VSG or RNY: Most Effective?
SassyCappy
Posts: 7 Member
Hi all. I'm new to the group and began my weight loss surgery journey today!
I've struggled with my weight for most of my life. I've been researching weight loss surgery for years, always convincing myself that I can "do it on my own." But at 25, I was diagnosed with PCOS; not only is weight loss still a struggle, but I was told that I may never have children. So I've finally taken those first few steps and I'm now pre-op.
I thought I had decided on VSG, mainly because of the malabsorption and lack in nutrients that accompanies gastric bypass. But today I had my consultation with the surgeon and although it's up to me as to which surgery he'll perform, he thinks I'll be more successful with the RNY. I'm 28 and weighed 313 today. I'm 5'4" and my BMI is 54. I've had high blood pressure since 14-years-old, which I'll more than likely be on medication for the rest of my life for it. I also have PCOS.
My surgeon is very blunt; people have told me that when he gives you a number, that's what he expects. He said with the VSG my weight will be in the upper 100s, lower 200s...while with the RNY, it will be no more than 170. Of course this will depend on me and my eating and exercise behavior. He wants me to lose as much weight as possible prior to the surgery.
My main concern about getting the RNY is that I want to get pregnant someday and I fear with the lack of nutrients that I'll have problems. The success stories with the VSG are wonderful...I've just never really thought about having a "limit" as to how much I'll weigh in the end.
My ideal weight is between 124 and 138. Personally, I'd be happy with 150. So I guess my question is this: with dedication to healthy eating and being active, is it possible to achieve a goal of 150 with the VSG?
I know ultimately this is MY decision, and when it all boils down to it, I need to be confident in my decision and that I'll be happy with the decision later down the road. I would greatly appreciate some feedback!
I've struggled with my weight for most of my life. I've been researching weight loss surgery for years, always convincing myself that I can "do it on my own." But at 25, I was diagnosed with PCOS; not only is weight loss still a struggle, but I was told that I may never have children. So I've finally taken those first few steps and I'm now pre-op.
I thought I had decided on VSG, mainly because of the malabsorption and lack in nutrients that accompanies gastric bypass. But today I had my consultation with the surgeon and although it's up to me as to which surgery he'll perform, he thinks I'll be more successful with the RNY. I'm 28 and weighed 313 today. I'm 5'4" and my BMI is 54. I've had high blood pressure since 14-years-old, which I'll more than likely be on medication for the rest of my life for it. I also have PCOS.
My surgeon is very blunt; people have told me that when he gives you a number, that's what he expects. He said with the VSG my weight will be in the upper 100s, lower 200s...while with the RNY, it will be no more than 170. Of course this will depend on me and my eating and exercise behavior. He wants me to lose as much weight as possible prior to the surgery.
My main concern about getting the RNY is that I want to get pregnant someday and I fear with the lack of nutrients that I'll have problems. The success stories with the VSG are wonderful...I've just never really thought about having a "limit" as to how much I'll weigh in the end.
My ideal weight is between 124 and 138. Personally, I'd be happy with 150. So I guess my question is this: with dedication to healthy eating and being active, is it possible to achieve a goal of 150 with the VSG?
I know ultimately this is MY decision, and when it all boils down to it, I need to be confident in my decision and that I'll be happy with the decision later down the road. I would greatly appreciate some feedback!
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Replies
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Congratulations on your decision to make a healthy choice for yourself.
Remember that none of us are medical professionals (at least we are not YOUR medical professional) and thus cannot give you the same quality advice that your doc can.
That being said: All things are possible. The surgery, be it VSG or RNY, is a tool. Treat it as such and use it according to the guidance given to you by your team, and you will be successful. Treat it as a cure-all or a magic bullet and you will fail.
The sleeve is a much newer surgery, so there are fewer long-term studies to look at and an overall smaller sample size for any research than is available to folks looking at RNY.
I can speak from my own experience and that of my wife - we've both been very successful with our sleeves. She was sleeved in January and has already reached her personal goal of being under 200 (She's 5'9") and is within 15 pounds of the surgeon's "suggestion" of where she should level out. I am far more recently post-op (I had my sleeve done on 8/26/14) and I've already lost almost 40 pounds since surgery. I love my sleeve. I still have a long way to go to get to my goal of under 130, but I'm getting there.
For us, the sleeve was the way to go - we didn't want the rerouting, both of us were reasonably healthy prior to surgery (save for being fat), and we have both always been active, so the team was not concerned about a lack of physical activity post-op.
