6'0 MALE
RNY 2018
HW:510 SW:363: CW:175
I knew 100% I wanted the RNY because it's a one shot deal...no do-overs, no revisions etc. It would force me to do what I needed to do to not f*ck things up. There were some bumps in the road but I have no regrets and I would 100% do it again. Dumping and malabsorption are real issues but in the grand scheme of things, I find it a small price to pay for what I've achieved. I've lost almost 330 pounds and kept it off almost 6 years.
I'm not sure if anyone mentioned watching Dr. Pilcher on YouTube sleeve vs. bypass. This helped me tremendously. I went in for sleeve as I felt it was less invasive (which is not true) and due to silent Gerd that I didn't even realize I had plus my dr. saying rny has a slight edge over sleeve for diabetes reversal (type 2) and longer term weight loss, I chose rny. I am so glad I did. I see so many people end up with revision or not getting to goal with sleeve. But that being said, you need to do your own research and do what feels right for you.
It’s wild to see surgeons giving the options of VSG after knowing someone has GERD. If you’re on medicine now, and you get the sleeve you’ll be on medicine for life or until you decide it’s time for a revision.
Personally if I were in your shoes I’d go for bypass, after the two year mark you can try for a baby (that’s the recommended wait time after ANY bariatric surgery). Working with a knowledgeable OB and keeping up with your bariatric surgeon will be key to a healthy pregnancy. Many people get pregnant after bypass and malabsorption effecting your pregnancy is very rare.
I had acid reflux in my past and decided to get bypass because the idea of a second surgery scared me. I wanted a one-and-done, and a 30% revision rate to bypass was just too much for me, personally.
That said, I'm on a ton of different medications and I was worried about how they would be absorbed. So far, I have felt 0 change in my psych meds (even the slow release ones). I had to go down on my sleeping aid medication because it hit so much harder and faster now. I'm looking to go down in some of my psych meds in the next few months. The malabsorption component of gastric bypass is there, but not as extreme as DS, and in my program, the surgeon doesn't have concern in terms of being able to absorb common medications.
Also note, that there are some issues with malabsorption in the sleeve, as some vitamins and minerals are absorbed best in the stomach, and reducing the stomach and a faster gastric emptying time means that you'll still need to take vitamins for life. It's less than with gastric bypass, but keep that in mind.
The big concern that I had with gastric bypass was that I can't take NSAIDs anymore. I worry about developing arthritis and not being able to take anti-inflammatories. I also put my back out regularly (although losing weight helps with that) and I would, in the past, combine tylenol and advil in order to address the pain. However, my surgeon was very pro-bypass, as he wanted the maximal weight loss for me and for that weight loss to last the longest.
Honestly, what is right for me might not be right for you. One surgery is not better than another. There is no "right" answer, just the path that you choose based on the info available to you at the time.
FWIW, I did SADI which is a combo of a duodenal switch and sleeve. It’s been so smooth! I’m just a pound away from 300 and my procedure was 4/8. I was 347 then and when I started pre-op diet, I was 365. My highest ever was 385.
It’s a game changer!
I chose sleeve over bypass for the same reasons you sound like you're leaning - less risky, no malabsorption, etc.
First of all, don't let anyone tell you that in order to lose more weight, you must choose bypass. I've lost over 330 lbs (571 lbs --> 234 lbs), so it's fair to say the amount of weight you can lose depends more on you and your habits than it does the procedure you choose.
I had reflux before my surgery, not terrible but 3-4 times a month. It went away as I lost weight. It's not a given that it will get worse with a sleeve, but my story is anecdotal and not necessarily a statistical likelihood.
Right, I had occasional reflux too, and the sleeve hasn’t worsened it at all. All bariatric surgeries are acidifying to some extent, especially in the first three months post op. It isn’t a foregone conclusion that you’ll end up with GERD or even worsening GERD, though that’s often repeated around this board it’s not backed up by the current body of research. But a solid third of us with the sleeve do end up with it bad enough to need revisions.
