Yes, I'm the devil's advocate...

I started with a BMI of almost 60 and did look into the DS...I didnt go with it as I was concerned at the degree of malabsorption. Ive yet to get under 200 lbs...really freaking close....but down almost 200 lbs from my highest. I eat right 90% of the time and I exercise. Lifestyle changes are very very necessary to be long term successful at this I think. DS is generally for people who have a much higher BMI I think.

Thanks all for your replies!  I want to be super educated going into this and I thank you for any info I get!

Hi

You mentioned vit B. I do the monthly shot at home. Tiny needle no pain. It cost me $3.30 for the B12 and 35 cents for the needle. 

I'm in a similar boat so wanted to chime in here.  I'm working on getting a revision (from a lap band) now. Originally I was looking into RNY also but now have decided that the DS is the surgery for me. Both surgeries seem to be great choices, I think it just comes down to what's most important to you and what you are honestly capable of committing to.

I'm also a "lightweight" with a BMI of about 41. The surgeon I'm working with told me that because of my BMI he would make my common channel longer than others to help keep me from going too far in the other direction with my weight. So, that's something to think about - there are ways the surgeon can set you up for success but limit your long term risks. Also, although it's not ideal, the bypass portion of the DS is reversible if medically necessary (the RNY is completely reversible if medically necessary as well) so you'd still be left with a sleeve if that had to be done.

My suggestion is to be completely honest with yourself about what you can really commit to FOREVER. Trust me, you don't want to go through the feeling of being a complete failure and fighting for a revision. It's much better to do way more research than you think you'll ever need and then be completely real with yourself about your strengths and weaknesses. 

I believe that the DS is the most forgiving of the surgeries and that appeals to me because I know that I'm completely imperfect. I've also read a lot of stories of DS'ers *****gain some weight and then go back to low carb, high protein diets for a few weeks and drop it right back off. For me - I KNOW that I will stumble so being able to trust that my tool will help me get back up and on track is a huge advantage to me. Because the malabsorbtion with the RNY goes away (or declines) over time I'm not sure it would be as helpful in this regard. 

I guess for me (right or wrong) I look at the RNY as being a perfect surgery for people who need help getting the weight off but have the fortitude to keep it off on their own. I'm not that person. I see the DS as more for the person who needs more help sustaining their weight loss, that's right up my alley.

Here are some of the questions I considered:

For the DS: Can I live the rest of my life taking many, many vitamins everyday to ensure I stay healthy and don't loose my hair or develop osteoporosis or other worse issues?  Yes.  Can I commit to getting twice as much protein in my diet everyday as a normal person? Yes. Can I live with the possibility that I will have super stinky poop and gas? I'd prefer not to but yes, I can. Can I commit to getting blood drawn on a regular basis (at least every six months or year for the rest of my life) to ensure I'm not deficient in any vitamins?  Yes. Can I commit to the high cost associate with lab work and vitamins for the rest of my life? Yes

For the Bypass: Can I live the rest of my life with a "pouch" that may cause food to get stuck and lead to vomitting?  No, I already tried that with the lap band. Can I live knowing that I can never taken NSAID's like Motrin or Aleve for pain?  No. Not that I take them often but occasionally I get a headache that Tylenol just won't kick so I like having other options. Can I life with dumping if I get it? No, this sounds horrible to me, I don't respond well to negative reinforcement.  Can I live with reactive hypoglycemia if I get that? No, this worries me.

Best of luck with your decision!  I don't see how you could go wrong either way on this as long as your honest with yourself and do what's really best for you.

 

I'm not a vet by any means, but the deciding factor for me was pre-existing acid and bile reflux. I wanted the sleeve, and it's a part of the DS. The sleeved stomach has a increased chance of worsen pre-existing reflux, and can also initiate reflux for some people who've never had problems before. So I chose RNY. I think it's great we do have options and can go with the one that works best for us personally. I do regret that NSAIDs are off limits. Good luck in making the decision that's best for you.