Trying to decide which surgery is most effective?

Yes, her PA was useless.  I refused to see her after getting told that pain in my upper abdomen was from an ovarian cyst and to see my OB/GYN (despite my insistence that i knew well what cyst pain felt like, this was completely different pain and wasn't even in the vicinity of my ovary) and they actually put a note on my electronic chart that I was to see only Dr Rita. (Over a year later we found that it scar tissue binding my intestine to the mesh from my hernia repair and it took over 2 hours to free it.)

Perhaps she updated her nutritional info for DSers later on?  I know two of the last few people she did the DS on and their info seemed to be good based on ASMBS recommendations. I never saw her nutritional info before that. When Maguire stopped doing it -- and now Teel and the other guy are severely limiting it -- though, that held more "weight" than her stopping it.  I never saw his DS guidelines, and the only person I know who had DS with him was compliant for about 2 years then slacked off (and ended up with issues).

There are a lot of regain posts on the DS forum, too. There is no perfect surgery.

Personal responsibility is key no matter what surgery someone chooses.

Quote from AMSBS clinical guidelines, 2013 update: "Physicians should exercise caution when recommending BPD, BPD-DS, or related procedures because of the greater associated nutritional risks related to the increased length of bypassed small intestine."  

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JAMA Surgery Releases for September 17, 2012  Study Compares Duodenal Switch vs. Gastric Bypass for Morbid Obesity   "Although researchers note a relative increase in the use of the DS, this procedure is still used much less in theUnited States compared with gastric bypass. The researchers suggest that is likely due to several factors, including the technical difficulty of the procedure, the higher reported rates of short-term complications and concerns about the longer-term nutritional consequences of a primarily malabsorptive procedure (where absorption of calories and nutrients is reduced)."

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Duodenal Switch vs. Gastric Bypass "There are higher complications with the duodenal switch as opposed to a gastric bypass or a laparoscopic sleeve gastrectomy or a lap band.  There is a higher risk of leak and a higher mortality with the duodenal switch versus the gastric bypass. Also, there are many more nutritional and vitamin deficiencies with the duodenal switch. Duodenal switch patients have a higher incidence of diarrhea after the procedure, as well." David Buchin, MD Long Island Bariatric Surgeon  

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I think it is essential that a person be as informed as possible regarding the risk/benefit ratio with whatever they undertake, especially in the case of extensive and complicated surgery such as weight loss surgery. Weight loss surgery is also an elective surgery- personal informed awareness is even more important in undertaking it. In the case of the sleeve, the RNY, and the DS, the impact is irreversible. Even if a reversal surgery is performed, it can only be like repairing a broken vase.    

I'm not saying that the DS doesn't have benefits, especially with diabetes Type 2 (often caused by obesity and poor food habits), sleep apnea, and long term weight loss. It's just that a person needs to be aware of the costs and to look at the possibility from many different aspects.    

The DS is by far the most extensive and complicated of all the weight loss surgeries. There are only around 50 surgeons worldwide who are willing to perform it and it is by far the least performed of all the available weight loss surgeries- why is that? Clearly it is not seen as a moneymaker, let alone something most surgeons want to undertake. I don't think that has much to do with skill level, either, because many thousands of surgeons perform operations even more complicated and extensive on a routine basis. My Bariatric surgeons won't do it at all, and say the added weight loss from DS compared with gastric bypass is offset by risk of complications that far outweigh any potential benefits.    

Plus the jury is still out with regard to the long term effectiveness of all the weight loss surgeries, impact on long term health, and effect on life length.     

Professional research backed knowledge and opinion with a qualified Bariatric surgeon, several if necessary, is the primary place people should want to go in making a choice that impacts every aspect of a person's health, well-being, and life. Personal experience is all well and good and often useful, but not sufficient, and can only be an opinion, including this one.

“People do not want to be confused with facts that contradict their pre-conceived opinions.” Geoff Metcalf

The key word is "effective." All of the surgeries are only tools. When used correctly they are all extremely effective. I read most of the major boards and each of them have had people who have fallen off the wagon (for lack of a better term) and then gotten back on to find that their tool was still there and ready to work for them. In my mind, THAT is effective. 

All of the surgeries are only as good as the person who is using their tool. 

JMO. of course. 

Yup. Well said- thanks.

hi in my opinion the Vertical Sleeve Surgery is the best if you are thinking of doing any of that kind of surgeries I can recommend you a really good doctor would you like that? 

Bella, are you a clinical research scientist?  A physician?  What data have you gathered to lead you to this conclusion?

As you may already know, the Sleeve is the nascent WLS. Data is still being accumulated. It is still not being covered by some insurance companies as a stand-alone surgery. So, asking someone for data seems kind of spiteful, imo. 

Also Bella said it was her opinion. 

The "fact" is, all of the WLS's have positive and negative attributes that make them only as effective as the person utilizing their tool. To lend any more influence to one surgery or another begins to make it look like you might be trying to say that the WLS has more power than just the tool our weight loss surgeries are supposed to be. That seems like a dangerous path, imo. I have yet to meet a WL surgeon who will give more power to WLS than saying it's a tool. As with any tool, we each have a personal preference - one that works best for us, our lifestyles, our personalities, our strengths and weakness. 

WLS is a tool. Tools are only as effective as the person using them.