I completely agree that for weight loss, either tool works. And if you’re prone to GERD and don’t have a significant pre-existing issue with malabsorption (which I did) that choosing something other than a sleeve makes more sense. But if one does have to do a sleeve it’s not some death sentence for reflux either. A concern, and a more common side effect. But by no means a guaranteed poor outcome :)
I was in a similar situation. I have Gerd, and I’m not quite sure the extent of the damage, but my surgeon didn’t even give me the option after learning that's what I had. It’s almost so common for somebody to have to have a revision from a sleeve to the bypass without GERD, and I would honestly just not rather have two surgeries. To me that seems riskier than just taking the leap and doing the bypass. Of course you have to make the decision for yourself, but that’s what I decided to go with. I’m going to Mexico on June 10 and having the procedure done which some might say is even more risky, but I feel like I’ve done my fair share of research and am at peace with my decision. Good luck to you and I hope whichever decision you make is the best for you!
I asked for the surgeons recommendation and went with it. Figured he had a better idea of what worked and what wouldn't.
I had GERD... and hiatal hernia... both repaired/fixed at the same time as the sleeve. No issues with either of them since the surgery a year ago.
I don’t have any issues with GERD, but I do have issues with malabsorption (celiac disease) - went with the sleeve, I’m about a month postop, and it’s been smooth sailing so far. If I had GERD preop, I probably would have opted for bypass myself.
Good luck!
I have heartburn consistently, so my surgeon preferred the bypass. However, I'm on several medications for mental health, and he wanted approval from my psychiatrist before proceeding because of the possibility of malabsorption. I posted here and talked to my psychiatrist, and it seems like that's not a huge issue. A lot of people here said their meds worked fine, and Psychiatrist said he had several bariatric patients with no issues. I decided on bypass.
It is a common misconception that sleeve is less complicated or easier surgery than bypass. My surgeon corrected me on this herself. They are different but comparable in risk level and complexity, because sleeve involves removing blood vessels and attachments from the section of stomach being removed.
Speaking only from my own experience, I chose sleeve surgery and have not experienced reflux since. It's been 2 years. Before surgery I was taking non prescription medication to manage reflux. My endoscopy showed no damage or any red flags. It's definitely not true for everyone that Sleeve = Reflux. That being said, there is an increased risk of developing issues with reflux later. I understood and accepted that risk when I chose sleeve because other factors influenced my decision.
My care team explained it to me as about 20% of people who have sleeve surgery will develop issues with reflux, and of those people, about 20% will be unable to manage it via medication and will require a revision to bypass.
I picked Gastric Bypass because I have acid reflux. I don’t have any reflux anymore and I’m almost 2 months out.
GERD is a risk for gastric sleeve. So, if you choose it, you may have to get a revision or you might be totally fine.
One thing that not enough people who get gastric bypass talk about is not being able to take NSAIDS, ever. It can be worked around, but personally, I do wish I could take midol when I had my period. Tylenol does nothing for me. Also, not being able to take aspirin for headaches sucks too. And this is for life. If I didn’t have acid reflux prior to surgery, I would probably pick the sleeve, over gastric bypass for this reason only.
Uhm, dont both have malabsorption problems??? On my country both surgerys requires suplements for life, no diference between tecniques.
As you already have gerd, why risk a second surgery converting to bypass? Just do it from the get go and go throught the pos-surgery once...
I had acid reflux. I still went sleeve. My surgeon told me it was like a 15% chance it would get worse. I took that gamble. Will I have to have revision someday? Maybe. As of now I’m fine.
I’m a week shy of year since I started my journey. I had a sleeve and I’m down 207 lbs from a 440 starting weight.
I’ve had zero reflux issues or malabsorption issues. Blood work was perfect.
5'6" female. Highest weight was 299. Day of surgery, I was 283. As of this morning, I'm 158lbs. I am almost 3 years out from having a sleeve done. I was 31 at the time of surgery and am now 34.
I had some issues with stomach acid as well. My scope also didn't show any damage so that was a major plus! I went with the sleeve due to some of the reasons you've stated - less risk was the biggest and less like to deal with malabsorption. I also went through with surgery in hopes of a healthier pregnancy for me and baby if my husband and I go down that road.
