Confused bmi too high?

on 1/29/18 7:38 pm

I spoke with a surgeon today my bmi is 58.6 he said it was too high for DS. I was under the impression from the research I've done DS was better for higher bmi. Very confused now any insights appreciated.

on 1/29/18 9:54 pm

He or she made a mistake.

on 1/30/18 7:12 am - Nashville, TN
Revision on 03/18/15
On January 30, 2018 at 3:38 AM Pacific Time, Babs1972 wrote:

I spoke with a surgeon today my bmi is 58.6 he said it was too high for DS. I was under the impression from the research I've done DS was better for higher bmi. Very confused now any insights appreciated.

you BMI is not to high for the DS. You BMI is too high for the skill level of the surgeon you saw. He is not a good enough surgeon to do it, so he has done you a favor.

Now, find a better surgeon.




Janet P.
on 1/30/18 8:48 am

With a BMI of almost 60, you are in fact the perfect candidate for the DS. Is your surgeon trying to push the DS in two parts (VSG then the switch)? Many surgeons will recommend that option for people who they may feel are too high risk (surgery can be 5-6 hours, which is a long time to keep someone under). The DS is a complicated surgery that requires an experienced surgeon (and by experienced I mean an experienced DS surgeon). My BMI was almost 57 and my surgeon didn't blink an eye at doing the DS in one surgery.

Are there other DS surgeons available in your area?

Janet in Reston
DS 2/25/03
Hazem Elariny
on 1/30/18 9:20 am

I live in Canada so no I am having to look into Mexico for surgery as I can't afford US prices. The surgeon did suggest gastric sleeve then the DS revision. I need to do this in one shot just financially even if it means waiting until I can get down to a 54ish BMI which is what they suggested. I do understand that the surgery is more complex than RNY or sleeve just knowing myself I really feel it's the right option. I don't carry much of my weight in my tummy either so thinking that makes me a better candidate as well.

Valerie G.
on 2/9/18 12:09 pm - Northwest Mountains, GA

Dr Esquerra is the only doc in Mexico you want to trust.

Dr. Marchenesi in Brazil is another.

Dr. Baltazar in Spain

11 years post op DS 
There is room on this earth for all of God's to the mashed potatoes

on 1/30/18 2:42 pm - bay area, CA

While the DS works well for anyone who medically qualifies for bariatric surgery, it is especially beneficial for people with higher bmi's, as it provides the highest percentage excess weight loss AND the best maintenance of that weight loss of any available bariatric surgery. So, you were right, and the surgery is just not comfortable operating on someone with your bmi. I understand that, given your location, your options are limited, but just for comparison, Dr. Rabkin in San Francisco has done the full DS, in one operation, on patients up to 700 lbs, which you are not remotely near. Obviously this is a surgeon with tremendous DS experience, and for your bmi you don't need that level of experience, but still, this surgeon just isn't comfortable with your bmi.

If he/she is saying that if you could get your bmi down to 54, perhaps that's something you can manage? I don't know how tall you are, but at an average height of 5'6" it's 6 lbs per bmi unit, so 24 lbs would do it (sorry about not using metric for you, just to lazy to convert!). That might be quicker than saving up for Mexico. OTOH, if you'll nervous about having this surgeon operate on you at any bmi, Mexico beckons.


on 1/30/18 5:11 pm

Thanks I am definitely going to keep my options open and get the surgery I need not what is in their comfort level.

on 1/30/18 9:31 pm, edited 1/30/18 1:32 pm
Mini Gastric Bypass on 04/10/17

Contact Dr. Esquerra at Mexicali Bariatric Center for a consult. He is one of the best DS surgeons in Mexico.

on 1/31/18 6:20 am - Parma, OH
DS on 04/15/13

Giving him the benefit of the doubt maybe he is just uncertain about performing the DS on you with a high BMI. A skills issue like others mentioned. My surgeon wouldn't do the DS in a single step when I had a BMI of 72. H would have done it in 2 steps, first the VSG and then once I had lost some weight he would do the switch.

I was able to get my BMI down to 66 and he felt comfortable doing both steps at once, He did warn me that depending on what he found when he did the operation he may still have to do 2 steps but it was unlikely. It had more to do with the limitations of laporscopic tools dealing with excess layers of fat around the stomach.

I saw you were thinking about Mexico and a lot of people have had very good results going that way. You might also talk to your Doc about a 2 step process if you can't get down to the BMI he is comfortable with. I found getting down was easier knowing that the end result was the surgery and not just a continuation of the high protein diet.

I hope it all works out,


 HW  552    CW  229  SW 464 4/15/13 - Lap DS by Dr. Philip  Schauer - Cleveland Clinic.