It's hard to say but if you have already lost 30 with just 10 gained back I would definately consider it. They told me that I could have it put in if I needed it later but there were possibilities of higher risk of infection and I noticed that I would have already been in pretty rough shape had I had to have it. There is also the possibility of having to hold up on treatments for a couple of days if I had to have one put in during treatment. I made it through but I also had chemo and that was what really caused me the most problems early on. I started tx at about 195 after being at 210 before the surgeries. By the time it was all over I was 35 lbs lighter. In hindsight if I were in your situation and was starting out 20lbs light I would really consider it. Also you don't have to use it. You can swallow as long as you want or can and only use it for have to situations. Talk to your doc and my experience was the hardest thing about all of this was keeping my weight and nutrition at a healthy level. Good Luck