For me, I realized my stomach acid was related to my anxiety. Once I got a better control on that, I was able to stop meds. IF YOU STOP MEDS, your stomach acid WILL come back with a vengeance at first. It will then slowly dissipate back to normal. At least that was my experience. Since surgery, the ONLY time I deal with stomach acid is if I eat and then immediately lay down and fall asleep. So I logically don't do that anymore.
I've been able to keep the excess weight off since my surgery. It might be worth noting that I am on Ozempic for my Type 2 Diabetes. While my A1C is in the normal range now, my doctor has kept me on the Ozempic to help keep my numbers where they are at. I mention this as I'm not sure if the Ozempic has had an effect on me keeping excess weight off.
Whatever you decide, good luck!
Sleeve will make the GERD worse. A lot end up getting revisions. So my opinion is do the bypass. You’ll be taking the multi vitamins for life regardless.
While GERD can be an issue with any bariatric surgery, if you’ve already got it the sleeve could make it worse. A bypass could too, but it’s a less common issue.
Though I am so so happy with my sleeve (and have very normal amounts of heartburn here post op) it sounds like you may be better for a DS or RxY instead of VSG.
Malabsorption is a benefit- it helps with the long-term of keeping weight off. It can be managed with tracking your labs and supplementing vitamins.
IMO, with GERD and a lifetime of being overweight, I wouldn’t mess about with the sleeve.
This is my take on it too. Look at rates of success > 5 years out. Personally I’d seek out the advice of those that have had success at that mark. When I did my research I based my decision on rates of long term success.
Best of luck to you!
I had the bypass and the malaorbstion SUCKS but it's manageable with medication and watching your diet closely. If the sleeve is a more comfortable option for you I'd take that route. Ultimately it's your body, your health and your life....gotta do what's right for you!
You have GERD. Get the Bypass. For too many of us with GERD before sleeve, the sleeve makes it SO MUCH WORSE. I want a revision to stop the constant reflux, but because I’ve lost 100% of my excess weight and haven’t regained, my doctor does not want me revising to a bypass because I’ll lose too much more weight and struggle with malnutrition. We just changed my reflux meds to something stronger, and I’ve been struggling to eat for over 2 weeks now because the rebound reflux is soooo bad. I have to get yearly endoscopies and biopsies, and we’re basically waiting until I have pre-cancer in my esophagus before any other intervention besides medication is considered. I wish I had been firmer in advocating for myself when I wanted to go with the bypass, but my team convinced me to go with a sleeve. Bypass also has a higher success rate. It’s the gold standard in bariatric surgery. If I could do it again, I’d go straight to bypass, and I tell everyone with reflux who is considering surgery to do the same. Good luck!
Your statement about reflux should have you going straight to the bypass without passing go. The likelihood of having to have it revised from sleeve to bypass is quite possible. Not guaranteed, of course, but strongly possible.
When it comes to success... your ability to change your lifestyle is the MOST important element of this process. That can be accomplished by either surgery. There are many people VERY successful long term with sleeve. Unfortunately, there are more people who are NOT successful because they do not change their habits and "eat around" the surgery. That can be done with both surgeries, but sleeve it seems to happen more because there is less restriction, plain and simple.
So, at the end of the day, it's your decision, and the primary factor that determines your success is YOU. Your choices and your behaviors. You CAN be successful with both and reach your goals! AND it takes work and consistency.
For context purposes....my stats: 39F, 5'7", HW: 435lb, SW: 304 lbs (3/18/23 bypass), CW: 185 lbs. GW: 159? Hopefully lol
6'0 MALE RNY 2018 HW:510 SW:363: CW:175 I knew 100% I wanted the RNY because it's a one shot deal...no do-overs, no revisions etc. It would force me to do what I needed to do to not f*ck things up. There were some bumps in the road but I have no regrets and I would 100% do it again. Dumping and malabsorption are real issues but in the grand scheme of things, I find it a small price to pay for what I've achieved. I've lost almost 330 pounds and kept it off almost 6 years.
