Hi I'm new here , I will be having wls this year , I'm still undecided if I'm going to have the sleeve or bypass, my bmi is 42 I carry most of my weight on my tummy , I've seen alot of people who have had the sleeve then go and have further surgery for the bypass , I know it's a tool but do people tend to keep the weight off more with the bypass ? It states with the bypass you struggle to absorb Vitamins so you have to take vitamins for the rest of your life , does this work ? As I don't understand how you can't absorb vitamins from food but they give you tablets? Sorry for all the questions I'm really stuck and don't know which surgery to choose ! It also worries me with drinking liquids as I drink 3lr Water a day can i do this with the bypass ?any people have success stories with the sleeve that has kept their weight off for 3+ years ?
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- Thread starter Frankvo
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Hi, and welcome!
I had the VSG (sleeve) in 2008 and am a sucess with it but the majority of people on this forum needed malabsorption and got the DS rather than better known Gastric Bypass.
You should know about all the options before you decide, not just sleeve and bypass. If you haven't heard of it, there is a good chance your doctor doesn't do the DS.
So it's good you came here where there is a ton of info! Like here.
Keep asking questions and if you tell us more about yourself like how have you tried losing weight in the past and why didn't it work for you, we can help more.
I had the VSG (sleeve) in 2008 and am a sucess with it but the majority of people on this forum needed malabsorption and got the DS rather than better known Gastric Bypass.
You should know about all the options before you decide, not just sleeve and bypass. If you haven't heard of it, there is a good chance your doctor doesn't do the DS.
So it's good you came here where there is a ton of info! Like here.
Keep asking questions and if you tell us more about yourself like how have you tried losing weight in the past and why didn't it work for you, we can help more.
hilary1617
First time at the rodeo.
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- 3,870
Hi and welcome Frankvo.
I had the full traditional Duodenal Switch and my only regret is not having it sooner.
DS patients do need to supplement with vitamins. We don't absorb 100% from food or tablets, so we take more to absorb 100% of what we need. For some vitamins like A,D,E and K, we use special water-miscible instead of oil-based forms that are more readily absorbed.
I drink as much fluid as I like - and only ever had a restriction of liquids while recovering from surgery. But I don't want to drink as much as I once did. I'm not as hungry or thirsty as I was before DS.
I would caution against the RNY, as in creating the pouch, use of the very important pyloric valve that controls outflow is lost and the remnant "blind stomach" is left around generating hormones and without access to be scoped.
Best wishes and welcome!
I had the full traditional Duodenal Switch and my only regret is not having it sooner.
DS patients do need to supplement with vitamins. We don't absorb 100% from food or tablets, so we take more to absorb 100% of what we need. For some vitamins like A,D,E and K, we use special water-miscible instead of oil-based forms that are more readily absorbed.
I drink as much fluid as I like - and only ever had a restriction of liquids while recovering from surgery. But I don't want to drink as much as I once did. I'm not as hungry or thirsty as I was before DS.
I would caution against the RNY, as in creating the pouch, use of the very important pyloric valve that controls outflow is lost and the remnant "blind stomach" is left around generating hormones and without access to be scoped.
Best wishes and welcome!
I didn’t have the bypass. I had the duodenal switch July 2019. I chose the duodenal switch because I saw how others vomited with the gastric bypass when they ate something they shouldn’t and I didn’t want that. I also wanted something that didn’t have the five year regain that they like to blame on us and our lack of willpower. My back is bad and I’m disabled so exercise is out. Eventually I won’t be able to walk so I need malabsorption so I don’t regain then too.
We do have to eat more protein because we malabsorb everything. It’s why we have to take MORE vitamins to offset what we don’t absorb from our food. It’s also based on getting regular blood work and testing vitamin and mineral levels in our blood. The vitamin thing was why it took me a long time to actually be mentally ready for this surgery. Because it’s a serious commitment. You can’t be depressed and stop taking vitamins and quit eating! You can be severely depressed like me 
and keep on taking your vitamins and eating meat! It’s such a part of my routine that it hasn’t changed. But also anything else is a slow suicide and so I stay as consistent as I can.
Anyways, welcome!!
We do have to eat more protein because we malabsorb everything. It’s why we have to take MORE vitamins to offset what we don’t absorb from our food. It’s also based on getting regular blood work and testing vitamin and mineral levels in our blood. The vitamin thing was why it took me a long time to actually be mentally ready for this surgery. Because it’s a serious commitment. You can’t be depressed and stop taking vitamins and quit eating! You can be severely depressed like me
and keep on taking your vitamins and eating meat! It’s such a part of my routine that it hasn’t changed. But also anything else is a slow suicide and so I stay as consistent as I can.Anyways, welcome!!
Munchkin
Full of Fairy Dust
The sleeve is a diet with a smaller stomach. If diets don’t work for you, you need malabsorbtion to get the weight off and keep it off. I had my DS 20 years ago and I wish I would have done it sooner! But it is still work. I maintain by eating high protein and low carb. I cope with it long term by giving myself cheat days for holidays and out of town vacations. I know myself. I can’t tolerate never ending deprivation. I can gain weight… It is still a lot easier to gain than lose!
Over time the sleeve gets bigger. I can eat a normal size meal and drink like a normal person. But it will take time to get to that point. At first you have to sip and eat slowly one bite at a time.
I take my supplements twice a day, morning and evening. It is NBD, a habit. I count out/prep my pills twice a month and it takes me about 10 minutes. I always have a list of pills to buy the next time I find a sale. I have a whole cabinet of nothing but supplements.
