DS Vs. RNY Questions - ThinnerTimes

Zenomia · 11-16-2006, 08:16 PM

Ok..I go to OH every now and again and read over some of the posts. I was there recently and saw a post topic that said, You can NOT eat anything you want and still lose weight.

I know this is a mantra here, but I found the posts from Duodenal Switch patients went completely NUTS! Apparently they can eat anything they want, just in smaller quantities. They are talking about eating a Whopper and large shake and still losing weight.

#1, is that a fact, can the DS patients eat that kind of thing and still lose weight?

#2 How is that healthy? Isn't the stuff in whoppers and Shakes mostly FAT, carbs and other crap we don't need? Aren't we supposed to be getting healthier eating habits?

#3. Is DS fool-proof? Long term results? You can eat crap on a regular basis and not suffer effects? It's a wonder the WLS community is freaking out and people without WLS are saying we are taking the easy way out.

I personally was told DS was not an option for me as my BMI was too low to be considered. Though I was unaware of the lack of diet restrictions. I guess I was just plain shocked by this and want someone to tell me the facts man. I am learning that FACTS aren't always what I am reading at OH...there is a lot of bias opinion floating around in the guise of fact though!

MiladyB · 11-16-2006, 08:38 PM

Well Zen, I don't know a lot about the DS but this is what I do know. They actually do a gastric sleeve which has the restrictive component but you keep your original outlet from your stomach to your intestines. As a result from my understanding you can eat more of a normal diet, just like those who have had a LAP band. BUT they do tend to have a lot of liquid stools, sometimes that eventually stops, sometimes not. Often with people who have a really high BMI, the gastric sleeve is the first step and then after losing some weight they go in and do the DS. The DS has much more of the malabsorption component then the RNY and as a result those people do tend to have liquid stools a lot more than we do. They also are required to take a lot more vitamins because of the increased malabsorption. I think if you eat the "crap" you will find yourself with major diarrhea issues and running the risk of messing up your body electrolytes, dehydration, malnourishment, etc....not something I would play around with, that's for sure.

In general it just sounds a lot more of a drastic procedure and I think that is why they tend to reserve it for those with the extremely high BMI. It just doesn't sound like the best thing for your body, to me. I know my surgeon's office will only do them on extremely high BMI patients, but that's it.

Zenomia · 11-16-2006, 08:41 PM

Thanks Beth. I just don't know a lot about the DS and I was really bothered by what I was reading. It's a real fight over there over which is the better option. I'm of course not involved, but I did want to get the facts strait.

information whore that I am...*L*

MiladyB · 11-16-2006, 08:56 PM

Okay, found out a little more info for you, Zen.

DS:

Quote:

Advantages

These operations often result in a high degree of patient satisfaction because patients are able to eat larger meals than with a purely restrictive or standard Roux-en-Y gastric bypass procedure.

These procedures can produce the greatest excess weight loss because they provide the highest levels of malabsorption.

In one study of 125 patients, excess weight loss of 74% at one year, 78% at two years, 81% at three years, 84% at four years, and 91% at five years was achieved.

Long-term maintenance of excess body weight loss can be successful if the patient adapts and adheres to a straightforward dietary, supplement, exercise and behavioral regimen.

Risks

For all malabsorption procedures there is a period of intestinal adaptation when bowel movements can be very liquid and frequent. This condition may lessen over time, but may be a permanent lifelong occurrence.

Abdominal bloating and malodorous stool or gas may occur.

Close lifelong monitoring for protein malnutrition, anemia and bone disease is recommended. As well, lifelong vitamin supplementing is required. It has been generally observed that if eating and vitamin supplement instructions are not rigorously followed, at least 25% of patients will develop problems that require treatment.

Changes to the intestinal structure can result in the increased risk of gallstone formation and the need for removal of the gallbladder.

Re-routing of bile, pancreatic and other digestive juices beyond the stomach can cause intestinal irritation and ulcers.

RNY:

Quote:

Advantages

The average excess weight loss after the Roux-en-Y procedure is generally higher in a compliant patient than with purely restrictive procedures.