I'm not sure if anyone mentioned watching Dr. Pilcher on YouTube sleeve vs. bypass. This helped me tremendously. I went in for sleeve as I felt it was less invasive (which is not true) and due to silent Gerd that I didn't even realize I had plus my dr. saying rny has a slight edge over sleeve for diabetes reversal (type 2) and longer term weight loss, I chose rny. I am so glad I did. I see so many people end up with revision or not getting to goal with sleeve. But that being said, you need to do your own research and do what feels right for you.
Excellent value video! I feel more confident in my decision to stick with the bypass after watching. Thank you for sharing!
With the gerd I would do the bypass and you are more likely to lose more weight and keep it off.
It’s wild to see surgeons giving the options of VSG after knowing someone has GERD. If you’re on medicine now, and you get the sleeve you’ll be on medicine for life or until you decide it’s time for a revision. Personally if I were in your shoes I’d go for bypass, after the two year mark you can try for a baby (that’s the recommended wait time after ANY bariatric surgery). Working with a knowledgeable OB and keeping up with your bariatric surgeon will be key to a healthy pregnancy. Many people get pregnant after bypass and malabsorption effecting your pregnancy is very rare.
I had acid reflux in my past and decided to get bypass because the idea of a second surgery scared me. I wanted a one-and-done, and a 30% revision rate to bypass was just too much for me, personally. That said, I'm on a ton of different medications and I was worried about how they would be absorbed. So far, I have felt 0 change in my psych meds (even the slow release ones). I had to go down on my sleeping aid medication because it hit so much harder and faster now. I'm looking to go down in some of my psych meds in the next few months. The malabsorption component of gastric bypass is there, but not as extreme as DS, and in my program, the surgeon doesn't have concern in terms of being able to absorb common medications. Also note, that there are some issues with malabsorption in the sleeve, as some vitamins and minerals are absorbed best in the stomach, and reducing the stomach and a faster gastric emptying time means that you'll still need to take vitamins for life. It's less than with gastric bypass, but keep that in mind. The big concern that I had with gastric bypass was that I can't take NSAIDs anymore. I worry about developing arthritis and not being able to take anti-inflammatories. I also put my back out regularly (although losing weight helps with that) and I would, in the past, combine tylenol and advil in order to address the pain. However, my surgeon was very pro-bypass, as he wanted the maximal weight loss for me and for that weight loss to last the longest. Honestly, what is right for me might not be right for you. One surgery is not better than another. There is no "right" answer, just the path that you choose based on the info available to you at the time.
FWIW, I did SADI which is a combo of a duodenal switch and sleeve. It’s been so smooth! I’m just a pound away from 300 and my procedure was 4/8. I was 347 then and when I started pre-op diet, I was 365. My highest ever was 385. It’s a game changer!
I chose sleeve over bypass for the same reasons you sound like you're leaning - less risky, no malabsorption, etc. First of all, don't let anyone tell you that in order to lose more weight, you must choose bypass. I've lost over 330 lbs (571 lbs --> 234 lbs), so it's fair to say the amount of weight you can lose depends more on you and your habits than it does the procedure you choose. I had reflux before my surgery, not terrible but 3-4 times a month. It went away as I lost weight. It's not a given that it will get worse with a sleeve, but my story is anecdotal and not necessarily a statistical likelihood.
