that I do that make up for the hypothyroidism lack of energy.

I am also on the roller coaster of a sedentary job and lack of exercise capability due to the arthritis.

Unfortunately, there is no surgery that will magically help you to curb you affliction for carbs. The RNY may potentially cause dumping if you overindulge in carbs, but only about 30% of RNYers experience dumping long term, so I wouldn't bank on that. Some DSers experience gas and bloating from overindulging in certain types of carbs, but again, not all of them experience this. Some people experience a reduction in overall appetite and certainly in cravings after WLS, but it's highly individual.

With 80 pounds to lose, I might typically suggest the VSG, as lightweights tend to do very well with it, but with lack of exercise ability also being a factor, I still suggest the DS, as it is the most "forgiving" (calorie-wise) due to the greater amount of malabsorption.

Hi and

We're glad to have you

I also would suggest researching the different types of surgery and then finding a surgeon and discussing your options, telling him exactly what you told us, don't hold back. Its such a personal decision as one size does not fit all.