Weight loss surgery- Sleeve vs. Gastric.

TannunisFred

Diabetic Dr went really well today. He wants to start weaning me off the insulin. He also wants me to really consider the weight loss surgery even though I am doing so well. I told him I've lost 130 pounds in the last 6 months, but he still wants me to consider the surgery. He's the second doctor that's tried to get me to do this in the last 3 months and I wasn't sure why, considering how well I am doing. He explained to me that there are real physical changes that are made to the body when you have these surgeries. Dr's aren't sure why, but it seems to do a reboot and you can come off all medicines almost immediately. It minimizes plateau's and there are higher success rate at maintaining the weight loss. He also suggested I look into the sleeve instead of the complete gastric so I guess I have some research to do. Anyone had this done and able to comment?

elphie754

Tannun wrote: »

Diabetic Dr went really well today. He wants to start weaning me off the insulin. He also wants me to really consider the weight loss surgery even though I am doing so well. I told him I've lost 130 pounds in the last 6 months, but he still wants me to consider the surgery. He's the second doctor that's tried to get me to do this in the last 3 months and I wasn't sure why, considering how well I am doing. He explained to me that there are real physical changes that are made to the body when you have these surgeries. Dr's aren't sure why, but it seems to do a reboot and you can come off all medicines almost immediately. It minimizes plateau's and there are higher success rate at maintaining the weight loss. He also suggested I look into the sleeve instead of the complete gastric so I guess I have some research to do. Anyone had this done and able to comment?

If you don't believe you need it to lose weight, then do not do it. Complications from wls can be fatal and some become chronic issues. If you can avoid it, I would.

amyk0202

I had the sleeve & it was the best decision ever for me. I am not diabetic but I have a strong family history of it & that was one of my biggest fears. From what I understand, having the surgery for weight loss & having the surgery to improve your diabetes are 2 separate things. You will get a lot of people on mfp who are very against wls for any reason. Since you already have a very serious condition, I think it is worth looking into & weighing whether the benefits are worth the risks. I've read that it is almost like being cured from having diabetes. I don't know how accurate that is, but I think it would definitely be something you should explore with your doctor.

I have personally not had any complications with my sleeve. I had my surgery on 4/04/12. My sister had her sleeve done about a year before me. She did end up having her gall bladder removed which I think many people end up having to do (just from reading forums). She vomits if she eats foods high in fats--not a bad problem when you are trying to lose weight, but still a life changing effect. I do not have any problems eating anything. I picked the sleeve because I was worried about the malabsorbtion issues you can get with a gastric bypass. I went in wanting the lap-band, but my surgeon said he had seen so many complications that he wasn't performing them any more. WLS is a very personal decision & it does sound like you are making the life style changes that would make it successful for you if you decide to do it. Good luck!

PALady4JC

I had gastric bypass surgery on 11/18/14. I'm doing great. As for the comment about complications from wls can be fatal...be sure to have the surgery done at a Center for Excellence. And, fatalities are rare today. There are, of course, risks as with any surgery. I had mine at St. Luke's Hospital in Allentown, PA. Their statistics are high compared to the national average. I at one time was very opposed to weight loss surgery thinking of it as an easy way out. I was borderline diabetic (in a family where many have died due to complication from the disease), had high cholesterol and high blood pressure, and struggled with being obese for a very long time. I am 57 pounds down. So for me the pros definitely outweigh the cons. Be sure to attend information sessions, research, and talk to other bariatric patients to be mentally, emotionally, and physically prepared. It is NOT an easy way out. It's a tool. Almost everyone I've met at support groups who was diabetic is no longer diabetic or their insulin dosage has been drastically reduced. I was taken off blood pressure and cholesterol medicine the day after the surgery and both are in normal range. I started out wanting the sleeve, but conversations with my surgeon led me to decide to do the bypass. Check out http://mystlukesonline.activeboards.net/forums.html. It's a forum of bariatric patients started by St. Luke's, but anyone can participate. You'll get a good feel for patients' experiences, ups, downs, regrets, etc. Best success on your journey, whichever path you choose!

jgnatca

I had the bypass this past June and I am doing very well. Very quickly I was off all medications including Metformin, blood pressure, and cholesterol meds. These surgeries also reduce the hormone Ghrelin which affects your hunger response. If you do the surgery at this point in your life-change, you will have a very, very good chance to keep that weight off for good.

Responses to the surgery varies quite a bit. I have very few food intolerances and I have no trouble meeting my minimum calories a day. Some of my compatriots struggle to eat enough. I'd say the efficacy of the bypass over the sleeve is a toss-up, an individual decision. Mine is the bypass.

