Question:
How do I decide between the RNY vs. DS?

I need to lose nearly half my body wt, about 140 lbs. I'm having trouble deciding between the RNY and DS. I really want a lap procedure but fear dumping. Also, I'd like to be able to be able to eat a more normal meal so as to not be so "obvious". However, the absorption issues concern me. Can anyone tell me why they decided on one surgery over the other?    — Devonne O. (posted on February 25, 2001)

February 24, 2001
Well, I am in the same situation as yourself, same amount of weight to lose, I am 33 years old. I have chosen the DS after doing a lot of research and weighing the pros and cons of both procedures. I did the vast majority of my research on this very site. The "information library" and Q and A sections archives have a TON of info for you! Also check out the DS website, www.duodenalswitch.com. With either procedure there is the "malabsorbtion" mechanism which will mean that we will be taking supplements for the rest of our lives, but I feel it's a small price to pay to be able to change my life in such a dramatic way!! =) Check out the info here and to other links people recommend, and keep up posted! Good luck to you.
   — ChristiMNB

February 24, 2001
As a nurse, I researched the subject of WLS for many months before coming to a decision. I also made an objective analysis of my eating lifestyle and those factors that had contributed to or helped to create my morbid obesity over the years. In addition to a strong genetic factor in my family, I faced the facts that I ate too much, was a "grazer" throughout the day, ate too fast, hardly chewed my food at all, and ate an incredibly high fat diet. I chose a lap RNY because I wanted a surgery which would encourage me toward a more normal and nutritionally correct eating lifestyle...the things that our more slender friends do without thinking: eating smaller portions, chewing thoroughly, eating more slowly, limiting sugars and fats, and stopping when feeling full. The RNY gives me all those things, and I have never felt "deprived". I already suffered from Irritable Bowel Syndrome, so I clearly was not in the market for a surgery which would increase my malabsorption problems. I do experience "dumping" when I eat refined sugars (dessert items), but it is not the horrible experience that many make it out to be...at least not for me. It is an unpleasant sensation of nausea, weakness and slighly rapid heart rate which lasts for about 20 minutes...not life-threatening, but certainly a reminder that sugar is not a good thing for me. I have not considered "dumping" a bad trade-off for the 125 lbs. lost over the past 11 months. Aside, from desserts, I eat everything my friends eat, just much less of it. No one comments on the size of my portions, and when I look at the plates of my very slender friends, I find that we eat about the same amounts....phenomenally less than I ate before! I felt that I needed and wanted to make constructive changes in my life...both inside my body with the surgery, and outside with my lifestyle. It seems to me that DS surgery is an option for those patients who do not wish to make changes in their eating lifestyles or fear that they cannot make lifestyle changes and would "grieve" the loss of their favorite foods. Malabsorption becomes the major mechanism for weight loss rather than lifestyle changes. I have "missed" nothing, I am never hungry and have to look at the clock to remind myself that it's time to eat, I take a multivitamin and a calcium supplement daily and all my lab values are "picture-perfect" nearly one year post-op. Whatever your decision, make it based on all the research possible. That's the only way you will know that you made the decision that was right for you. Remember, both procedures accomplish the same goal...it's not so much which path we take, it's that we start and finish the journey. Good luck!
   — Diana T.