Overall, I am very healthy and have fewer problems than many people my age. I take no prescription drugs and can still do anything I could do when I was 30. I still walk, run, swim, and do yard/house work.
I think you are considering the RNY? In a standard proximal RNY very little is bypassed and around the 2 year mark your body will adapt and it becomes easier to gain weight. I chose the DS because so much is bypassed that your body can never completely adapt. If you can, keep a real stomach with a pyloric valve. Avoid the pouch! Make sure you read and learn a lot before you make your decision. The idea is to think twice and cut once. Know yourself and know why you are fat and you will be able to chose the correct surgery for you. Once you know what you need, don’t settle for anything else. Don’t worship any surgeon. They are like used car salespeople, selling you on whatever procedure they do. You need to be able to advocate for yourself and get the surgery you need.
20 years ago I had the DS and 9 co-workers also had WLS. 1 DS, me, 1 lap band, and 8 RNY. Fast forward to today and ONE of the RNY people and I are the only average looking old bags. The person who had the lap band never lost anything noticeable and 8 of the RNY folks are still as heavy or heavier than when they had surgery. Choose carefully!
Over time the sleeve gets bigger. I can eat a normal size meal and drink like a normal person. But it will take time to get to that point. At first you have to sip and eat slowly one bite at a time.
I take my supplements twice a day, morning and evening. It is NBD, a habit. I count out/prep my pills twice a month and it takes me about 10 minutes. I always have a list of pills to buy the next time I find a sale. I have a whole cabinet of nothing but supplements.
Overall, I am very healthy and have fewer problems than many people my age. I take no prescription drugs and can still do anything I could do when I was 30. I still walk, run, swim, and do yard/house work.
I think you are considering the RNY? In a standard proximal RNY very little is bypassed and around the 2 year mark your body will adapt and it becomes easier to gain weight. I chose the DS because so much is bypassed that your body can never completely adapt. If you can, keep a real stomach with a pyloric valve. Avoid the pouch! Make sure you read and learn a lot before you make your decision. The idea is to think twice and cut once. Know yourself and know why you are fat and you will be able to chose the correct surgery for you. Once you know what you need, don’t settle for anything else. Don’t worship any surgeon. They are like used car salespeople, selling you on whatever procedure they do. You need to be able to advocate for yourself and get the surgery you need.
20 years ago I had the DS and 9 co-workers also had WLS. 1 DS, me, 1 lap band, and 8 RNY. Fast forward to today and ONE of the RNY people and I are the only average looking old bags. The person who had the lap band never lost anything noticeable and 8 of the RNY folks are still as heavy or heavier than when they had surgery. Choose carefully!
I’m 12 years, I’m also a DSer. In fact most of the members here are DSers so we are heavily team DS here. But we do realize there are good reasons for other surgeries. Except the lab band . That one should never have existed.
Anyway, here is my anniversary post: https://bariatricfacts.org/threads/it’s-been-12-years-and-i-almost-forgot.16593/
Anyway, here is my anniversary post: https://bariatricfacts.org/threads/it’s-been-12-years-and-i-almost-forgot.16593/
Spiky Bugger
Well-Known Member
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- Jan 5, 2014
- Messages
- 6,310
Not many bypassers here.
The sleeve is th “upper half” of the DS, and…from what I understand…the DS is the easiest surgery to revise to after a sleeve.
I would have had to lose about 75 lbs to get down to a BMI OF 42! I first had the Band. It was worthless. So when I decided to get rid of it, I decided I needed the procedure with the BEST long term weight loss. That was about 17 years ago. I never got down to lower than the low end of “overweight,” but that equals 140#s+ gone for all that time.
Good luck with whatever procedure you decide on.
The sleeve is th “upper half” of the DS, and…from what I understand…the DS is the easiest surgery to revise to after a sleeve.
I would have had to lose about 75 lbs to get down to a BMI OF 42! I first had the Band. It was worthless. So when I decided to get rid of it, I decided I needed the procedure with the BEST long term weight loss. That was about 17 years ago. I never got down to lower than the low end of “overweight,” but that equals 140#s+ gone for all that time.
Good luck with whatever procedure you decide on.
Re "I don't understand how you can't absorb vitamins from food but they give you tablet"
Good question... simple answer..
1) you take ~3x more multivitamins than a person without the operation.. so even though you absorb less, so much is taken the portion you do absorb is enough
2) some vitamins, A E D and K, come in two forms: water and fat soluble.. a person with DS has trouble absorbing the fat soluble form, so they take the water soluble form
3) you take blood tests, usually every year, to make sure you have enough vitamins.. if you don’t you take more of the one you are missing
4) if you tried to do all of the above with food, it's just too hard since most foods only have trace amounts of vitamins, and lots of other things that you might not need at the moment ( possibly extra calories)
Well.. it sounded simple till I started to write it all down...
Good question... simple answer..
1) you take ~3x more multivitamins than a person without the operation.. so even though you absorb less, so much is taken the portion you do absorb is enough
2) some vitamins, A E D and K, come in two forms: water and fat soluble.. a person with DS has trouble absorbing the fat soluble form, so they take the water soluble form
3) you take blood tests, usually every year, to make sure you have enough vitamins.. if you don’t you take more of the one you are missing
4) if you tried to do all of the above with food, it's just too hard since most foods only have trace amounts of vitamins, and lots of other things that you might not need at the moment ( possibly extra calories)
Well.. it sounded simple till I started to write it all down...
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