Question:
How does weight regain compare with the rny vs. vbg
I have had the vbg done a couple of times and regained weight both times over the years. I am thinking of having the rny done at this point, wondering if anyone has been through this and how long they have kept there weight off. thanks for any information. — Lisa B. (posted on March 14, 2001)
March 14, 2001
I've heard the VBG is 50% effective and the RNY 85%.
— [Anonymous]
March 14, 2001
My surgeon's Patient Guide says that with his version of the RNY, an
average of 40% of preoperative weight is successfully lost. An average of
6% weight regain occurs 3-5 years later, e.g. a 260 pound patient will lose
an average of 104 pounds; then will regain 15 pounds for an average
permanent weight loss of 89 pounds. It has a 90% success rate. Please
note: that says 'average' so some will do better (through their own extra
efforts, I'm sure) and some will not do as well (also due to their own
habits). I've met so many VBG patients on this website who have not done
well at all and have wanted or gotten revisions to RNY. So, I sure
wouldn't recommend VBG again, that's for sure!
— Cindy H.
March 17, 2001
Have you considered a duodenal switch? How much weight do you need to
lose? I've seen MANY former VBG revisions go to duodenal switch without
problems.. plus, there are a few more reasons to consider the DS, in my
opinion..
Biliopancreatic Diversion with Duodenal Switch (BPD/DS) procedure.
This procedure is most effective for patients who are in the "super
morbidly obese" range (BMI higher than 50), and provides the best
chance at achieving a satisfactory
percentage of excess weight loss (%EWL) for the patient.
Dr. Douglas Hess of Bowling Green, Ohio, who initially devised the BPD/DS
procedure in 1988, published a clinical study in 1998 (Hess, et al.:
Biliopancreatic Diversion with a Duodenal Switch, Obesity Surgery, 8, 1998;
267-282.) concluding that the BPD/DS procedure achieves an average of
80%EWL, which occurs at 24 month post-operative and
continues at a 70% level for eight years and beyond (By contrast, the
Roux-en-Y procedure promises only 55%EWL.). In the case of those who are
super morbidly obese, the BPD/DS procedure is
warranted in order to give one the best chance to reach a healthy weight
and to maintain the weight loss for the long-term. Other benefits of the
BPD/DS procedure that are not
found in the roux-en-y "pouch" procedure are as follows:
1.) Retention of the natural functionality of the reduced stomach.The
partial gastrectomy leaves the pyloric valve intact and functioning, which
means that there is no chance of
post-operative problems that can plague RNY patients: blockages of the
stoma, marginal ulcerations, narrowing of the anastomosis requiring
endoscopic dilation, dumping syndrome. All
of these problems can occur repeatedly in RNY patients; none of these
problems can occur after the BPD/DS procedure.
Furthermore, the BPD/DS stomach is left large enough that food can be
properly digested before it is expelled into the
small intestine. This means that BPD/DS patients may see greater protein
absorption, and do see adequate production of
intrinsic factor for vitamin B12 absorption, benefits that are not enjoyed
by RNY patients.
2.) Retention of the duodenum in the food stream.
Unlike other forms of gastric bypass, the BPD/DS procedure does not
completely bypass the duodenum. The duodenum is
where calcium,iron, protein and zinc absorption take place, so BPD/DS
patients seldom experience dangerous deficiencies of
these nutrients. By contrast, the RNY procedure completely bypasses the
duodenum, which seems to compromise absorption
of these nutrients to a greater degree.
3.) The BPD/DS's distal gastric bypass provides the best long-term weight
loss potential, with little to no
late regain of weight, as noted in the above-referenced Hess report.
BPD/DS patients can reasonably expect to reach
and maintain a healthy weight, whereas other forms of gastric bypass
surgery see much greater failure rates and late regain of
weight.
Just a consideration.. I think that there is not nearly enough information
about the DS on this website. I don't know why, but there just isn't. For
more info, go to the duodenal switch information zone @
www.duodenalswitch.com.
Good luck, no matter what you choose to do!
— Liane F.
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