That being said: If your surgeon is recommending RNY, there's probably a good reason for it. If s/he can't express any reason beyond numbers on a scale, you may want to consider finding a different doc. There are good seeds and not so good seeds. Make sure you get a good seed.0 -
I was 382 at the beginning and I am 5'-4". I had VSG nearly a year ago, I lost 70 lbs prior to surgery, and I have been aiming for a goal weight of 150. I haven't weighed in for over a week but I am probably at 175 ish now. I do believe 150 is totally doable, however, in my case, I know I have a lot of loose skin and I am not sure how that will factor into my goal weight. I am sure there is at least 15lbs of loose skin. I see my surgeon Friday so I will be asking him about that. My surgeon had told me that if necessary, I could get a revision to gastric bypass in the future, but at this point that won't be necessary at all. I am not sure he was expecting me to lose as much as I have.
All that said, you can get to whatever weight you want with either surgery if you commit to the process. I have seen different levels of success with different surgeries. You are right that the results will vary based on your behavior. Surgery is just a tool, YOU have to make it work, and if you want to, you will. Regarding getting pregnant - my sister in law had gastric bypass surgery, and she was told she could get pregnant, but they wanted her to wait two years I believe. I am sure with the RNY it would be the same.0 -
I know someone that was in a similar situation with PCOS and her surgeon told her he has seen the best results w/ RNY and reversing many of the side effects of the PCOS. The sleeve is newer and may do the same or similar, just passing on what I have heard.0
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I, personally, think success is more about mindset and determination than which surgery you choose.
I started this process at 323 pounds at 5'3" - that's a BMI of 57. I never considered RNY for a variety of reasons (the biggest was not wanting to deal with malabsorption of medications and vitamins forever or have my guts rerouted) so I really only considered VSG. I am a week shy of 6 months post-op and weighed 231 this morning. You can eat around every surgery so I don't think that one surgery is necessarily more "effective" than another one - you can't count on having dumping with RNY, for example.
I'm am following a low carb/high fat nutrition plan and have seen very steady weight loss. I will not stray from this course until I get to my goal weight; for me, it's as simple as that. I also follow the VSG rules - protein first, don't drink and eat at the same time, no carbonation. I also think it's very important to stay involved in these support communities; my weight loss and nutrition are my biggest priority right now and going to my in-person support group and participating in online communities here, on instagram, facebook, and obesityhelp.com keep my head in the game.0 -
They are both effective as long as you make the necessary changes required for either surgery. They are both a fabulous tool that can help you reach a healthy weight, which helps with PCOS.
I know people who have PCOS and have had one or the other surgery and both ended up having healthy pregnancies.
I also choose the sleeve for a number of reasons, but do not personally have PCOS.
Good luck and congrats on taking steps towards a healthier you!!0 -
Thank you all so much on your feedback!
My gut says to go with the sleeve, and that's what I'm doing. Besides, in the end, it's not about the number...it's about maintaining a healthy lifestyle, and I know I'll exceed my own expectations!0 -
I too am on the same journey as you as for which surgery to do. I also have PCOS and my weight is 290. Even after them telling me I would have no children....God granted me with the gift of 2 children. Truly God's miracle. I was dead set on the VSG but both the surgeon and PCP told me I would have better results with RNY. Finally the surgeon told me to do an EGD to look at what he is up against due to I also have a bad case of GERD. When he went in he found over 100 Polyps and a hernia. With this information he said I can still have VSG but the chance of leakage would be high and it would worsen the GERD. I too was worried on the malobsorbtion problem with RNY and he said the rate is same with both surgeries. They have found that VSG and RNY has the same rate and problems it is not one more than the other and no matter what I will be on vites for life. I had a friend that did the RNY and just had a baby...Healthy! She also had PCOS and her beginning weight was 324 and has lost 142.
Good luck with your journey.0 -
I too am on the same journey as you as for which surgery to do. I also have PCOS and my weight is 290. Even after them telling me I would have no children....God granted me with the gift of 2 children. Truly God's miracle. I was dead set on the VSG but both the surgeon and PCP told me I would have better results with RNY. Finally the surgeon told me to do an EGD to look at what he is up against due to I also have a bad case of GERD. When he went in he found over 100 Polyps and a hernia. With this information he said I can still have VSG but the chance of leakage would be high and it would worsen the GERD. I too was worried on the malobsorbtion problem with RNY and he said the rate is same with both surgeries. They have found that VSG and RNY has the same rate and problems it is not one more than the other and no matter what I will be on vites for life. I had a friend that did the RNY and just had a baby...Healthy! She also had PCOS and her beginning weight was 324 and has lost 142.
Good luck with your journey.
Just to clarify, I was mainly talking about medication absorption. Since most medication absorption occurs in the small intestine, and VSG does not touch the small intestine, there shouldn't be an issue with medication dosing for VSG-ers.
From my research, and backed up by my surgeon, the main draw back of VSG is lack of long-term data but the data that is available is very reassuring and comparable to RNY. I would also add that VSG is not a standardized procedure and some surgeons have different ideas about the ideal sleeve size (that might be something worth asking your surgeon about...). Most people are passionate advocates for their own surgery type, so, thankfully, you'll most likely be very happy no matter which route you take. Good luck to all of you waiting on surgery - we'll keep the loser's bench warm for you.
