I was weighed at my dr's office. I'm a 5'5" female. Now 326 lbs. (a few years after the...

I have never yet read one post about the DS on the Main Board that addresses the disadvantages or risks of the DS, and I have been reading this forum for years. I also have yet to hear my specific issues I raise addressed on this thread.

In order for a person to make an informed choice about anything, let alone a major, invasive, permanent surgery, they need to know about all aspects of what they are considering, including the disadvantages and risks.

They also need to do the primary part of their research into weight loss surgery with a Bariatric Surgeon who is expert, trained, licensed and objective, not possibly biased nonprofessional amateur strangers on the internet.

I gather you don't hear what I am saying, because these points have yet to be addressed on this interminable thread- poor OP.

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

I respectfully decline your invitation to "move on".

Let the **** go. You keep saying no one is listening to YOU. I think everyone hears you yapping. You seem to have the problem with others opinions and quite frankly comprehension issues. 

Can you cite your source for the 50 surgeon thing?  As I already responded, that number cannot be correct worldwide.  I doubt it is even correct for the US.

Lora

I would respectfully offer that Y ou are one of those "amateur strangers" making recommendations against something you don't really even know. Anything about.

I briefly skimmed this thread, so I don't know everything that has been said on this topic, but just wanted to comment on my own experience and concern.  I had the sleeve in 2009 and lost 120 pounds within about 18 months.  I was mostly compliant during that time.  Two or so years into it, I started slipping and sliding around with carbs.  A biscuit here, some ice cream there.  And the weight crept up.  A pound or two at a time.  Woke up one day and was back in territory I never thought I would see again.  I tried to get serious, upping my protein, cutting back on carbs.  I lost a bit but struggled for months until I stumbled across the concept of low carb, high fat (not high protein).  I adopted a modified "ketogenic" food plan (you can do a search for more info on line), and the excess weight fell off in about a month.  I am not an expert on any of the surgeries.   And I fully understand that the low carb, moderate protein and high fat way of eating is controversial.  But it worked for me.  It seems to quiet my mind, quell the hunger, sooth the anxiety and keep my body chemistry where it needs to be.  And yes, I have had cholesterol checks along with extensive blood work, and everything appears to be good.  

I wanted to put this out there because, if you decide to experiment with something like this, it would need to be done before you have any surgery that changes your absorption.  I'm not sure how this would work if your absorption of fat was altered through surgery.  

There is a fair amount of info on the web on this.  I have been participating in one of the FB support groups and there appear to be a whole lot of people who have maintained a hundred pound or more weight loss for several years doing this.  

What I know to be true for me is that anything grain based changes my brain chemistry and makes me crazy.  I know this is not true for everyone (and for those of you who are out there, I so wish I was one of you!)

Whatever you decide to do, I wish you all the best.  This is a lifetime journey.  

Hamptons: read these.   http://www.ncbi.nlm.nih.gov/pubmed/24018763
Surg Endosc. 2014 Jan;28(1):91-9. doi: 10.1007/s00464-013-3176-0. Epub 2013 Sep 10.

Response to glucose tolerance testing and solid high carbohydrate challenge: comparison between Roux-en-Y gastric bypass, vertical sleeve gastrectomy, and duodenal switch.

Roslin MS, Dudiy Y, Brownlee A, Weiskopf J, Shah P.

RESULTS:
Data from a total of 38 patients (13 RYGB, 12 VSG, 13 DS) were available for analysis. At baseline, all groups were similar; the only statistically significant difference was that DS patients had a higher preoperative weight and body mass index (BMI). All operations caused weight loss:

BMI 47.7 ± 10 -> 30.7 ± 6.4 kg/m(2) in RYGB;
45.7 ± 8.5 -> 31.1 ± 5.5 kg/m(2) in VSG;
55.9 ± 11.4 -> 27.5 ± 5.6 kg/m(2) in DS),

reduction of fasting glucose, and improved insulin sensitivity.

RYGB patients had a rapid rise in glucose with an accompanying rise in 1-h insulin to a level that exceeded preoperative levels. This was followed by a rapid decrease in glucose level.

In comparison, DS patients had a lower increase in glucose and 1-h insulin, and the lowest HbA1c. These differences were statistically significant at various data points.

For VSG, the results were intermediary.

CONCLUSIONS:
Compared to gastric bypass, DS results in greater weight loss and improves insulin sensitivity and glucose homeostasis without causing a hyperinsulinemic response.

