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My daughter's friend's mom is having this done in the next couple months. One complication is the insurance company wants the woman to try out alternative diets for six months before she is covered. The insurance criteria is BMI 40 or above OR BMI 35 and one pre-morbidity such as sleep apnea or diabetes. This woman BMI is in the 40s, she is pretty big.
Another friend of my mother in law, had it done a couple years ago. She (an RN by the way) paid cash (actually her aunt paid as a gift..) because insurance then didn't cover it. Her BMI was above 40. She looks great now. She told me she only vomited two times which she said is an unusually low number of times. I guess it takes getting used to not eating too much.
These women told me the reason it works is
1) They are limited in how much they can eat. Because a lot of the stomach is permenantly surgically removed, it is smaller and they get fuller sooner.
2) Also, the part of the stomach that stretches is removed.
3) Finally, the part of the stomach that produces the "I'm hungry" ghrelin hormone is removed.
There are a ton of before and after videologs on YouTube with fascinating results:
I know this thread is older but I just wanted to post my experience. So far, I think the sleeve is great. I had it in February of 2012 so it's been over 8 months now. I've done really well with it. It allows for the most normal post op lifestyle I can imagine after weight loss surgery. No malabsorption to worry about. However, you CAN get vitamin deficient since you aren't eating very much. So it is recommended to at least take a multivitamin every day. It's just much less of an issue with the gastric sleeve than it is with the bypass. But it can happen.
From all the studies I've seen, it looks like the vertical sleeve is keeping off about the same amount of weight as the gastric bypass after 5 years. However, there are some factors to think of. Some of the studies coming out now that are showing weight loss after 5-8 years are covering the very earliest of sleeve surgeries done as a stand-alone operation. The first sleeves done as a stand-alone surgery were often made quite a bit larger than they are now. Also, the first generation of sleeves weren't done the same as they are now as far as technique. Doctors are learning better ways to conduct the surgery to ensure the most amount of weight loss and ability to keep the weight off. In the beginning, doctors were going farther from the pylorus when doing the surgery. Now it is being noticed that people benefit from being closer to the pylorus. Also, some doctors are "oversewing" the staple line to make it a little "tighter" and some aren't. So they have made the surgery "better" over the last few years compared to when it first emerged. I honestly don't think the best long term studies on the sleeve showing the smaller size stomachs with the improved surgical techniques will be out until at least 2018-2020. Any studies that come out in the mean time are, in my opinion, speculative based upon the first generation or so of sleeve surgeries. Also, you have to keep in mind the wide ranges of BMI in these studies. They don't usually individualize them to BMI ranges such as 35-45, 45-55, 55-65 and so on. Usually, the people with BMI over 55 don't lose but about 50% of their excess weight to start with. A lot of them need more help than that. Some of them go on to get the duodenal switch, which is the sleeve plus an intestinal bypass that has a LOT of malabsorption. This surgery has the best excess weight loss of any out there--above gastric bypass--but it's not done by many surgeons. It works really well but the trade-off is you have to take a lot of vitamins and you can't miss your doctor's visits. You can get VERY sick VERY fast if you don't keep up with it. It takes a very dedicated individual usually with great insurance or a nice lifestyle to get this surgery. The vitamins and supplements required for that surgery are expensive. If you live paycheck to paycheck, it's a huge gamble to get that surgery. If you lose insurance or income--you could be in deep crap. Anyway....some of the people with much higher BMI's don't often lose as much (although I've heard about some with very high BMI's getting down to a below 30 BMI! Amazing! I've seen one guy lose 350 lbs with just the sleeve!) So anyway my point in mentioning that is the much higher BMI folks who only lose about 40 or 50 percent excess weight are included in the results so that can make it look a bit deceiving. Those people often need the VSG as part 1 of the 2 part duodenal switch and should probably not be included in the results but that's just my opinion.
I have to agree with everyone that keeping weight off after surgery is such an INDIVIDUAL thing. Sure, yes, some people gain the weight back after gastric bypass. They start drinking when eating again (huge no no as it just flushes the food on through like a funnel). Some of them graze on sugary or carb-rich foods alot of the time. They just don't adapt to the lifestyle that is required to make the surgery successful. It can happen with any weight loss surgery. There are SOME sleeve people reporting weight regain now after a few years. Most of them admit to eating more times throughout the day than previously and choosing poor quality foods as well. Some of these people report losing the weight again after going back to the rules of protein first--no drinking when eating--and etc. Some of them are never heard from again and it is possible to assume that they just don't want to do the work required to get their weight back under control.
You can gain weight back with any surgery if you have your mind set to it. It's just one of those things. I have to eat high protein for the rest of my life--I have no choice. I had diabetes type 2 when I had surgery and even though it's in remission--the truth is that it could come back easily if I stop trying to eat healthy and begin down the path of high sugar and carbs.
I wish everyone all of the best no matter what they choose. I know weight loss surgery is highly controversial in our society. It is taboo still--people think lower of you for it. The only people who understand are those who have been overweight/obese in their lives. Those who haven't been can preach from their soap box all they want but all I hear is "blah, blah, blah, blah blah blah".
And to anyone who has complications during surgery--you have my deepest sympathies. I'm sure it is a scary situation. I've heard of it happening. It DOES happen. The complications are low but someone has to fall into that 1-2% and it could be you or someone you love. Most of the time, everything turns out ok, but I'm sure sometimes it doesn't. Unfortunately, it's something that can happen during any surgery.
