Duodenal Switch Information

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How it Works

In a duodenal switch, one’s stomach is surgically reduced in size so it can hold less food. The intestines are also rerouted so the body absorbs less nutrients (and thus fat and calories) from food eaten.

Eligibility

Most people who get a duodenal switch or other weight loss surgery are at least 100 pounds overweight. However, those who are slightly less overweight but have other serious health conditions such as high blood pressure, sleep apnea (when one stops breathing intermittently while asleep), or diabetes often are eligible for a duodenal switch. Weight loss surgery can in some cases be reversed (except for the portion of stomach removed) but is considered a permanent procedure for when all other diets and methods of attempted weight reduction have failed. It is not appropriate for someone who has a little weight to lose, and virtually all doctors would refuse to perform such a drastic procedure on anyone whose life is not in danger due to their obesity.

Potential Risks

Most serious risks, such as death, have about a one percent or less chance of happening due to a duodenal switch. However, evaluating potential risks is an important part of any surgical decision. The most common risks include blood clots, pneumonia, bowel obstructions, gastric leaks, post-operative bleeding, and pneumonia.

Potential Benefits

The duodenal switch statistically has a reputation for long-term and excessive weight loss, which is defined as maintaining at least a 50 percent weight reduction. Surgeons have reported that most patients experience long-term maintenance of reducing their excessive body weight by 70 to 80 percent. Type 2 diabetes, sleep apnea, and hypertension are typically resolved or their health impact significantly reduced. There are also extensive psychological and physical benefits to a successful weight loss surgery, such as ability to do more activities and increased self-esteem.

Dietary Changes

The duodenal switch, like any type of weight loss program, is not a “magic bullet.” Strict dietary guidelines must be adhered to for the procedure to work in weight reduction. As the body heals after this major surgery, the patient will be given only liquid and then pureed foods for about four weeks.

Once the body has healed and these foods and liquids are well-tolerated, then the newly “switched” person should eat three meals and one snack per day, focusing on high-protein foods and dairy products. He or she should avoid sugared drinks and foods and make sure 60 to 80 mg of protein is consumed. Secondary food choices good for promoting weight loss and general health after a duodenal switch include whole-grains, fruits, and vegetables.

An average stomach after a duodenal switch can only hold about six to eight ounces of food, so eating just a few tablespoons at a time is advised.

Financial Considerations

Duodenal switch surgery, in the absence of any complications, can cost well over $30,000. Many insurance companies will cover part of all of the cost of the procedure, but often enforce strict guidelines which may include requiring up to five years of documented weight loss efforts, extensive counseling programs, and may require the patient to consider another surgeon or type of weight loss surgery.

Some people choose to self-pay and pursue their surgery with reputable doctors in Brazil, Spain, Mexico, or Russia, paying $10,000 to $20,000 for their procedure and travel expenses. Others try to find a United States doctor willing to take a flat rate, which still usually is about $30,000 to $50,000 if there are no complications. There are patient financing programs but these are usually limited to people without a history of credit problems. Others use credit cards, health care reimbursement plans, personal loans, second mortgages, fundraising, second jobs, or gifts from family and friends to finance their duodenal switch.

References

“Benefits of Duodenal Switch.” https://www.dsfacts.com/benefits-of-duodenal-switch.html

“Dietary Guidelines for Gastric Bypass Surgery.” https://www.cornellweightlosssurgery.org/pdf/diet_guid_duod_swit.pdf

“Duodenal Switch Information Zone.” https://www.duodenalswitch.com/index.html

“Duodenal Switch Weight-Loss Surgery.” https://www.lapsf.com/duodenal-switch-weight-loss-surgery.php