Because the response to challenge after VSG is intermediary, pyloric preservation alone cannot account for this difference.   http://www.ncbi.nlm.nih.gov/pubmed/23803250

Tohoku J Exp Med. 2013;230(3):129-32.
Duodenal switch for intractable reflux gastroesophagitis after proximal gastrectomy.
Someya S, Shibata C, Tanaka N, Kudoh K, Naitoh T, Miura K, Unno M.

In conclusion, the duodenal switch may be surgical treatment of choice for intractable reflux gastroesophagitis after proximal gastrectomy.   http://www.ncbi.nlm.nih.gov/pubmed/22189411

Surg Obes Relat Dis. 2013 Jan-Feb;9(1):63-8. doi: 10.1016/j.soard.2011.10.021. Epub 2011 Nov 15.
Perioperative complications in a consecutive series of 1000 duodenal switches.

Biertho L, Lebel S, Marceau S, Hould FS, Lescelleur O, Moustarah F, Simard S, Biron S, Marceau P.

CONCLUSION:
The early and late mortality rate of BPD-DS is low and comparable to that of other bariatric surgeries.

Text (not publicly available):

"First, the perioperative mortality rate in the present series was low (.1%). These results are consistent with those from other reports. Buchwald et al. [11], in a series of 190 BPD-DS procedures (168 open and 32 laparoscopic) did not experience any 30-day mortality. Prachand et al. [12] experienced 1 death in a series of 198 laparoscopic BPD-DS procedures in superobese patients. Rabkin et al. [13], in a series of 345 BPD-DS procedures (27 laparoscopic and 318 hand-assisted) did not experience any mortality. In a recent meta-analysis of published mortality data after bariatric surgery [14], the mortality rate at ≤30 days for all restrictive procedures was .3% for the open and .07% for the laparoscopic procedures. The mortality rate for RYGB was .41% for the open and .16% for the laparoscopic procedures. Large single-institution series of laparoscopic RYGB have also reported the same level of mortality, at .14% [15]. The results of the present study suggest that BPD-DS can obtain similar mortality rates."

"The reasons for the amelioration of the mortality rate associated with BPD-DS in the past few years are probably multifactorial. First, it has been previously demonstrated, for other types of surgeries, that the overall morbidity and mortality rate can be decreased in “high-volume” centers [16], especially for higher risk patients. Also, a general trend has occurred in the improvement of mortality and morbidity rate over the years, with overall improvement of preoperative preparation of the patients and medical, surgical, and nursing care. From 1991 to 2006, our mortality rate was 1% (22 of 2068). In the present survey, it decreased to .1%, with no other mortality in our whole bariatric population during the study period (1 of 1450)."

"That the duodenal anastomosis remains the demanding part in laparoscopic BPD-DS is expressed by a 2.6% leak rate at that level versus no leak at the level of the sleeve gastrectomy. We developed some modifications of our technique to correct that problem and now use a hand-sewn technique. With these modifications, our leak rate has decreased to 1% (1 of 92)."

"One of the concerns that remains with BPD-DS is the long-term risk of nutritional deficiencies. However, other reports with longer follow-up have shown that severe nutritional deficiencies are rare with good long-term follow-up and adjustment of vitamin supplements [18]. "  
Surgery for Obesity and Related Diseases
Volume 9, Issue 1 , Pages 63-68, January 2013
Perioperative complications in a consecutive series of 1000 duodenal switches
Presented to the 28th Meeting of the American Society of Metabolic and Bariatric Surgery, Orlando, June 2011.

Laurent Biertho, M.D.email address, Stéfane Lebel, M.D., Simon Marceau, M.D., Frédéric-Simon Hould, M.D., Odette Lescelleur, M.D., Fady Moustarah, M.D., M.Sc., Serge Simard, M.Sc., Simon Biron, M.D., M.Sc., Picard Marceau, M.D., Ph.D.

"Certain hypotheses, or rather speculations, can be drawn from the shifting percentages of the type of procedure being performed. Over time, a given operation’s weight-loss efficacy decreases and long-term complications increase. This predictable evolution could explain the drop in AGB in Europe, with the longest history of AGB in the world, and the decrease in RYGB in the USA/Canada grouping, with the longest history of RYGB in the world. With the overall number of operations essentially constant, a reduction in the number of a given operation must be balanced by an increase in the number of another. Worldwide, this increase has occurred in the number of SG performed, which rose from 0.0 % 8 years ago to over 25 % today. Another factor in the global popularity of SG may be faddism; surgeons and patients are not exempt from gravitating toward the latest innovation, even in their choice of a surgical operation.

A reason rarely discussed in the choice of operations is the skill of the surgeon. The numbers of BPD/DS remain extremely low (