February 25, 2001
I will tell you my thoughts and feelings as I made my choice. I chose the DS for many reasons. The number one reason I chose the DS was that it was not a VBG or an RNY. I know that many people love and are very happy with highly restrictive procedures, but for me there was little upside in those options: I was not a slave to sugar, so I didn't feel that setting myself up for physical discomfort (dumping) in that regard was necessary. I was not an eater of mass quantities of food, so a high level of restriction didn't appeal to me either. I saw lots of "pouch" issues being discussed online; marginal ulcers, blockages, strictures and repeated endoscopies were repellant to me. While I made bad food choices at times (just like any other normal person), I was able to honestly assess my eating patterns and see that my intake was not the main problem. The problem was how my body was treating the intake. I needed the metabolism "tweak" that the malabsorptive procedure would give me.<br> <br> Years of yoyo diets and failed exercise resolutions had shown me that I realistically wasn't going to make sustained "lifestyle" changes. I refused to put on the rose-colored glasses again. The surgery is too big and the stakes too high for me to try to fool myself in that regard. I have never liked exercise, even at my lower weights, and my years of yoyo dieting had screwed my metabolism completely. I couldn't lose weight without sustaining an intolerably low caloric intake.<br> <br> I didn't want to choose a surgery that would require me to make "lifestyle" changes. I'm not saying that I was stubbornly unwilling to do my part. I'm saying that I wanted a surgery that would work for me moreso than a surgery that I would have to work for. Subtle but significant distinction.<br> <br> Given all of that, and all the research I had done and reading of clinical reports, I decided that a mostly restrictive surgery would not make me happy, nor would it give me the long-term results I wanted. All of the choices require lifelong vitamin compliance and aftercare, so that was not a deal-breaker for me. The DS surgery has the best percentage of excess weight loss over the long-term, with the fewest restrictions on types and amounts of food. There are no ongoing "pouch" issues with which to contend. As long as I get my annual bloodwork and stay religious with my daily multivitamin and calcium, I will stay healthy. To me, that's a miniscule price to pay for a real chance at normal.<br> <br> I'm 16 months post-op and have gone from 299 to 161 and still losing (but tapering off slowly now). I truly eat what I want, when I want, and treats included. My bloodwork has been consistently good, and my overall health and well-being are phenomenal. I love being unrestricted and feeling utterly normal.
   — mmagruder

February 25, 2001
The main reason I chose the DS over the RNY, having thoroughly investigated them both is that the RNY creates an abnormally functioning stomach, for no good reason as far as I can tell. The loss of the pyloric valve is unecessary. I even asked the RNY doc if he could do the RNY and do the DS version of the stomach. He said he WOULD not, and refused to offer any reason why except that "We don't do that here." that told me they were way too interested in the assembly line approach to the surgery. My stomach was reduced from one that could hold upwards of 1.5 GALLONS of food, to one that feels full with about 1.5 cups. My food selections were pretty good before hand, it just took a huge volume for me to feel full. Now, I eat pretty much the same things I ate before: Egg McMuffin and nurse a large ice tea for breakfast, 8oz yogurt or a banana about 10:30, soup and salad(with dressing!) or a tuna sandwich (before I used to eat 3-5 sandwiches) for lunch, 1/5 cups of baby carrots for a snack, a 4 inch square of lasagna for dinner, 2-3 cups of watermelon (before I would eat about 1/4-1/3 of a melon), or a cup of frozen yogurt or a couple of cookies and milk before I go to bed. Obviously I vary the vegies, sometimes make my own scrambled egg omelette, etc., but for the most part that is what satisfies me. I am 9 months post op and have lost 142 pounds. I will put up a new picture when I hit the 150# lost mark. Good Luck to you!
   — merri B.

February 25, 2001
I started out at 280 pounds 13 months ago and had open RNY surgery. I am down 130 pounds so far and still losing slowly. I don't know alot about the DS, but for me, the RNY is perfect. I eat around 1-1/2 cups of food at a sitting, and I eat normally (it doesn't take me 45 minutes to eat). Quite honestly, I DON'T want to eat the way I ate before- even if I don't absorb it. I was out of control and I didn't like the amounts I ate- there was nothing normal about those portions. I think the amount I eat NOW is normal for me:) I know the dumping and food restrictions sound scary, but they don't last forever (even if some AMOS members think they should). I didn't have this surgery to keep me in bondage to food, I had it to free myself from it. I can and do eat sweets occasionally, high fat foods, and carbs. None of them do I eat in large amounts, or often, but I will eat if I have a craving (especially during that time of month). The surgery is a great tool for me. Good Luck in whatever you decide!
   — M B.

February 25, 2001
This is an easy one for me to answer for two reasons: #1 There are no doctors in our area doing the DS. #2 Sugar and sweets were one of my BIG problems and I needed something to force myself to give them up. Just the threat of dumping has kept me away from most sugar. That doesn't mean that I don't have any at all, it just means that now I eat ONE Girl Scout cookie instead of a BOX of Girl Scout cookies! As far as eating a normal meal, I eat the same thing as the rest of my family just in smaller portions. Good luck with your decision.
   — georgiacarol