PRE-OPS ONLY! Post-ops, read about the DS at your own risk.

If you have not THOROUGHLY studied the benefits of the duodenal switch (DS), you cannot make a fully informed decision about which surgery is the best one for you:

1. The DS has by far the best average weight loss of any of the surgeries – a statistical fact
2. More importantly, the DS has by far the best average LONG TERM MAINTENANCE of weight loss of all surgeries– a statistical fact
3. The DS has by far the best CURE RATE FOR TYPE 2 DIABETES, including LONG TERM CURE, even with weight regain (the others have substantial rates of diabetes returning, especially with the far more likely weight regain) – a statistical fact
4. The DS is suitable for ANYONE who qualifies for bariatric surgery, and not just SMOs, which has been recognized by the ASMBS, ACE, Medicare, and most insurance companies, even for BMIs >35 with a serious co-morbidity (especially if that is diabetes or hypercholesterolemia – a statistical fact
5. The DS has the easiest post-op dietary regimen of all of the surgeries – FAT IS YOUR FRIEND.  Little to no restriction on eating delicious high fat, high protein foods, because you don’t absorb much fat – and your cholesterol and triglycerides will plummet, without meds
6. Good DS foods include marbled steak, crab legs with butter, chicken WITH the skin, cheeseburgers with all the fixings (but hold the bun), scallops sautéed in butter, cheese of every sort, eggs – and BACON!
7. No dumping, no food getting stuck, no limitations on drinking with meals, no sliming or “productive burping," no fills and unfills, no stoma blockage, no marginal ulcers, no restrictions on taking NSAIDs

However, you should NOT consider the DS if you

1. Are too stupid to follow the simple rules of the DS: eat high protein, take your supplements, get your labs done diligently and adjust your supplements as necessary
2. Are too lacking in self-control to manage/time your overall intake of refined carbs to avoid weight gain and gas
3. Are too sheep-like to argue with your PCP or surgeon for the right to have the most effective WLS
4. Are too passive to fight your insurance company to get the DS, when most of them will LOSE on appeal
5. Are too cowed by doctors to stand up to them in the future, to explain what surgery you had and how your treatments need to be tailored
6. Are too submissive to advocate for yourself
7. Are too weak to be certain that you will ALWAYS ensure your access to necessary protein, supplements, lab tests and other medical care
8. Are too dim-witted or so brainwashed by Judeo-Christian “morality" to understand that eating delicious flavorful food that you enjoy and which is right for your anatomy is not sinful or gluttonous – it is wonderful!
9. Are so self-loathing that you feel you need to suffer to atone for your sins in order to enjoy life with weight loss surgery

Remember:

1. Insurance coverage for the DS is expanding all the time, and even if your policy does not cover the procedure you have a good chance of getting it covered on appeal
2. Only a qualified DS surgeon can help you figure out if the DS is for you - if you see a RNY surgeon, he is going to tell you to have a RNY
3. If you see a surgeon who SAYS he offers the DS, but then tries to talk you into something else, odds are you’ve gone to a “bait-and-don’t-switch" surgeon – check the surgeon list at DSFacts.com before you go.
4. WARNING: More and more insurance companies are instituting a “one bariatric surgery per lifetime" restriction on their policies, no matter WHO paid for the first surgery – and you may not get a second chance to have a revision if you pick a surgery that doesn’t work for you in the first place
5. Revision patients lose more slowly and lose less on average
6. Revisions are MUCH more dangerous surgeries than virgin surgeries
7. Think about the psychological damage it would cause you to work your ass off to work your ass off with a less effective surgery – only to have it fail

THINK TWICE, CUT ONCE!