just attended a seminar on wls and my heads spinning a bit. They do 3 procedures here in northwest indiana. the band, the sleeve and the bypass. first off, its given me a lot to think about, too much really. My soon to be insurance would require that I do 6 months of diet w/ a nutritionist. The more i think about it, the more i like the idea that there's a window of time for me to wrap my head around what i'm about to do.

Originally my goal was just to get the lapband. but for my weight, 320 and having just turned thirty, I feel like i'd be recommended the bypass. The average weightloss is 100+ lbs vs the sleeve which is around 80lbs on average for women. Now I was wondering if it was just that maybe they gave the sleeve to women who weight less or that since there wasn't as much data the number might be lower. I'm ok w/ the idea of the sleeve. I've very much not comfortable w/ the bypass. maybe over time i would be. but when they basically say i get one bite at the apple in terms of surgery....i worry that if i don't do a more drastic surgery, it sort of makes me feel like i'm condemning myself to weight more because i'm not comfortable w/ a full reroute. Anyone get the sleeve and wish they had gotten the bypass?

My surgeon who was originally from NY said that the studies they have for long term sleevers aren't really any good and that in his experience the weight loss compared to bypass is similar. I have had moments where I wish I had the bypass but overall I am happy with my sleeve. It is what you make of it. Bypass or sleeve people will ultimately fail if they don't change their behaviours.

Jen's right - without committing wholeheartedly to the lifestyle changes required by ANY of the surgeries, you won't get the most out of it. Having said that, take a REAL close look at the weight loss data for any of the surgeries - pay special attention to the RANGES, not just the AVERAGE. You see, the AVERAGE includes people who completely blew off changing their behaviors and who either regained anything and everything [in some cases, managed to get to even HIGHER weights], as well as those people who did everything they were told to do.

this doesn't guarantee what your results would be, of course, because a lot of other factors go into how much a person loses. But at least this way you can see what others are REALLY accomplishing. And remember, even though many surgeons say that people with the lapband don't lose as much weight as those who have other surgeries, there IS a group of people who have lost more than 200 pounds with the band and kept it off. they work the band HARD all the time.

I'm not trying to sway you in one direction or another, but rather to suggest that you also have to figure out how YOU'RE willing to live your life - for me, I'm glad I don't have the band. If the sleeve had been available back when I had my surgery, I would have given it very serious thought [but I'm not sure it would have been the right choice for me, since I needed to lose a huge amount of weight very quickly].

I don't regret the bypass for a minute [although when I couldn't keep anything down for about 6 hours the other night, i WAS NOT HAPPY].

keep investigating and asking Qs.

I don't regret the bypass! All of them require hard core eating and life changes. I didn't want the band b/c I didn't want a foreign object in my body. . .the sleeve wasn't an option when I had mine

I am a featherweight so maybe my situation doesn't apply to yours, but I got the sleeve and haven't regretted it for a minute! I love that all my insides are still fully functioning just as they were intended to function, except that my tummy is now tiny and the hunger-hormone-producing hormones are gone or nearly so! I would not have considered the bypass and I rejected the band, but I LOVE my sleeve!

And yes, you MUST change your lifestyle. I am a picky-eating gym rat now, which is like a miracle but I love it.

Anyone who gives you average weight loss statistics in terms of pounds is doing you a great disservice. No, the average weight loss with the sleeve is NOT 80 pounds. Nor is the average weight loss with RNY 100 pounds. Stats should be provided to you in terms of percentages - what percent of excess weight loss is the average per surgery. Some people who get the sleeve don't even HAVE 100 pounds to lose, so maybe 80 pounds is 100% of their excess weight. Some people who have the RNY have more than 200 pounds to lose, so losing 100 pounds is only 50% of their excess weight, leaving them still morbidly obese.

Don't worry about what you would "be recommended." I honestly believe we each need to do our own research and choose the procedure we want before ever talking to a surgeon. Read articles and studies on sites like PubMed as a good starting point. Consider both short- and long-term information on each procedure (for example, you seem to think the band is the least "drastic" procedure, but did you know it also has the highest future re-operation rate? Is it still less "drastic" if you end up needing additional surgery again in the future?), and consider all the procedures - band, VSG/sleeve, RNY/gastric bypass, and duodenal switch (DS). Don't limit yourself to what one practice performs - for example, if you decide the DS is the best fit for you, then don't be afraid to go to a different practice to get what you know is the best fit for you (I drove about 2 hours away for my surgery, and I know some who literally flew across the country or even to other countries to get the procedures they knew they needed).

