Is the DS destined to be the red-headed stepchild of WLS?

 LOL! No offense toward red-heads intended, I should have said.

Oh, no offense taken.  It is all good and you know what, yep- if surgeries had hair colors the DS would definitely be RED!!!!!!!!!!!

This is probably not a popular opinion but i'm not sure I want it to be anything but the redheaded step-child.  When I pay it forward I do so with trepidation.  If someone is really resistant, I don't push the issue at all because I don't want people who aren't going to be compliant or who can't handle the 'differences' of this surgery coming along and ruining our numbers.  i'm fairly certain it's why my surgeon seems to make people earn this surgery.  He wants the obsessive-compulsive for this surgery. 

So, yes, I think it will always be the red-headed step child and I might be ok with that. 

HOWEVER - I do think DOCTORS should be more informed and not say stupid things about the surgery and also, I think people should know the options.  

I completely agree that the DS is not for everybody. However, I think it should be much more widely used than it is today, as long as there is an appropriate screening process.

I guess my question essentially boils down to: where do people see the DS in 5 years? It sounds like most who have chimed in so far do not see it becoming more popular and mainstream, which I find interesting.

Well - since it's been around for quite some time and hasn't gained popularity, I don't see it becoming more popular.  But how the hell do I know? lol

When I first met with Pomp he told me the DS really peaked about five years ago and then interest in it since that time has waned.  No idea why. 

What I have seen change over the last 7 years:

1) More insurance companies covering it, at least for people with BMI >50, in particular some of the BCBSs, as well as Medicare
2) More frequent overturn of denials by external medical review, including for BMI <50
3) More publications about how the DS is better for BMI >50 than any other surgery, and better cure of comorbidites
4) More data about how the DS is better for diabetes
5) Some comparative studies with the RNY for BMI <50

Ongoing problems:

a) DS surgeons who can't be bothered with patients, including providing adequate nutritional guidance, support groups and general follow-up care, resulting in bad outcomes and them stopping doing the surgery (e.g., Simpson, Herron, Anderson)
b) Similar to the above, surgeons -- including DS surgeons (e.g., Schweitzer who requires the DS to be done in two parts, and the LapSF surgeons Cirangle and Jossart) -- who push the VSG as a safer alternative and "maybe you won't need the second part" -- of course, when the VSG fails, they either try to talk them into an RNY revision, adding the switch with a stretched out sleeve that isn't going to work as well as a virgin DS would, do the switch with a resleeve, which is much more risky, or the patient's insurance company won't cover a second operation for one of several reasons.
c) Ongoing deliberate disinformation about the DS from non-DS surgeons and insurance companies, as well as websites
d) Crappy DS surgeons who give the DS a bad name

What will create a sea change?

* A significant paper definitively showing the long-term safety and efficacy, both in terms of weight loss and comorbidities cured or ameliorated, of the DS over the RNY for BMI <50.
* The ASMBS endorsing it as the platinum standard (yeah, when pigs fly)

I was just going to type basically the same thing!  I really feel people who get the DS,have to be advocates for their own health.  Non-compliant people have NO business getting the DS.
But on the flip side, I wish the DS would get proper notice and that physicians actually understand how works.

RNY is Blu-Ray and the DS is HD ..lol thought I would update it!

I swear the Mayo Clinic in Rochester, MN IS performing DS.  I believe there are a couple MN DSers who had surgery there. 

 You are such a cute geek with your Betamax vs VHS analogy.

 I think there is one at Mayo who has done a few.  

 You're right.  We are the stepchild of WLS.

Too bad because the DS works better than anything else out there.  But I also agree it takes more vigilance and understanding to remain healthy postop.  You have to be smart and willing to advocate for yourself.

Lots of people aren't capable of doing this.