Gastric bypass vs the sleeve

Question
Today I met with my doctor. Before walking into her office I had my mind made up that I was having the sleeve. When I told her that she said she recommended the bypass instead because it's been proven for long term where the sleeve hasn't. The tough part of me is my Aunt works at a hospital in New Orleans and she swears by the sleeve. I just feel like I'm being pulled in two different ways. My father had the bypass and is doing wonderful. I just don't know which way to go. I'm only 30 and I am worries about malnutrition if I have the bypass. What sugery do you recommend?

Answer
Sarah,

I cannot possible tell you what procedure is correct for you.  That should be a decision that you make with your doctor.  What I can tell you is that your doctor is correct that the sleeve is a very new procedure for primary weight loss, has a higher complication rate, and no long-term data (at least nothing past 3 years).  So we don't even know the long-term weight loss little yet about long-term complications such as nutritional problems.  We just haven't studied it.

For this reason, the American Society of Metabolic and Bariatric Surgery considers the sleeve to be experimental.  You can read their current position statement here:http://www.asmbs.org/Newsite07/resources/asmbs_items.htm

Nutritionally, the early data indicates that sleeve is not much different that bypass.  The only procedure that does not alter the digestive system is a gastric band - but that tends to produce lesser weight loss.  that said, if you intend to have children, nothing is safer or better studied that the band.  And, bands are fully reversible or can be converted to a gastric bypass later if you don't loss enough or gain weight.

I would suggest that you spend more time exploring your choices.  Read some of the information on the Obesity Action Coalition website.  Visit some patient support groups so you can get familiar with all the things people deal with after surgery - good and bad.

I hope this helps.

In health,

Dr. Jacques  

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