Is VSG alone enough?

For many people, the sleeve is the perfect solution, which is exactly why it has gained such respect in the last 5+ years and now covered by insurance.  Is it enough for you?  Your own weight history can likely answer that.  Are you a volume eater?  Does simply eating less yield weight loss today?  Do you always feel hungry?  Answering yes to these questions, the VSG may be perfect.

OR...does your body fight you tooth and nail, hardly losing anything no matter how hard you try?  Have you yo-yo'ed so much that you're afraid that your metabolism is screwed?  These types of yes answers may indicate that you may benefit more from the malabsorptive procedures, like RNY and DS.  Many have had their sleeves revised to the DS, and some have had results while others haven't.  There's something about the synergy of the virgin DS that is proving to be the most effective, so I recommend you put a LOT of thought into this.

The DS is the most drastic and has the strongest long-term statistics, but in the wrong hands, it's downright dangerous.  Some of the same can be said of the RNY, because one must pay extra attention to their bodies' nutritional needs, while the sleeve has all parts as designed, only with smaller volume consumption.  Someone unwilling to comply with what is needed will lead themselves to an untimely death of malnutrition, so care must be taken when considering DS

• In the hands of a skilled surgeon, risks are the same as RNY
• Vitamins must be taken with DS and RNY
• Nutritional levels must be monitored with DS and RNY
• Many surgeons/docs/nutritionists lump wls into one category.  DSers need much more, and need to advocate for themselves, sometimes even arguing for what they need.  Fortunately, we share a lot of information between each other and are miles ahead of the medical community, so alternative resources other than a packet given at the surgeon's office is critical.  In other words, it takes brains and balls to keep up.

I hope this helps.  Both procedures can be very effective if done on the right type person.   Unfortunately, you're the better judge than a surgeon doing a 15 min conversation, so think this through for yourself.

Wow valerie you're so well informed. I answered all "yes" to vsg questions in my head and all no to ds/rny ones. Thankyou so much for sharing this excellent information.

I am 2 1/2 years out and doing great.  Made goal in 10 months and have stayed right with it ever since.  I am never hungry.  I keep only good stuff in the house to eat and my meals remain small and fruit etc as snacks.  I love my sleeve.  Speedy recovery and rapid weightloss.

I had the same concern during my pre-op stage. I had decided on the sleeve at first, then started to read more and more about the DS, and began to think I should switch. I eventually chose VSG for 2 reasons: 1. I lost weight on low calorie diets in the past. I struggled with staying on the diets due to hunger/portion size and the weight always returned. So that told me that a restrictive-only procedure would work for me. 2. I knew with either procedure, I would have to eliminate simple carbs and restrict total carbs. DS reduces absorption of fat, but not carbs. So if I have to watch carbs with either procedure, I might as well go with the one that is less invasive and has fewer side effects.

Being 5 months out, I'm feeling very good about the chance of long term success. It has changed my approach to eating-quite naturally. I eat when I'm hungry and am full after a small amount. Even when I eat off plan, I only want a few bites. Food has become just a necessity for me and I think that is the biggest change that will help long term-regardless of the surgery type or with or without malabsorption. 

I chose the DS because I am not a good restrictive dieter.  I also had a BMI near 70.  I did not want to hae to worry about significant regain, because I can and have gained weight on " diets", which like it or not, you will eventually return to with a surgery that is restriction only.

The trade-off is what I have at times called a brutal vitamin and supplement regimen, but in rethinking that phraseology, it is not brutal at all.  Many times what other WLS patients and normies take for sure, but it is simply part of taking care of myself, just like anyone else would.

Having the DS is like having an insurance policy for me, and it is very freeing to know that I can eat what I want without fear that I will gain weight.

That said, DSer's do not sit around gorging themselves with food, unlike many non-DSer's think.  Our focus is on nutrition, and making sure that we get our protein and supplements in.  If you have a personality that likes detail and order, once you learn what you need, then the DS is a walk n the park, considering the alternative, if none of the other WLS options appeals to you.  I know it has been that way for me.  YMMV.

I wanted ds but my surgeon said they don't do that surgery and further its more for much higher bmi than mine (42). I am a bit disappointed but figure if I end up needing it figure I can always get part II at a later date. I already have learned healthy eating habits but have issues with bring hungry and portion sizes. Hoping the sleeve gives me good results!