Thanks for all the information. I think if anything the seminar gave me TONS to think about. I know this is a life change. It has at least put it in my head how much of a change this will be. I'm still very conflicted about it. I'd like to believe I can do it myself but I've been big since i was 11 years old. even when I did make positive changes, they don't stick. And as scared as I am about to choosing to have a surgery that's going to change my life and at least temporarily bring me pain, I no longer see a way around it. But at least now I have a starting point. By the time surgery comes along I want to have already made a lot of the choices that are more closely in line w/ how I should eat and exercise after the surgery. Not sure this is reasonable.

it's ABSOLUTELY reasonable! any changes that you can make before surgery can only help you through it!

I don't regret the sleeve for a minute. It's also not true that you have no future options if you get the sleeve - there are some surgeons who do sleeve-bypass if needed (although it's obviously subjecting yourself to another op). In fact, the sleeve was developed as step 1 in a 2 step operation plan for bypass for superobese people to allow them to get to a safer weight for the bypass surgery.
I would not get the band after reading about the lifestyle and sacrifices required. The sleeve to me seemed to be the most "set and forget" procedure, and it's turned out to be that way for me.
Just keep in mind - any of the surgeries can help you get rid of most to all of your excess weight, but keeping it off becomes intake/output like everyone else after that. The good news is its a lot easier to do that when you feel good, look good, and don't get very hungry!

You could also revise a sleeve to a DS (which makes more sense since the DS has a sleeve stomach). There are also some surgeons who will put a band over a sleeve; I'm not saying I would personally recommend it, but just agreeing that there are options.

The catch is insurance - many polices are now limiting WLS to a one-per-lifetime benefit, even if you change insurance companies/policies. So it's still wise to go with what is right for you from the start in terms of your expectations, long-term goals, etc.

Yep sorry meant sleeve-any kind of bypass including DS.

I highly endorse this recommendation. Make sure you understand long-term restrictions, issues, etc. I would encourage you to look at people who have "failed" the different surgeries to see what their issues were, as well as talk to some experienced successful vets (who I think of as being at least 3 years out). When you read high praise from people like me (a new postop...8 months), you might not get the full picture of the surgery you are considering.

Thanks for the info. They have a get together once a month and I intend on going to the one in may. I have an appt w/ the surgeon in mid may, and I'm hoping he'd be ok w/ recommending the sleeve. there's a part of me that feels like the full bypass would be better for me but my comfort zone is the sleeve. I'm not getting a whole lot of support at home, they don't think it's worth the risk of death or other complications, but none of them are my size. I looked back at the pictures of when I had lost 20-30lbs to go on vacation...even then it wasn't enough weight gone.

i just had the sleeve 13 days ago so i am really too new to comment on long term likes and how it is, but for me the choice was mostly me and also because i have ibs which already caused me to be malnutrition
i really didn’t want the bypass anyway i didn’t like the idea of the intestine moving and i was happy they agreed with me and told me with my ibs i wouldn’t absorb anything and be really sick.
so other factors do go into which one you should have.
i was also told the sleeve is 60-80% of excess body mass loss on average, no you will lose 100lbs or 200 etc
i think people get confused with a percent of total body weight instead of what you are being told which is excess.
i was 415 at my heaviest and down to 387 day of my op so i am in the top band for weight my surgeon has been doing this for 10 years and he thought i would do well with the sleeve so i dont; think its just a stepping stone in terms of what one to pick or its the one given to smaller people.
like others have said end of the day its up to you to work with what you get and work with it to reach your goal and body size if i want to eat cake 6 times a day in tiny portions i can none of them is really going to stop me i have to stop me eating stupid after i put my body through the surgery.

oh also i do know here in the uk at least with the sleeve if in a couple of years time your stalling or not doing well they can go back in and make your sleeve smaller again if its stretched out.
Not that I intended to do that I just met a lady who was having it done when I was in for mine.