Good luck everyone!
Last edited by missladytexas; 10-23-2012 at 07:52 AM..
I have a few more questions that I have not seen addressed.
1. With the Gastric Sleeve do you having dumping syndrome like in Gastric Bypass surgery?
2. I read that with the Gastric Sleeve that there is not the malabsorption problems. So is it then true that medications you take before the surgery you can continue to take and they will be dissolved and absorpted the same way as before the surgery?
3. I know with the Gastric Bypass you have to chew all your food very well and the opening into the pouch is small. I take some large pills and wonder if they will be an issue or not.
I have a few more questions that I have not seen addressed.
1. With the Gastric Sleeve do you having dumping syndrome like in Gastric Bypass surgery?
2. I read that with the Gastric Sleeve that there is not the malabsorption problems. So is it then true that medications you take before the surgery you can continue to take and they will be dissolved and absorpted the same way as before the surgery?
3. I know with the Gastric Bypass you have to chew all your food very well and the opening into the pouch is small. I take some large pills and wonder if they will be an issue or not.
1. Not as much but it can happen if you pound a bunch of ice cream or something.
2. As far as I know, this is true.
3. No Issue. You won't even feel any different after a VSG unless you eat too much or eat too fast. You can take big bites of steak or pizza or a hamburger. But, you can only take a couple bites then you're full.
Hey Brokencrayola,
I agree with Charles. I have heard that there are a very small percentage of people who report dumping syndrome after the sleeve. I suppose it can happen. I don't doubt that it's possible. However, I think it's much more rare with the sleeve than the bypass. I've never had that issue.
I also agree that most medicines are most likely absorbed the same after VSG. However, that is something that should be discussed with a bariatric surgeon. I can tell you that the multi vitamin I take is huge--and I was able to start taking it without issues about 3 weeks after surgery. I think that first month or so it might be hard to take the large pills but it really depends on the person. Some people crush their medications after getting sleeved for a while after surgery but that is something you should ask a doc about because I've heard that crushing medications can cause the medicine to hit the blood stream too fast sometimes so I would definitely ask a doc about that for sure. I definitely think the medicine question is something you need to ask a bariatric surgeon.
Hey Brokencrayola,
I agree with Charles. I have heard that there are a very small percentage of people who report dumping syndrome after the sleeve. I suppose it can happen. I don't doubt that it's possible. However, I think it's much more rare with the sleeve than the bypass. I've never had that issue.
I also agree that most medicines are most likely absorbed the same after VSG. However, that is something that should be discussed with a bariatric surgeon. I can tell you that the multi vitamin I take is huge--and I was able to start taking it without issues about 3 weeks after surgery. I think that first month or so it might be hard to take the large pills but it really depends on the person. Some people crush their medications after getting sleeved for a while after surgery but that is something you should ask a doc about because I've heard that crushing medications can cause the medicine to hit the blood stream too fast sometimes so I would definitely ask a doc about that for sure. I definitely think the medicine question is something you need to ask a bariatric surgeon.
These concerns are pretty much low level and are uncommon and "no big deal". Compared to the benefit the VSG provides these are nothing. It is the equivalent of someone questioning whether they should use a car vs a horse and buggy because they are concerned a car might get dirty driving across town.
The VSG is the closest thing to a "silver bullet" out there. It really works for the right population. The only negative is the cost. I had thought it cost $20K, but I was wrong. It's more like $40K. If your PPO insurance covers it (BMI >40 or >35 with one premorbidity) then it is a no brainer.
I have a few more questions that I have not seen addressed.
1. With the Gastric Sleeve do you having dumping syndrome like in Gastric Bypass surgery?
2. I read that with the Gastric Sleeve that there is not the malabsorption problems. So is it then true that medications you take before the surgery you can continue to take and they will be dissolved and absorpted the same way as before the surgery?
3. I know with the Gastric Bypass you have to chew all your food very well and the opening into the pouch is small. I take some large pills and wonder if they will be an issue or not.
Being nine months out from having a VSG done I can answer with some more authority on this matter.
1. You can have dumping syndrome but it's rare and minor compared to any other form of WLS. I had it once a few weeks out from surgery when I added peanut butter to a protein shake and it took me a few moments to realize what it was. We do not get the "oh god, I'm about to die" feeling other WLS patients get.
2. Correct. We do not suffer malabsorption because we still have the same digestive process we've always had, we just require much smaller amounts of food. I can take large pills now without any issue but since I've been on chewable or dissolvable vitamins since the surgery and have developed a liking for them I keep using them vs. solid vitamins.
3. Retraining eating habits is a must for all WLS, including the VSG. I have to, and I still forget sometimes, chew very thoroughly. In the early stages of solid food if I took too big a bite and didn't chew it thoroughly my stomach would let me know, sometimes not very comfortably.
The VSG is an adjunct to a diet and exercise program. It is not, as one person here keeps saying, a "silver bullet." You can fail to lose weight and put weight on post-VSG if you do not change everything about how you relate to food. It is not an "easy way out" as some armchair scientists have said. It's been hard, painful, and expensive but for me and many others, the only way to be successful at losing weight after a lifetime of failed diets.
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Hello all