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It's up to you. I chose the sleeve because I just wasn't comfortable with the rerouting the guts, and viewed it as riskier. I also worried about malabsorption of food. My doctor recommended the rny but said I would do well with either.
It's all about what you put into it. A coworker had the sleeve about a month before me and is cheating on the plan big time, eating stuff she is not supposed to, and when she was supposed to be on liquid. I am worried about her success, and she is pushing the envelope eating french fries and throwing up. I am following the rules because I am so afraid of side effects and complications, so as a result I have not had any issues. You will be successful as long as you follow everything your doctor tells you for diet and exercise.0 -
when I started this journey and had the sleeve 3 years ago. I lose slow and stall often and do not/sometimes cannot exercise as much as we all should. So I am still working towards goal. Truth is, both surgeries really depend on if you are going to embrace the lifelong, lifestyle changes needed to get and keep the weight off. These are tools, not cures. As my doctor said, you can outeat any of the WLSs.
I chose the sleeve because I didn't want the disconnect and reconnect that comes with the bypass. I also didn't want to have to live the rest of my life with the restrictions in meds and such that go with bypass. Since the sleeve simply removes the stretchy part of the stomach, I felt it was the surgery for me.
Best of luck on your journey. Everyone is different, so do your homework and find the best surgery for you and remember. Success really depends on you and your commitment to using the tool WLS is.
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I opted for RNY 2.5 years ago. When I investigated my options, RNY was the "gold standard" of weight loss surgeries. Meaning it had the best long term success rates, the best overall weight loss rates, the lowest mortality and complication rates. That being said, I was 45 when I had surgery and did not plan to have any more children. And honestly I would have had questions and reservations about my ability to carry a successful pregnancy after ANY type of weight loss surgery. However, there have been many cases of successful pregnancies post RNY. My surgeon asks that patients wait 18 months before they become pregnant post op.
I am 5'7" tall, my starting weight was 347.5lbs. I had surgery on 3/16/2012 and today I weight right around 170lbs. I would like to lose another 35lbs or so and get to about 135lbs. I had no co-morbidities prior to surgery except high cholesterol. My surgeon monitors my vitamin levels on an ongoing basis, as well as BP, heart rate, body measures and cholesterol. All my numbers are really good. As a matter of fact he was shocked at my last appointment (last March) by my resting heart rate (about 40 beats per min) because it was as low as an athlete's. But I do work out a lot now and I am training for a 1/2 marathon so I run a lot.0 -
I too am on the same journey as you as for which surgery to do. I also have PCOS and my weight is 290. Even after them telling me I would have no children....God granted me with the gift of 2 children. Truly God's miracle. I was dead set on the VSG but both the surgeon and PCP told me I would have better results with RNY. Finally the surgeon told me to do an EGD to look at what he is up against due to I also have a bad case of GERD. When he went in he found over 100 Polyps and a hernia. With this information he said I can still have VSG but the chance of leakage would be high and it would worsen the GERD. I too was worried on the malobsorbtion problem with RNY and he said the rate is same with both surgeries. They have found that VSG and RNY has the same rate and problems it is not one more than the other and no matter what I will be on vites for life. I had a friend that did the RNY and just had a baby...Healthy! She also had PCOS and her beginning weight was 324 and has lost 142.
Good luck with your journey.0 -
I guess I'm a little slow at my reply. So, Hildabean, just wanted to thank you for giving us your history on your surgery choices. As you know, also have GERD and my surgeon is also recommending RNY over the sleeve. I didn't realize they did a scope and holy polyps! Will they be able to fix the hernia at surgery time? My nurse said he may opt to do a scope and stomach acid ph test? And if all is ok, I may still be able to get the sleeve. But I have been reading where so many people didn't know they had a reflux disease until after VSG and then ended up with RNY anyways. So I am seriously thinking I will just go with RNY.0
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I guess I'm a little slow at my reply. So, Hildabean, just wanted to thank you for giving us your history on your surgery choices. As you know, also have GERD and my surgeon is also recommending RNY over the sleeve. I didn't realize they did a scope and holy polyps! Will they be able to fix the hernia at surgery time? My nurse said he may opt to do a scope and stomach acid ph test? And if all is ok, I may still be able to get the sleeve. But I have been reading where so many people didn't know they had a reflux disease until after VSG and then ended up with RNY anyways. So I am seriously thinking I will just go with RNY.
kchaki They will be fixing the Hernia at time of surgery. They said that is pretty routine. He said he likes to test GERD patients with EGD to see what he is working with. I had my last pre op appointments yesterday. I do get to see the dietician again at end of month but that is not holding up the scheduling of my surgery. I am wanting to do it end of January so I can get through the holidays. I think I will go ahead with the RNY due to the complications he foresees with at VSG is scary.0 -
Both are extremely effective. I believe surgeons need to concentrate more on body issues (like GERD, as mentioned) and also individual patient physiology and not just how much he thinks a person will lose and in what amount of time (because this is more a reflection on him and his success rate, not your health).
