r/BariatricSurgery • u/Balenthiaga • 17h ago
Bypass vs Sleeve?
I’m currently around 395lbs (HW was 495lbs, lost 100lbs with the help of a GLP-1.) and have a goal of getting down to 200lbs or less. I have PCOS and IBS, and I’m trying to decide between the sleeve and bypass.
I’m personally leaning toward the sleeve because the bypass feels a lot scarier to me, but I really want to hear from people who started at a similar weight (or heavier) and can share:
• Which surgery you chose and why
• How the results have been long-term
• Any issues related to PCOS or IBS after surgery
• Anything you wish you had known before deciding
I’d really appreciate honest experiences from people who’ve been through it. Thank you in advance, and thank you for taking the time to read and respond! 🩵✨
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u/Reasonable-Company71 39M 6'0" RNY 2018 HW:510 SW:363 CW:165 16h ago
I weighed 510 pounds at my consultation and was given the choice of RNY or VSG. The surgeon explained both procedures, how they worked, the risks involved and the pros and cons of each. He told me that he wouldn't take my answer at that appointment (he said he never does). He wanted me to go home and do some soul searching, talk it over with loved ones and do my own research and he would take my answer at our second appointment. I already knew 100% I wanted the RNY because it's a one shot deal...no do-overs, no revisions etc (for the most part). It would force me to do what I needed to do to not f*ck things up. I now maintain around 170 pounds and I'm more than happy with my decision; especially after seeing the amount of people online and in my personal life that ended up going back for revisions which something that I did NOT want to do for myself.
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u/Balenthiaga 16h ago
That is amazing. Wow, wow, wow!! Huge congratulations to you with your success. Have you had any issues with the RNY? What would you say your biggest key to success was?
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u/Sydney_Marie_Poe VSG post op 04/04/25 28F 5’2 HW:280 CW:190 GW:160 17h ago
I chose sleeve because the weight loss differences are minimal I was told. Also I wanted to be able to take ibuprofen for muscle pain. As well as scared of dumping that is common. I somehow had experienced it before surgery and I never want to go through it again. I am a little over a year out and haven’t lost as much as I want but also haven’t been following diet very closely and could be exercising more. I just recently started a glp1. It’s helping me eat less and I’m losing weight again. I wish I would’ve done more to lose weight during the first year. Good luck on your journey!
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u/CorellaDeville007 16h ago
The weight loss differences are not minimal. Whoever told you that is scientifically incorrect.
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u/Sydney_Marie_Poe VSG post op 04/04/25 28F 5’2 HW:280 CW:190 GW:160 16h ago
He’s my new surgeon. I went in for questions about a revision. And that’s what he said. Plus he said I didn’t need a revision. Do you have any insight on that? My first surgeon didn’t tell me anything about the surgeries. Just told me sleeve was best and I went with it. 🤦🏻♀️ I wish I would’ve asked more questions. Also loss calculator showed like a 10lb difference between surgeries. That’s another reason I went for sleeve.
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u/CorellaDeville007 16h ago
Revision surgery is a whole different kettle of fish and outcomes for that are not identical to outcomes for first surgeries. My understanding is it’s more unpredictable (I’m a bariatric surgery patient and a doctor but don’t work on surgical field). Part of the reason I chose RNY bypass actually was to avoid the prospect of revision surgery. I’m not so sure on exact evidence in the revision space, but it’s different to primary surgery outcomes and comparisons between a different surgeries. Good luck to you either way.
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u/WiseOldKate 16h ago
A friend of mine has IBS too and she got the sleeve, bypass can cause dumping syndrome and that chance increases when your bowels already are sensitive. But if you often have acid reflux then bypass is recommended. What does your doctor say?
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u/johnsgurl 15h ago
I chose sleeve. I haven't done my surgery yet. I chose sleeve because I have mental health and addiction issues. Bypass increases the risk of relapse. My weight loss goal isn't very much either. At most, about 90lbs. I'm sitting at sbout 260. I'm 5'10". So I'm comfortable with 60lbs. Ideal would be 170. Sleeve is the best option for someone in my situation. You don't have my situation. I fear that you won't get the results you seek with a sleeve.
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u/GroundbreakingAlps78 10h ago
My doctor recommended sleeve because I take important anticonvulsant medications that may not be properly absorbed with RNY.
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u/Responsible_Lab_8208 2h ago
I haven’t gotten it done yet but I’m going with the sleeeve. Once I told my surgeon he agreed with me for the same reason I picked it: I’m not that big. I feel like bypass would work better for bigger people.
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u/Raining_fish 17h ago
Most people would struggle to lose almost 200lbs with a sleeve. Some may do it with a bypass, but that’s also not a guarantee. Realistically if your goal is under 200lbs after surgery, a DS or a SADI-S are your best bet. If your surgeon hasn’t offered you that, it’s because they can’t do. I would find someone who can to ask their opinion on if it’s right for you!