Duodenal switch VS Gastric bypass

Adam - another thought just popped up after reading one of Pete's posts. Another important reason for me was regain. One of my co-workers at the time had the RNY. She never really changed her behavior (she continued to eat the way she did pre-op) and after losing 100 pounds in about a year, she slowly started putting on weight, until she was almost at her pre-op weight.

When I started researching the DS and understood the major differences between the RNY and DS, I knew for me it was a no brainer.

Being 15 years post-op I pretty much eat like a "normal" person. I eat three full meals and then snack along the way. The differences are now my meal sizes are small to normal and I focus on protein. Before the DS my plate would be carb loaded (I could eat a half pound of pasta in one sitting along with bread, salad, etc.). Now I can barely eat one serving (2 ounces) of pasta. But I still eat pasta, and rice, and potatoes. I don't deprive myself of anything. I eat cookies and ice cream and cake. The difference is in the choices. I may have 2-3 spoonfuls of ice cream instead of an entire pint. Two or three oreos instead of an entire box. It can be done.

I lost 100 pounds in the first 5 months post-op, then the next 50 took me another 5 months. The last 25 were the hardest but I finally got there and have maintained that weight loss (except for maybe 10 pounds) for the last 13 years.

I take vitamins and supplements, get labs done regularly, and just accordingly. I feel better than I felt ever!

That's why I had the DS.

i was reading ur message, i felt for a second that u were talking abt me.. i am exactly the same who u were before.. i eat a lot of pastas breads pastries and all kind of carbs.. i can eat the entire orio box or an entire pint of ice cream in one shot n not smacking my eyes.

My question here, if u did RYN, would u have eaten more? if yes, why?

if ur friend did DS, would she has eaten less n be capable to stick to a diet plan? if yes, why?

what helped u to eat less n stick to a diet even though her stomach is much smaller than urs, she has only a very small pouch instead, she is supposed theoretically to eat less not more? do u think is it because of the DS surgery or the person herself / himself?

i am asking these questions because success stories can be noticed n seen in both surgeries? what makes DS surgery better then? the percentage of success stories in DS is higher? or the lost of the excess weight is higher in DS then RYN? or improvement in health condition in DS is better?

to be more precised:

1- if we take 2 person, one with DS n the other with RYN surgery, they both r gonna eat the same, exercising 3 times per week, will they get the same result? if no, why?

2- after 2 years, the same 2 person continue to eat and exercise exactly the same, will they have the same result? if no, why?

3- after 5 years, the same 2 person continue to eat and exercise exactly the same, will they have the same result? if no, why?

NB: result can be measured in weight, health condition, style of life and others

if u answer no on the last three question, there is no doubts that DS is better

but if u answer yes on one of the 3 last questions so tell me plz why DS is better if the same result can be reached by following the two surgeries but with different risks and complications rate.

I would really appreciate too much ur reply because these questions r always on my head n no one till now gave me straight forward answers ..

ty very much

Adam

Adam - my friend of regained from the RNY never modified her eating habits. She continued to eat exactly the same way post-op. She was setting herself up to fail.

The DS gives you two things - restriction and malabsorption. The restriction part (the sleeve) is what helps you eat less, so the combination of restriction and malabsorption is what helps you lose alot of weight pretty fast. As you get farther out the sleeve stretches (because the sleeve is just a smaller version of your stomach, which is very stretchable) so the malabsorption is what helps you maintain your weight or helps you lose if you need to. I lost 8 pounds over the last 6 months simply because I'm paying closer attention to the carbs I eat. That's the malabsorption still working :)

I can't answer the question about how I would have done with the RNY. I hope I would have handled it the same way as the DS. There are absolutely no guarantees with any WLS. I was extremely obsessive about everything (eating, exercising, vitamins, etc.) Part of the reason was I didn't want to come close but never get to the finish line. Several people I knew with the DS never quite got to their goal weight. Once the "honeymoon" window starts closing it's harder to lose the weight. What's meant by the honeymoon period. Several thoughts on this - first with the DS the main way we stop losing is by adding carbs (otherwise you would continue to lose). Once you start introducing more carbs it's finding the balance of how much/what you can eat without gaining. That's where choices come in. If you choose to eat something, you have to understand the ramifications of that choice. Will it cause gas and bloating, will I gain/lose, etc.

IMHO the answer to all your other questions is no. No two people are exactly the same, had the exact same surgery/surgeon, eat exactly the same way.

I have come and gone from OH for years. The support is so important even at 15 years post-op. If I can answer questions I can - but the answers are only my opinions.

ty Janet for the explanation.. it seems like protein is the key of weight loss even without surgery, 2 years before i lost abt 80lbs just by following protein diet with a bit of exercises 3 times per week but then i regained back all the 80lbs i lost n put on 60lbs extra.. very disappointing!!

I heard that too much protein is not good for the liver? and it's recommended to consume 120 g of protein daily after DS.. is that OK?

Janet,

congratulations on your weight loss WOW 175 #s. What was your starting weight and your target weight? Did you have much trouble with the intestinal stuff like diarrhea and gas etc? I watched a video that claims you won't crave carbs like you did before your DS, was this true for you"? I have so many questions for all of you that have gone before.

Lesa

Adam,

the dr I found that I like is Daniel cottom in SLC u****ch his videos on their website. According to him, DS patients lose their desire for carbs, especially refined sugars. Has anyone else here heard this?

Lesa

No i dont, i'll look to his website.

I had a gastric bypass 20 years ago. I went from 330 lbs to 206 within about 18 months. I ended back up to 283 when I started back on the dieting thing, which of course I couldn't stick with any better than before my surgery. The only option I have now is the DS but I have to have gastric bypass reversed before the DS can be done. If Imhad it to do all over again I would have had the gastric sleeve first (wasn't done then) so that the gastric bypass wouldn't have to be reversed first. Just something to ponder.

Very sad n very frustrating to get back to the same point from where to start.. this is what bothers me the most..

Dont give up n do the DS surgery.. Good luck

I will definitely have the DS if I can get my insurance to pay. I have Medicare and my secondary is state Medicaid. I live n Colorado but there aren't any doctors doing the surgery in this state. There is a doctor I really like in Salt Lake City, but don't feel like I should go into it blind, without knowing my out of pocket. Has anyone else dealt with issues like this. Or anyone know what the 20% copay would be for a for a revision gastric bypass to DS.