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Why choose bypass over the DS?  The real DS.  Doing some research it seems the DS is a better option. More success and less anatomy changes.  So I am curious. 

 

 

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Often DS isn't on offer so it isn't even an option. I've read at various times that some insurers don't cover it so that would affect people's decisions as well.

Then there's the issues that even greater malabsorption can bring with it. I guess if I was really huge, and the DS was an option (as in my surgeon performed it and recommended it) then I would very seriously consider and research it. In my case though it was RNY or nothing for anatomical reasons.....any surgery that involved a "sleeve" was just not physically possible in my case.

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I’ve not found that to be true at all @Aussie Bear.

Perhaps it’s a geographical difference, but the research I did for here in the US shows the DS to be just as safe but perhaps more effective long term than other wls. I don’t have diabetes, but I do have high blood pressure and sleep apnea. I’m 53, and this will be a one and done shot for me. Blue cross, a major insurer in the US, DOES cover the DS.

I consulted 3 different surgeons (in different practices) in my journey and all 3 recommended the DS. The one I chose has done 100s, successfully.

But maybe that just makes me “ huge”...

 

Edited by Boston Redhead
To tone it down

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8 hours ago, Aussie Bear said:

Often DS isn't on offer so it isn't even an option. I've read at various times that some insurers don't cover it so that would affect people's decisions as well.

Then there's the issues that even greater malabsorption can bring with it. I guess if I was really huge, and the DS was an option (as in my surgeon performed it and recommended it) then I would very seriously consider and research it. In my case though it was RNY or nothing for anatomical reasons.....any surgery that involved a "sleeve" was just not physically possible in my case.

This basically sums up my experience too (other than Aussie's anatomical limitations). My surgeon didn't even present it as an option and, other than a fleeting thought as I researched all the different surgeries, I didn't really consider it. But I barely qualified for insurance to cover my surgery (BMI of 40 with no co-morbidities) and part of the reason I chose RNY was because I hoped I'd get dumping as a side effect (a negative physical reaction to sugar? Yes please! Lol) and considering how thin I am after having RNY, the extra malabsorption of DS would probably not be a good thing. @Boston Redhead it sounds like you've done your research and your doctor agrees with you about doing DS. I'm glad you've chosen the surgery that you & your doctor feel is the best one for your specific situation. Sorry there's not more people on here that you can compare notes with. 

Edited by athenarose

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6 hours ago, Boston Redhead said:

I’ve not found that to be true at all @Aussie Bear.

Perhaps it’s a geographical difference,

 

Perhaps it is. There are very few surgeon's in Australia that even offer the DS. I think I've only seen one that even advertises they do it. As a country we don't seem to have the levels of "Super Obesity" that seems to exist in other countries......lots of obesity and morbid obesity, but not a great deal beyond that. Most of my research indicated that DS was only recommended for those that for the "super morbidly obese" BMI  category, due to the very serious malabsorption it causes....while that can be seen as a positive for super morbidly obese, it's just an unnecessary risk for those whose BMIs would suggest equally effective results with less malabsorption. 

As for your reaction regarding my use of the term "huge".....I used it rather than using the standard BMI obesity levels, which given I was using the term in reference to myself seemed reasonable to me.  I apologise if you believed I was making pointed judgements about anyone, because that certainly wasn't the case. In fact I was surprised that the OP was even considering that surgery with his BMI.

Whether we like  it or not a BMI of 50 is considered "super morbidly obese". Regardless of how we feel about these terms, or whether the categories applied to BMI are meaningful or otherwise, we are all subject to being medically judged by where we sit within those catagories.

Edited by Aussie Bear

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On 1/14/2019 at 10:38 AM, mikef said:

Why choose bypass over the DS?  The real DS.  Doing some research it seems the DS is a better option. More success and less anatomy changes.  So I am curious. 

 

 

I chose RNY because it was either lap band or bypass that the military insurance would cover :huh: so I went with the much safer option, the bypass. I wanted the DS. I only know one person who had the DS and she's kinda successful with it however she's not really utilizing her tool right, she's drinking with meals therefore gaining weight and not where she could be. So never reached goal weight. Me I reached goal weight my first year and am maintaining within 10-20lbs pending my health issues. I did think from my research at the time 10 years ago that the DS had a lot less malabsorption issues so I'm shocked to hear about that. Hope this helps.

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Honestly I chose the Gastric Bypass over the DS because I couldn't find anyone in my area to do it and don't think my insurance even covers that particular procedure.

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There are many reasons people choose an RNY or MGB over DS, Reflux being one of them. Insurance stuff. Surgeons that don't perform DS or perform DS only on very heavy patients and even then surgeons seem to have become more hesitant and perform a sleeve first with the option of a second surgery, being MGB, RNY or DS (that's how things seem to be in Germany). However, there are always the different mindsets of different populations to keep in mind as well. 

As for the better long term results: DS doesn't seem to automatically prevent weight gain and has a bigger potential of complications due to malabsorption. Patients have to watch it as well though in a different manner as it seems. I've met a few BPD/DS patients in the hospital and what they eat doesn't sound very appealing to me as well.

 

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1 hour ago, summerset said:

I've met a few BPD/DS patients in the hospital and what they eat doesn't sound very appealing to me as well.

I met a person with a DS prior to my weight loss surgery and he explained to me how DS had given him loose bowel movement and smelly flatulence problems.  This information highly motivated me not to have a DS.

DS patients, unlike gastric bypass or sleeve patients, need to follow a low fat diet for the rest of their lives, as this diet helps to minimize (but not avoid) the smelly and loose bowel movements (and flatulence) that are very common after DS. This problem is caused by the fact that DS results a dramatic inability to digest fats and starches. 

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Weird, the people I've met ate quite a lot of fat to "get things going". Carbohydrates gave them smelly gas and made them gain weight.

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I’ve only paid passing attention as it’s not really relevant to me now but from what I’ve noticed DS seems to be gaining in popularity, with some surgeons now doing them exclusively.  I wouldn’t be surprised if DS is the bariatric surgery of choice down the track.

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Interestingly enough there seemed to be a DS hype in Germany some years ago. Patients who've got the DS talked about "having the Mercedes of WLS" while the classic RNY was the "VW". (Yes, that was the way some patients talked liked.)

Well, the hype seems to be gone since quite a few years in Germany and I doubt it's because the DS gets you the best weight loss results possible.

 

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On 6/22/2019 at 7:50 AM, summerset said:

Weird, the people I've met ate quite a lot of fat to "get things going". Carbohydrates gave them smelly gas and made them gain weight.

Everything I have read about the DS is that patients need to follow a low fat diet because of undigested fats often leading to loose and frequent uncontrollable bowel movements .

This is a good read:  https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=134&contentid=106

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On 7/5/2019 at 11:19 AM, cinwa said:

Everything I have read about the DS is that patients need to follow a low fat diet because of undigested fats often leading to loose and frequent uncontrollable bowel movements .

This is a good read:  https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=134&contentid=106

A good read, but factually incorrect in places,eg

"You will need to take high doses of fat-soluble vitamins every day."

 

you will need to supplement AEDK vitamins, but the dry form, you cannot absorb the fat soluble form of these vitamins

 

 

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