Choosing Weight Loss Surgery: The Duodenal Switch

Ask anyone who has had weight loss surgery and they will tell you why the one they had is the best. But what works for one person might not work for someone else. We each have to decide what works best for us.

I had heard about stomach stapling for years but never thought it was safe as the only thing I really heard about it was horror stories. After hearing that a family member had gastric bypass surgery, I decided to look into it a bit more.

As you can probably tell by the last post, I needed to lose weight. I had been overweight my entire life. I had also been on diets that long as well, with no luck. You name a diet and I have tried it, usually more than once. The most I ever lost was 30lbs. At one point I even went so extreme as to only eat one salad a day and I still gained weight. This is called Yo-Yo Dieting.

It seemed hopeless. I kept trying new diets with no luck. I thought I was just destined to be fat. Most kids wish for toys when they blow out candles on their birthday cake, but for me, I wished to be skinny. I even worked out at the gym for hours a day and never lost any weight.

I was started to get co-morbidities, or diseases related to me being obese, not to mention the emotional turmoil that being obese brings. I felt like I needed to do something drastic so I began researching weight loss surgery. Once I knew it was for me, I began to make the necessary steps to make sure it was covered by my insurance.

At first I was set on the sleeve because it let me keep a normal functioning stomach but then I was posting on forums, doing some research, and someone pointed me towards the duodenal switch. I had only heard of the lap band, gastric bypass, and sleeve, so I was curious and did more research. I knew it was the surgery for me. It is known as the hardest weight loss surgery to recover from. Many take up to 6 months to fully heal. I wanted the big guns, though, for my health. If I was going to get cut open, I wanted the surgery that would give me the best chance of reaching my goals, keeping the weight off, and regaining my health.

The research with the DS is amazing. It has the highest rate of resolution of co-morbidities of all surgeries. Also, it has the highest percentage of weight loss maintained. 94% EWL (excess weight loss) maintained at 10 years post-op, according to one study in particular.

There aren't a lot of doctors out there that know about the DS, so long term follow up can be tricky if not by the right doctor. You have to be knowledgeable about your surgery, and know what your labs mean, etc. It may not be for everyone. But I definitely knew it was the right one for me.

What Is the Duodenal Switch?

For those already familiar with weight loss surgery terminology, the duodenal switch (DS) is a sleeve with moderate malabsorption. For those that don't know what this means, I will start with the basics.

The DS is both a malabsorptive and a restrictive procedure, meaning it restricts the amount of food you can eat and some of your food isn't fully absorbed. With the DS, to get the restrictive part, 70% of the outside of the stomach is removed, leaving you with a 3-5oz banana-shaped stomach. The stomach functions like it would normally. With the malabsorptive part, the intestines are rerouted so that food and digestive juices travel different ways and don't meet up until a little bit at the end. The part at the end where they meet up is called the common channel. So food ends up bypassing, or not getting absorbed, until the common channel. The average absorption rates for a typical DSer are:

• 20% fat
• 60% protein
• 60% complex carbohydrates
• 100% simple carbohydrates

Since DSers absorb so little fat, vitamins that are fat soluble (A,D,E,K) or in oil are not fully absorbed, so we need dry forms. 

There is also a metabolic component to the DS, not found in other weight loss surgeries.There is a 99% cure rate of diabetes. In fact, in Europe, surgeons are performing just the intestinal part of the DS on skinny Type II Diabetics to cure diabetes.

Many surgeons also remove the gallbladder and appendix during surgery.