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.