Which weight loss surgery is best for me? (Photo)

For the MBI of 43.8, the history of thyroidectomy, prediabetes, PCOS, I recommend doing a gastric bypass since you have associated comorbidities and only the gastric sleeve would not be enough to obtain good results

Deciding between gastric sleeve and gastric bypass can be challenging, especially with factors like prediabetes, PCOS, and a history of significant weight changes. The gastric sleeve involves removing about 80% of the stomach, creating a smaller, sleeve-shaped stomach. It typically results in a 50-70% loss of excess weight within 12-18 months. The sleeve impacts hunger hormones, reducing appetite, but it’s irreversible and may lead to acid reflux or nutrient deficiencies, though less so than bypass. The gastric bypass, on the other hand, creates a small stomach pouch and reroutes part of the intestine, altering both food intake and absorption. It typically results in a 60-80% loss of excess weight in the same timeframe. Bypass has a more significant impact on hormones that control hunger and blood sugar, which could be beneficial for managing PCOS and prediabetes. However, it’s a more complex procedure with higher risks of dumping syndrome, internal hernias, and nutrient deficiencies. Given your history, the bypass may offer more lasting metabolic benefits, especially for insulin resistance linked to PCOS and prediabetes.

It’s great that you’re exploring options to improve your health.
Given your medical history: BMI 43.47, significant weight fluctuations, thyroidectomy, PCOS, prediabetes, and use of GLP-1 medications like Victoza, both the sleeve gastrectomy (gastric sleeve) and the gastric bypass are potential options. However, there are some differences to consider:
1. Gastric Sleeve: This procedure is less invasive, reduces your stomach size, and helps you feel full with less food. It’s often chosen for patients who have had fewer metabolic complications or for those who prefer a simpler surgery with a lower risk of complications, especially for younger patients. However, it may not be as effective in resolving metabolic conditions like diabetes in the long term.
2. Gastric Bypass: This procedure involves both reducing the stomach size and rerouting part of the small intestine, which can be more effective for weight loss and resolving conditions like type 2 diabetes, even in prediabetes stages. Given your history of prediabetes and rapid weight gain after your thyroidectomy, this might be a better option, especially if metabolic control is a top priority.
It is necessary to know your complete medical history, as there is other information that must be considered, for example, patients with gastroesophageal reflux, moderate/severe esophagitis, it is preferable to perform a gastric bypass.
Ultimately, the best option depends on your individual medical history, lifestyle, and long-term health goals.

Body mass index is suitable for sleeve gastrectomy.There is no superiority of gastric bypass over sleeve gastrectomy in terms of weight loss. We prefer bypass in patients with advanced reflux or those using insulin.Sleeve gastrectomy is the first choice in obesity treatment worldwide due to its easy application and success rate of more than 96%.Furthermore, sleeve gastrectomy surgery prevents the development of diabetes and hypertension by increasing GLP-1 secretion in the body.

gastric sleeve surgery has been found to have positive effects on various obesity-related comorbidities, including prediabetes and polycystic ovary syndrome (PCOS). Here's how gastric sleeve surgery may impact prediabetes and PCOS:
Improvement in Insulin Sensitivity (Prediabetes): Obesity is a significant risk factor for the development of insulin resistance and prediabetes. Gastric sleeve surgery often leads to rapid and significant weight loss, which can improve insulin sensitivity. This can result in better blood glucose control and may lead to a reduction or resolution of prediabetes.Changes in Hormone Levels (PCOS): PCOS is a condition characterized by hormonal imbalances, including elevated levels of androgens (male hormones). Obesity is often associated with PCOS, and weight loss can help regulate hormone levels. Gastric sleeve surgery-induced weight loss may contribute to improvements in hormonal balance, potentially alleviating symptoms associated with PCOS, such as irregular periods, acne, and hirsutism.Menstrual Regularity: For women with PCOS, achieving and maintaining a healthier weight can lead to improved menstrual regularity. The hormonal changes associated with weight loss following gastric sleeve surgery may contribute to more regular menstrual cycles in individuals with PCOS.It's important to note that while gastric sleeve surgery can have positive effects on prediabetes and PCOS, it is a significant medical intervention with potential risks and complications. Additionally, the long-term success of the surgery depends on lifestyle changes, including dietary modifications and increased physical activity, adopted by the individual post-surgery.
Before considering any type of weight loss surgery, individuals should consult with healthcare professionals, including bariatric surgeons and endocrinologists, to assess the potential benefits and risks based on their specific health condition and medical history.