My endocrinologist discouraged the DS

In summary, there is about a 10% greater weight loss with DS over RYGB, but their complications are higher, sometimes requiring reversal. It is a difficult decision to make, but again, lifestyle changes are going to be the key to success regardless.

Yes but if you compare the 10yr results there is a 25% greater weight loss with DS and from the terrible vit schedule, im with everyone else thinking THATS why they needed the reversal! So you can either loss 25% of your EWL w RNY or you can loss 50% w DS and since you are on this site you know which vits to take:)

Even after i told my surgeons nurse i would be taking vitaladys schedule she still argued with me and asked me why i would want to take so many vitamins...um because i dont want to end up malnourished! (they recommend flinstones chewables, calcium chewables and adek bariatric advantage, SCARY!!)

Oh, my.  The ignorance is astonishing.  But then again, I have TA'ed medical students in biochemistry, and was not impressed with their scientific skills.  At. All.  Just their arrogance.

Let's just talk first about how this asshole is confabulating statistics.  Percent of initial body weight loss is NOT the same measure as percent EXCESS weight loss.  He is mixing them up, and I assume he is doing it deliberately.

Using the number of 10% greater weight loss baed on percent initial body weight is a deliberate obfuscation of the impact of that difference.  Very grossly, it minimizes the impact by well more than half - thus:

* If the average person weighs 300 lbs, and should weigh 150 lbs, then the loss of 37% of IBW (300 lbs) with the RNY = 111 lbs. 
* But that figure presented as %EWL would be 74%.  A number which is inconsistently high with almost ALL the published stats for the RNY.  At one year, of course.
* Meanwhile, he admits that the average %IBW loss of 50% for the DS means (and we know this isn't quite an accurate number, but it is HIS number) - wait for it - 100% EWL!!  (50% of 300 = 150 lbs)

So while he is trying to say that 37% isn't that much different than 50%, and amounts to a 13% difference in HIS definition of weight loss, in fact
IT MEANS THE DIFFERENCE BETWEEN 75% EWL AND 100% EWL!!  In other words, not a 10% difference, a 25% difference!!

And let's not forget, that doesn't take into account the LONG TERM differeces - his number is for RNYers at one year out.

As for his assertion that "DS has a rate of reversal of 2% per year" - I call bull****  I have NEVER EVER seen a published number anywhere near that rate.  And if their practice is experiencing that rate of "requiring reversal or revision," I would counter that this is something particular to their practice, and they are SCREWING PEOPLE UP.

I would run FAR away from this practice, whether or not they are affiliated with the otherwise respectable Mayo Clinics.  It sounds to me like they are ignorant, scientifically unethical, and are ******g people up because they don't know what they are doing and are too arrogant to learn better.  In my opinion, of course.

Well, now we know why the endo has seen something horrible. They give ****ty postop nutritional advice. That was easy (where's the red button when you need it?).

Do you have comorbidities?

38 is a lower bmi. A sleeve might be more appropriate. I had a bmi of 43 though and I'm very happy and could have only had a ds to be successful. You have options.

I was recently diagnosed with diabetes.  I also have high blood pressure and PCOS. 

and by the way, the only person I know with a feeding tube is a sleeve.

Our endo had never heard of DS before I had mine.  As a result of our converssations and his own independent research, he is now very pro-DS and preaches it from the proverbial pulpit.  There are 5 Lubbock-area patients having DS with Dr. Stewart this month alone - all from one physician's practice.  Three more are already lined up with surgery dates for next month.  More are in the works.  It's hard to argue with results.  No lap bands.  No RNY's.    

I actually had to sit on this post for a day before I felt able to do so without coming off high and mighty.
So here goes to from one endocrinologist to another to your endocrinologist I would say -bless your heart for your concerns for your patient, now please read the scientific studies and not use one or two patient files to base your opinion on.
Now my husband who is from the streets of NY and a licensed MD in Internal Medicine put it more succintly "what a f*cking idiot"

You see antedotal information is like looking at the only a small part of entirety and basing all knowledge and treatment plan on that one thing.

To your nutritionist I would not bother answering at all-because the information is inaccurate and truly could lead to the very malnution of vitamins, minerals they think they are preventing. Most of them have no scientific training in bariatric specificially and what little information they have is usually based on a RNY configuration.

That is not to say that problems do not occur but the reality is many of these problems may have occured without the DS being involved at all. Osteoporosis is a huge problem in the United States, vitamin D defieciency is a problem for a large part of the these patients. 
People are anemic especially menstruating women and the vast majority of these will not have had any wls procedure. There will be a subset of us that even with good supplementation may find ourselves needing additional amounts of oral supplements, and at times may need infusion or alternative treatments. That is why we have to advocate for our own health take supplementation, get repeat testing of levels to ensure that our vitamin and mineral supplements are at the correct level. As we age our needs will change.

I had the choice of a totally free RNY (insurance covered my husbands hospital completely) or paying a much larger amount to go out of state for the DS. There was really no comparision for me between the two- the studies showed the superiority of the DS in all areas( EWL for longevity, reversal of Diabetes, and for me the biggest of all an intact pyloric valve so I could take the medications I need for an autoimmune disease). It was the best $11,000 dollars I ever spent.

Personally it is your health, If need be you may need to find a new endocrinologist they are not gods, they do not know everything. The field of medicine constantly changes and depending on when they did their training this field of bariatrics may not have even been addressed in learning.

 
I had a DS.  My BMI was around 38, and I was about 100 lbs overweight.

Yes, I got malnourished, almost instantly after surgery.  I vomited stomach acid (not food) 3x/week for about 7.5 months.  After several tests that showed I didn't have a leak or a stricture, basically no one could tell me why I was puking.  I was compliant with as much as I could be, considering I was puking all the time and I could barely get out of my recliner.

Finally, my blood work stats sunk low enough for me to get on TPN.  After all of 24 hours on the stuff, I was no longer nauseous; I had tons of energy; and I could eat regularly.  Within 3 days, I could eat whatever I wanted, easily; AND I could drink protein shakes, which made me puke always before then.  For 3 months, I took TPN and ate a full day's worth of food by mouth at the same time.  

TPN was a Godsend.  Was it totally inconvenient?  Yes.  Did it totally resolve my malnutrition, nausea and vomiting issue?  Absolutely.  Did I get to keep my malabsorbtion from the DS and keep losing weight?  Yep (yay!).

I say all that to say, if there is a malnutrition complication, TPN is not a bad thing--it's a good thing!  The malabsorbtion from the DS is very effective and strong, and it can really do a number on some people , even if they're healthy and (relatively) young, like I was when I got surgery.  There's no way to know if you will fall into the tiny percentage of people needing malnutrion support until after you get the surgery.

The main questions to consider IMHO are A) can the possible nutrition complications be resolved, and B) will you get the result you want, which is a loss of the vast majority of your excess weight and help KEEPING it off long term with the surgery you choose?  Statistically speaking, only the DS will give you both.

The DS is not well known in the medical field, even among "well educated" doctors, nutritionists, etc.  We all have to do our own homework and make our own decisions.