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Surgeons Reveal Most Effective Weight Loss Surgery for Heaviest of Patients

Tim Boyer's picture
Duodenal switch procedure for most obese patients

According to news from the Penn State Milton S. Hershey Medical Center, the best weight loss option for the heaviest of patients may be this specialized type of weight loss surgery that only a few surgeons offer.


You may have heard about the success overweight and obese patients have with gastric bypass or the gastric sleeve bariatric surgery procedures―the most common types of bariatric surgery performed at the Penn State Milton S. Hershey Medical Center. Typically, obese patients weighing in at around 300 pounds can drop down to 200 pounds within the first 12-18 months following the surgery using either of these two procedures.

But what if you weigh among the heaviest of obesity patients—approximately 600 pounds?! That loss of 100 pounds―even 200 pounds―following surgery will still leave you in a morbidly obese medical condition.

According to a news release from Penn State Milton S. Hershey Medical Center, the heaviest of patients may benefit more from a bariatric procedure referred to as a Biliopancreatic diversion with duodenal switch―or “duodenal switch” for short. A procedure offered by Dr. Ann Rogers, who points out that it may take more than a gastric bypass to help very obese patients.

Difference between a gastric bypass surgery and duodenal switch

“If someone comes in weighing 300 pounds and we can get them down to 200 with one of our more common operations, that is often good enough,” Rogers said. “But if someone comes in weighing 600 pounds and they get down to 400, they are still morbidly obese. The duodenal switch is the only operation we have where we are likely to help them get to an ideal body weight.”

So what’s the difference between the different types of weight loss surgeries?

With the gastric bypass procedure, surgeons divide and reconnect portions of the stomach and small intestines to make a smaller stomach pouch and shorter path for absorbing food. With the gastric sleeve procedure, a significant chunk of the stomach is removed leaving only a vertical, banana-shaped sleeve portion that allows even less room for food to occupy and thereby physically limit how much a person can eat during a meal. The duodenal switch in comparison borrows from both techniques, which leads to the patient unable to absorb nearly as much digested food and calories, but at the cost of risking malnutrition due to less vitamins and nutrients are prevented from being absorbed into the bloodstream as well.

Here is an animated video of the duodenal switch procedure:

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However, choosing the duodenal switch is not for everyone warns Dr. Rogers. Duodenal switch patients have to follow a much more rigorous diet and take additional nutritional supplements that requires routine blood testing and frequent follow-ups with their doctor.

“That’s hard for a lot of people,” Rogers said. “You have to be good as gold with this procedure in order to be successful.”

If the duodenal switch patient is not as “good as gold” he or she will likely experience unpleasant side effects such as chronic diarrhea, or face more serious health complications and potential malnutrition.

“This is something we have in our toolbox for patients in special cases,” she said. “But I don’t put it out there for everyone. The patient has to ask me for this and convince me it is going to be a good choice for them.”

For more information about the various bariatric surgery procedures for weight loss, here is a sampling of related articles:

Lesser Used Surgical Method Actually Results in More Weight Loss

Here’s Why “The Sleeve” is the Preferred Weight Loss Surgery Procedure

New Weight Loss Procedure for Patients Not Obese Enough for Bariatric Surgery

Weight-loss Surgery Warning Hints it’s Really Not a Simple Decision

Reference: Penn State Hershey News “The Medical Minute: When duodenal switch may be the best weight loss option