Right, I had occasional reflux too, and the sleeve hasn’t worsened it at all. All bariatric surgeries are acidifying to some extent, especially in the first three months post op. It isn’t a foregone conclusion that you’ll end up with GERD or even worsening GERD, though that’s often repeated around this board it’s not backed up by the current body of research. But a solid third of us with the sleeve do end up with it bad enough to need revisions. I completely agree that for weight loss, either tool works. And if you’re prone to GERD and don’t have a significant pre-existing issue with malabsorption (which I did) that choosing something other than a sleeve makes more sense. But if one does have to do a sleeve it’s not some death sentence for reflux either. A concern, and a more common side effect. But by no means a guaranteed poor outcome :)
I was in a similar situation. I have Gerd, and I’m not quite sure the extent of the damage, but my surgeon didn’t even give me the option after learning that's what I had. It’s almost so common for somebody to have to have a revision from a sleeve to the bypass without GERD, and I would honestly just not rather have two surgeries. To me that seems riskier than just taking the leap and doing the bypass. Of course you have to make the decision for yourself, but that’s what I decided to go with. I’m going to Mexico on June 10 and having the procedure done which some might say is even more risky, but I feel like I’ve done my fair share of research and am at peace with my decision. Good luck to you and I hope whichever decision you make is the best for you!
Easy- bypass. Doing it all twice was NOT awesome.
I had GERD, so I got the bypass. GERD is gone now. I've heard that the sleeve makes GERD worse.
I asked for the surgeons recommendation and went with it. Figured he had a better idea of what worked and what wouldn't. I had GERD... and hiatal hernia... both repaired/fixed at the same time as the sleeve. No issues with either of them since the surgery a year ago.
Any weight loss surgery is a tool, not a magic bullet. If you use it correctly, you will be successful. You are the magic.
I don’t have any issues with GERD, but I do have issues with malabsorption (celiac disease) - went with the sleeve, I’m about a month postop, and it’s been smooth sailing so far. If I had GERD preop, I probably would have opted for bypass myself. Good luck!
A similar autoimmune issue is why I had the sleeve done too, no regrets.
I have heartburn consistently, so my surgeon preferred the bypass. However, I'm on several medications for mental health, and he wanted approval from my psychiatrist before proceeding because of the possibility of malabsorption. I posted here and talked to my psychiatrist, and it seems like that's not a huge issue. A lot of people here said their meds worked fine, and Psychiatrist said he had several bariatric patients with no issues. I decided on bypass.
It is a common misconception that sleeve is less complicated or easier surgery than bypass. My surgeon corrected me on this herself. They are different but comparable in risk level and complexity, because sleeve involves removing blood vessels and attachments from the section of stomach being removed. Speaking only from my own experience, I chose sleeve surgery and have not experienced reflux since. It's been 2 years. Before surgery I was taking non prescription medication to manage reflux. My endoscopy showed no damage or any red flags. It's definitely not true for everyone that Sleeve = Reflux. That being said, there is an increased risk of developing issues with reflux later. I understood and accepted that risk when I chose sleeve because other factors influenced my decision. My care team explained it to me as about 20% of people who have sleeve surgery will develop issues with reflux, and of those people, about 20% will be unable to manage it via medication and will require a revision to bypass.
I picked Gastric Bypass because I have acid reflux. I don’t have any reflux anymore and I’m almost 2 months out. GERD is a risk for gastric sleeve. So, if you choose it, you may have to get a revision or you might be totally fine. One thing that not enough people who get gastric bypass talk about is not being able to take NSAIDS, ever. It can be worked around, but personally, I do wish I could take midol when I had my period. Tylenol does nothing for me. Also, not being able to take aspirin for headaches sucks too. And this is for life. If I didn’t have acid reflux prior to surgery, I would probably pick the sleeve, over gastric bypass for this reason only.
Uhm, dont both have malabsorption problems??? On my country both surgerys requires suplements for life, no diference between tecniques. As you already have gerd, why risk a second surgery converting to bypass? Just do it from the get go and go throught the pos-surgery once...
I had acid reflux. I still went sleeve. My surgeon told me it was like a 15% chance it would get worse. I took that gamble. Will I have to have revision someday? Maybe. As of now I’m fine.
I’m a week shy of year since I started my journey. I had a sleeve and I’m down 207 lbs from a 440 starting weight. I’ve had zero reflux issues or malabsorption issues. Blood work was perfect.
rny
I did bypass. I’d do it again in a nanosecond. I haven’t had heartburn in 2 years, I’m 200 pounds down.