If you are a sweets eater, RNY is a good option because a great many RNY patients can't abide a lot of sugar. Dumping syndrome keeps them in line, not to mention the small portions. However, if you simply have an issue with portion control, I've seen VSG work for people as heavy as 460lbs. It just depends on your dietary weakness and how you need to combat it.0 -
Both are extremely effective. I believe surgeons need to concentrate more on body issues (like GERD, as mentioned) and also individual patient physiology and not just how much he thinks a person will lose and in what amount of time (because this is more a reflection on him and his success rate, not your health).
If you are a sweets eater, RNY is a good option because a great many RNY patients can't abide a lot of sugar. Dumping syndrome keeps them in line, not to mention the small portions. However, if you simply have an issue with portion control, I've seen VSG work for people as heavy as 460lbs. It just depends on your dietary weakness and how you need to combat it.
Exactly why I've decided to go with the sleeve - my problem is portion control. Thanks for your reply!
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Both are extremely effective. I believe surgeons need to concentrate more on body issues (like GERD, as mentioned) and also individual patient physiology and not just how much he thinks a person will lose and in what amount of time (because this is more a reflection on him and his success rate, not your health).
If you are a sweets eater, RNY is a good option because a great many RNY patients can't abide a lot of sugar. Dumping syndrome keeps them in line, not to mention the small portions. However, if you simply have an issue with portion control, I've seen VSG work for people as heavy as 460lbs. It just depends on your dietary weakness and how you need to combat it.
Just a warning about the RNY as a solution for sweets eaters...it is only about 30% of RNY patients that experience "dumping". I chose RNY hoping for that side effect, as I know I have a sweet tooth. At 1 year out, I can definitely eat any kind of sweet I want to with no side effects. Maybe not in the same volume as before the surgery, but I could go all day eating nothing but sweets if I want to. No matter what surgery you choose, I can't stress enough the importance of focusing on your mindset and underlying causes of overeating and/or choosing the wrong foods. Just want to put that out there because a lot of my pre-surgery prep and research touted the dumping thing, and it is simply not prevalent enough to depend on that for weight loss after the surgery.0 -
I am currently pre-op, looking at a December surgery date.
I had hoped to get the sleeve. I thought because I have irritable bowel at times, I did not want to do RNY and have even more irritable bowel (dumping).
My surgeon did an EGD a week ago and found I have a severe case of acid reflux (I had no idea), a hiatel hernia, and one stomach polyp.
With this information, he strongly recommends RNY because with the sleeve the reflux will more than likely get worse; not better.
So, after doing my own research I am now on board with the RNY.
I think it is a decision between you and your doctor. Tell him your concerns about having children in the future and malabsorption. If he still says RNY than you have to honor that, or get a second opinion.0 -
JohnnyMART wrote: »I am currently pre-op, looking at a December surgery date.
I had hoped to get the sleeve. I thought because I have irritable bowel at times, I did not want to do RNY and have even more irritable bowel (dumping).
My surgeon did an EGD a week ago and found I have a severe case of acid reflux (I had no idea), a hiatel hernia, and one stomach polyp.
With this information, he strongly recommends RNY because with the sleeve the reflux will more than likely get worse; not better.
So, after doing my own research I am now on board with the RNY.
I think it is a decision between you and your doctor. Tell him your concerns about having children in the future and malabsorption. If he still says RNY than you have to honor that, or get a second opinion.
I am in same boat wanted the sleeve then they did egd and found many polyps and hiatal hernia and awful GERD. With the risk due to the polyps causing issue with staples causing leakage...I am now on board for the RNY0 -
I had GERD bad before my WLS Sleeve in June 2012. When they did my sleeve they found a hital hernia and fixed that also. I have had no GERD issues at all post op and do not take Prilosec like I had to take on a daily basis before WLS. My surgeon did say that the sleeve can make GERD worse but for me it was the opposite. It could have also been all caused by the hital hernia too and once that was fixed no more acid reflux.
I lost 47 pounds pre op and 99 pounds post op (June 2012 to March 2013) I reached my personal goal in March 2013. Started out at 270 Feb 2012, got down to 124 by March 2013. I lost about 10 pounds per month. If you go to my profile you can see my monthly weight loss stats I tracked and posted on my profile.
I asked my WLS surgeon what he recommended and he said the sleeve and that was what I was leaning towards anyways. I have no regrets at all except I waited till I was 49 to have WLS!
Good luck!
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