My wife had gastric bypass (Roux-En-Y). They had recommended against lap band based on how much weight she needed to loose ( a similar amount that you want to loose. they didn't think lap band would do enough or that the results would last; i don't quite remember the details). I don't think sleeve was on the menu, so either not around back then (10 years ago?) or not in widespread use? She drank Pure Protein brand powdered chocolate protein shakes (powdered was cheaper than the cans, and the cans tasted funny to her). She had tried several other brands. I recall them saying it would boil down to individual preference on what brand/variety to go with. So, she was able to loose a lot of weight, which made her less self-conscious going out and about, taking some classes at the local college. It also helped with getting active in some physical hobbies. Some of the weight has come back. She still has to watch what she eats. I view the surgery as more of a jump-start to weight loss, that still requires lifestyle changes if you want to keep it off. Also, to this day certain foods don't sit well with her and she has to go throw up the meal. My recollection is that they told her she would need to eat a certain way and take multi-vitamins and extra this vitamin and that vitamin for life, and she doesn't really do any of that. She's not exactly withering away, but I wonder if she is not doing herself some harm. (But she won't listen to my nagging so I don't bother.) A couple of financial cautions: Although insurance covered a good bit of her surgery costs, it only covered a small part of anesthesia. I had asked the doctor's office before surgery and at the hospital the day of, to make sure we got an anesthesiologist that took our insurance, and was told not to worry. Then I found out when the $1200 bill came that no anesthesiologists take our insurance. (I wrote the ins. company a letter and they ended up paying all of that in the end.) Also, that kind of weight loss left a lot of loose skin that would not ever contract. So after a couple of years she had plastic surgery to remove it, and that was not covered by insurance (many thousands of bucks). (And it was very painful; afterwards she kind of regretted it for a time because of the pain.)