One year after surgery, weight loss can average 77% of excess body weight.
Studies show that after 10 to 14 years, 50-60% of excess body weight loss has been maintained by some patients.

A 2000 study of 500 patients showed that 96% of certain associated health conditions studied (back pain, sleep apnea, high blood pressure, diabetes and depression) were improved or resolved.

Risks

Because the duodenum is bypassed, poor absorption of iron and calcium can result in the lowering of total body iron and a predisposition to iron deficiency anemia. This is a particular concern for patients who experience chronic blood loss during excessive menstrual flow or bleeding hemorrhoids. Women, already at risk for osteoporosis that can occur after menopause, should be aware of the potential for heightened bone calcium loss.

Bypassing the duodenum has caused metabolic bone disease in some patients, resulting in bone pain, loss of height, humped back and fractures of the ribs and hip bones. All of the deficiencies mentioned above, however, can be managed through proper diet and vitamin supplements.

A chronic anemia due to Vitamin B12 deficiency may occur. The problem can usually be managed with Vitamin B12 pills or injections.

A condition known as "dumping syndrome" can occur as the result of rapid emptying of stomach contents into the small intestine. This is sometimes triggered when too much sugar or large amounts of food are consumed. While generally not considered to be a serious risk to your health, the results can be extremely unpleasant and can include nausea, weakness, sweating, faintness and, on occasion, diarrhea after eating. Some patients are unable to eat any form of sweets after surgery.

In some cases, the effectiveness of the procedure may be reduced if the stomach pouch is stretched and/or if it is initially left larger than 15-30cc.

The bypassed portion of the stomach, duodenum and segments of the small intestine cannot be easily visualized using X-ray or endoscopy if problems such as ulcers, bleeding or malignancy should occur.

So anyway, from what I have read the patients who have had a DS can eat more normal foods without the risk of dumping but that doesn't mean that they can eat whatever they want. They will absorb sugar and carbs just like they did before surgery but will not absorb fats at all. If they eat a lot of fat they will probably have diarrhea which can bring a whole host of problems if it happens a lot. Those who have had a DS STILL need to watch what they eat. It doesn't give them a free ticket to eat however they want.

Blueyz · 11-16-2006, 10:51 PM

Quote:

Originally Posted by Zenomia

Thanks Beth. I just don't know a lot about the DS and I was really bothered by what I was reading. It's a real fight over there over which is the better option. I'm of course not involved, but I did want to get the facts strait.

information whore that I am...*L*

I brought up the subject here on the forum about a year ago and mentioned only what I heard in seminars and boy did I get slammed for it. I am sure you can find it somewhere. I felt really bad because I was just stating what I heard from some doctors here in the SD area.

LisaBoston · 11-17-2006, 08:35 AM

Zen, I was going to respond, but then I see Beth did such a good job. I watched a program the other night on TV where a lady had DS and then bragged how she could eat all the crap she wanted and still loose weight. Made me mad. In the end, by eating that way, she may be thin, but not healthly and I think thats the most important thing. The malabsorbtion issues are a big deal to me.

Zenomia · 11-17-2006, 09:30 AM

I guess I was wondering about this because I was so taken aback by some of the comments I was seeing. Like from a DS patient. "I can eat whatever I want...a whopper, a large shake, and still lose weight! Why would I want a surgery that I couldn't eat the foods I wanted when I wanted them? If I could have done that I wouldn't have gotten FAT in the first place!"

To me, this says there is no personal responsibility for our own health. That we are 'entitled' to fill our bodies full of whatever we want, whenever we want it and not forced to suffer our unhealthy choices. It's this mindset that bothers me. It's what people who don't have WLS see or think of when they hear about someone who had it. We cheated, we don't work hard, we don't try...weight just falls off no matter what we do...that kind of thinking. This type of talk, (from RNY's or DS patients) leads to ideas that it's not up to the individual to become responsible for their health. That they don't need to change their lifestyle and there is no need to develop healthy eating habits.

I guess now I understand why a lot of society has such a negative attitude about weight loss surgery. This is just sad.