I will be on vitamins for the rest of my life forever, because of impaired absorption due to the surgery. For me, an easy trade-off.

jgnatca

P.S. my latest A1C came back as a solid 5. Yay!

gothchiq

I would probably get a second opinion. This procedure is not without serious risks.

solieco1

You've lost 130 pounds in 6 months. Yes, I know the surgery can lifesaving but you are drastically altering your body and the way it functions forever. I would avoid it if you can do it yourself.

mykaylis

how much weight is left for you to lose to get to a healthy BMI?

i am going for the gastric sleeve sometime this year. i have changed my habits significantly but i'm totally stalled. i am still close to 100 lbs overweight.

i chose the sleeve over the RNY because i wanted to leave my intestines intact, so my ability to absorb my medications will be little changed.

yourradimradletshug

My mom just got the gastric sleeve done this past Feb. and while she is SO happy with the weight loss there are a lot of MAJOR lifestyle changes she had to make. No more spicy foods, no soda, you can't drink anything 30 mins prior to eating or for 30 mins after, she can't eat a lot anymore (like 3 chicken wings and she is full) and there are gas bubbles that cause a lot of pain, risk of dumping, all that glamorious stuff! However my mom tired for SO long to lose the weight but NOTHING worked so the surgery was her last resort. To me is sounds like you are doing really well so I'd suggest keep working on it without surgery and see where you go. If you have any other questions, feel free to message me.

RBXChas

I'm not knocking weight loss surgery (WLS), but if you are losing weight without it and are happy with your progress, why would you undergo a surgery that is not without risks? Not only are there risks with the surgery itself, but sometimes the aftereffects are not so great. Two family members of mine had gastric bypass, and both had painful gallstones and required gall bladder removal surgery about 10 years after their initial surgeries. No one else in my family has had gallstones, and apparently they're not uncommon after gastric bypass. Gallstones are just one possible side effect - there are many others.

I assume that you'd have to pay at least something out-of-pocket for your surgery, plus I also assume that, if you are working, you'd have to take time off of work to have it and recover, which means either less pay, less paid time off for fun things, like vacations, or less sick days available for unscheduled medical issues.

If WLS is for you, and you've done all the research on the risks and benefits and have confidence in your doctor and hospital, go for it. But if you feel like you're doing fine without it, I wouldn't suggest that you put yourself through it.

PALady4JC

I agree that if you are able to do it on your own successfully, then by all means don't have the surgery. I lost a lot of weight many times then gained it back.
I was fortunate to have met my out of pocket and only had to pay about $400 toward anything having to do with the surgery. And, I have a lot of sick time. I was out of work for 2 weeks. Most people I know go back in 1 week.
It's both funny and sad how people get so fired up about the subject of wls. It's a personal decision and ignoring people's judgmental reactions is one of the things you need to be able to do.

mae7365

I had gastric sleeve surgery in November 2014. I was obese (36.1 BMI) vs. morbidly obese (BMI >40) but insurance paid for surgery due to my having comorbidities (high blood pressure, high cholesterol, sleep apnea, elevated A1C). At one month post op, I am off all prescription medications and have returned the bipap machine. I've lost 49 lbs in 14+ weeks and I look and feel 10 years younger. If you can afford WLS, it is a reset for your life. One of the benefits of having 3/4 of your stomach removed - the hormone that tells your brain your are hungry is pretty much gone. So you eat to live and food doesn't have control any longer (unless you let it as WLS isn't a magic bullet, its a tool).

CoraGregoryCPA

I totally agree with Mae from above about the hormone's changing in your brain. I think and feel completely different about food, hunger, cravings, desires after my RNY surgery. I eat to live and food doesn't control me any longer. It's not JUST shrinking your stomach or removing your intestines, the surgery does so much more.

Sued0nim

I have to agree with the comments above - you have done incredibly well, why on earth anyone would recommend surgery and all its potential risks in the light of your current success is beyond me...I have to ask, because I don't know the American system, do doctors earn from this kind of recommendation?

katherine_startrek_fan

WLS is not a magic bullet and has many complications.

If you're losing weight without, I'd skip it. Your stomach will naturally shrink on its own if you keep eating right and losing weight-- it just takes time.

katherine_startrek_fan

rabbitjb wrote: »

I have to agree with the comments above - you have done incredibly well, why on earth anyone would recommend surgery and all its potential risks in the light of your current success is beyond me...I have to ask, because I don't know the American system, do doctors earn from this kind of recommendation?

Actually yes, there is a push among some hospital/medical systems to recommend this surgery and many incentives across the board for having their patients lose weight. It's a very flawed system.

MKEgal

According to your ticker, you've lost 250 lb so far (WOW!!!!!!!!!!!)
and are more than halfway to your goal weight.
Why screw with that?
What you're doing is working fine. Amazingly fine. (And did I mention wow?)

Do your research, learn what you can from reputable groups & websites (look for professional organizations, not ones run by a doctor's office which does the surgeries, which would be biased).
I would akso suggest browsing sites where patients talk about the problems which come from these surgeries, because it's unlikely a surgeon trying to sell you a product (surgery) would actually fully inform you about the problems. You'd be unlikely to buy.

http://www.asbp.org/ American Society of Bariatric Physicians
http://www.nlm.nih.gov/medlineplus/weightlosssurgery.html The National Institutes of Health info page on weight loss surgery (links to lots of resources)
https://asmbs.org/ American Society for Metabolic & Bariatric Surgery


But from what you've told us, I don't see any reason to mess up your body for the rest of your life by having stomach surgery.

