gastrosleeve vs roux-en-y

Question
I am a 31 year old female that is 424 lbs. and 5ft 6 in tall, with no current health issues due to obesity execpt sore knees. I have been overweight my whole entire life. My question is I am paying for the procedure out of pocket and would like to know whick procedure will help me lose the most weight and keep it off for good. Thank you

Answer
Tuccia,
I am going to answer your question from the perspective of a surgeon who routinely performs gastric bypass, gastric sleeve, and gastric band.  I like all three, and I think there is a place for each in the battle against obesity.

So, if you are seeking the surgical procedure that is most likely to help you achieve lifetime weight control, the clear winner is the gastric bypass.  The sleeve has early weight loss results which are similar to the gastric bypass, but the data beyond 4 years simply does not exist.  In the medical field, we have learned over and over that we don't know the whole story until we know what happens 15-20 years later.

Specifically with the sleeve, the concern is that the narrow tube of stomach will gradually expand and food capacity will expand with it.

Best of luck!
Dr JP

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