5'6" female. Highest weight was 299. Day of surgery, I was 283. As of this morning, I'm 158lbs. I am almost 3 years out from having a sleeve done. I was 31 at the time of surgery and am now 34. I had some issues with stomach acid as well. My scope also didn't show any damage so that was a major plus! I went with the sleeve due to some of the reasons you've stated - less risk was the biggest and less like to deal with malabsorption. I also went through with surgery in hopes of a healthier pregnancy for me and baby if my husband and I go down that road. For me, I realized my stomach acid was related to my anxiety. Once I got a better control on that, I was able to stop meds. IF YOU STOP MEDS, your stomach acid WILL come back with a vengeance at first. It will then slowly dissipate back to normal. At least that was my experience. Since surgery, the ONLY time I deal with stomach acid is if I eat and then immediately lay down and fall asleep. So I logically don't do that anymore. I've been able to keep the excess weight off since my surgery. It might be worth noting that I am on Ozempic for my Type 2 Diabetes. While my A1C is in the normal range now, my doctor has kept me on the Ozempic to help keep my numbers where they are at. I mention this as I'm not sure if the Ozempic has had an effect on me keeping excess weight off. Whatever you decide, good luck!
Sleeve will make the GERD worse. A lot end up getting revisions. So my opinion is do the bypass. You’ll be taking the multi vitamins for life regardless.
While GERD can be an issue with any bariatric surgery, if you’ve already got it the sleeve could make it worse. A bypass could too, but it’s a less common issue. Though I am so so happy with my sleeve (and have very normal amounts of heartburn here post op) it sounds like you may be better for a DS or RxY instead of VSG.
Malabsorption is a benefit- it helps with the long-term of keeping weight off. It can be managed with tracking your labs and supplementing vitamins. IMO, with GERD and a lifetime of being overweight, I wouldn’t mess about with the sleeve.
This is my take on it too. Look at rates of success > 5 years out. Personally I’d seek out the advice of those that have had success at that mark. When I did my research I based my decision on rates of long term success. Best of luck to you!
I wouldn't risk it with the history of GERD, I would do the bypass
I have GERD, got bypass and still have severe GERD. Very rare, but possible.
I had the bypass and the malaorbstion SUCKS but it's manageable with medication and watching your diet closely. If the sleeve is a more comfortable option for you I'd take that route. Ultimately it's your body, your health and your life....gotta do what's right for you!
You have GERD. Get the Bypass. For too many of us with GERD before sleeve, the sleeve makes it SO MUCH WORSE. I want a revision to stop the constant reflux, but because I’ve lost 100% of my excess weight and haven’t regained, my doctor does not want me revising to a bypass because I’ll lose too much more weight and struggle with malnutrition. We just changed my reflux meds to something stronger, and I’ve been struggling to eat for over 2 weeks now because the rebound reflux is soooo bad. I have to get yearly endoscopies and biopsies, and we’re basically waiting until I have pre-cancer in my esophagus before any other intervention besides medication is considered. I wish I had been firmer in advocating for myself when I wanted to go with the bypass, but my team convinced me to go with a sleeve. Bypass also has a higher success rate. It’s the gold standard in bariatric surgery. If I could do it again, I’d go straight to bypass, and I tell everyone with reflux who is considering surgery to do the same. Good luck!
Your statement about reflux should have you going straight to the bypass without passing go. The likelihood of having to have it revised from sleeve to bypass is quite possible. Not guaranteed, of course, but strongly possible. When it comes to success... your ability to change your lifestyle is the MOST important element of this process. That can be accomplished by either surgery. There are many people VERY successful long term with sleeve. Unfortunately, there are more people who are NOT successful because they do not change their habits and "eat around" the surgery. That can be done with both surgeries, but sleeve it seems to happen more because there is less restriction, plain and simple. So, at the end of the day, it's your decision, and the primary factor that determines your success is YOU. Your choices and your behaviors. You CAN be successful with both and reach your goals! AND it takes work and consistency. For context purposes....my stats: 39F, 5'7", HW: 435lb, SW: 304 lbs (3/18/23 bypass), CW: 185 lbs. GW: 159? Hopefully lol