Despite having you as an example, those doctors can't seem to wrap their heads around the fact that people can lose weight without surgery and without signing up for the major health risks which come from them (which continue the rest of your life, because most stomach surgeries can't be undone).

The last time I was at my weight doc's office, they introduced me to an intern who was doing his endocrinology rotation, because he was so surgery-focussed and had never met anyone who'd been successful at losing weight w/o surgery. :facepalm:
I wish I could address every single class of medical students at our local medical college!
(And I've "only" lost 75 lb in the last year.)

.

there are real physical changes that are made to the body when you have these surgeries

Um, yeah... Isn't that kinda the point?
The mildest surgery would be putting a band around your stomach. This is reversable, and my doc told me that he's known of lots of removals. He also said that I've lost more than would be expected if I'd had that surgery.

The worst surgery would be removing all but a small part of your stomach & much of your small intestine. Aside from making it so that you physically cannot eat as much, this causes malabsorption. So you think you're eating 3000 cal/day, but maybe your body is only absorbing 1000. So you have to work to get enough food into you, in tiny portions, so your body can get the nutrients it needs (you're wasting most of the nutritional value of the food when it gets pooped out). You're spending more time & money eating, but getting less out of it. Oh, and you'll be taking lots of vitamins & minerals every day for the rest of your life.

samhennings

Ive never dealt with Diabetes or that sort of surgery myself, so my opinion may not be worth mcuh here.

However, it sounds like you are doing fantastically well by yourself (congratulations!) and to lose as you have in a healthy way would be my preference over major (life altering) surgery.

What is the benefit of having the surgery aside from a "head start"/time saving on your weight loss?

In a pro/con situation, all things being even, I would personally stick to what you are doing now and not take the risks and the life changing effects of surgery.

Unless of course there is a major reason the doctor can throw in to tip the balance.

UtahWI

You are doing beautifully. I absolutely would not do it if I were you. Too many permanent restrictions and changes.
I love one of the fifth year surgical residents I work with. His advice? "I always tell people to never ever have surgery unless they absolutely have to." I have had multiple abdominal surgeries due to cancer, and am an RN in a surgical/trauma ICU...and can just tell you that the guts do not like to be tinkered with. Having had patients come in years after their WLS with leaking anastomoses, becoming septic, having long stays, nearly dying, etc...if you are having success, leave your belly alone.
Before anyone gets excited, I fully support an adults right to make the informed decision to have WLS and certainly there are many that go very well and they never have issues. But if the OP is doing so well without it, why take the chance?
And yes...bariatric surgery is a big money maker for clinics...that's why they have "Bariatric surgery centers" and all the advertising and what not...

namelesshere

I would avoid the surgery if at all possible. Too many complications and risks. Though they claim it is rare, I have had a friend die on the table. If you are able to lose the weight without it, that is the way I would go. My doctor suggested it for me, and I asked him what is the success rate of keeping it off. He said many who don't change their eating habits soon gain the weight back. That confirmed in my head that it was not a good choice for me. I got a different doctor. She still is after me to lose weight, but not pushing the surgery. I think Dr's get financial kickback from promoting trendy procedures not always in your best interest. You have lost much without it so keep on, keeping on.

SezxyStef

you couldn't even pay me to have the surgery unless it was to save my life. I have watch coworkers, friends etc go through agony because of it...sure you lose weigh fast (loose skin everywhere), sure you come off meds and all is good...until you realize you are losing muscle because you can't eat a lot of food, life totally changes, eating out become a constant explaining no it was cooked fine I am just full after a couple of bites and I could go on but I won't...you are doing great without it...I say leave well enough alone...

maillemaker

He explained to me that there are real physical changes that are made to the body when you have these surgeries. Dr's aren't sure why, but it seems to do a reboot and you can come off all medicines almost immediately. It minimizes plateau's and there are higher success rate at maintaining the weight loss.

Your doctor is right. When you lose body fat, it causes, among other unknown effects, a drop in leptin, which triggers, defensive mechanisms to try and defend fat stores, at least in some people.

The only known mechanism that resets the hormonal and neural responsivity is bariatric surgery.

Surgery also has the best success rate both in amount of weight lost and in duration of time it is kept off.

But - everyone I know who has had bariatric surgery has had issues with it. Most of them get very ill if they over-eat even the slightest bit. One lady I know of every time we go out to dinner she is constantly running to the bathroom. So it is a serious procedure and not to be undertaken lightly.

If you are succeeding without surgery, I think I would stay the course and see how well you can do with behavioral modification alone. If you start to stall out or regain, then perhaps it would be time to re-assess.

ElliottTN

I just checked out your profile and the progress you've made is amazing. I have no idea what your overall medical background is nor would I ever qualified to give advice but it looks like you've had to fight your way back through the worst of it already. Not sure what cutting you open and modifying your body would really accomplish. You seem strong enough to do this on your own.

Of course I don't have one of those medical degree thingies......