Posted - June 5, 2024

BMI Over 40? The Duodenal Switch is Your Best Option.

The duodenal switch (DS) is considered one of the best options for people with Body Mass Index (BMI) over 40 due to several reasons

Knowing which weight loss option is right for you can be confusing, overwhelming and even a little scary. A quick Google search will provide you with a nearly unlimited list of the “best” ways to lose weight. But for those who continue to struggle and continue to put on pounds, there ARE options that can give you real results that last a lifetime. One of those is the duodenal switch.

The duodenal switch (DS) is considered one of the best options for people with Body Mass Index (BMI) over 40 due to several reasons:


  1. Superior Weight Loss

The duodenal switch typically results in greater weight loss compared to other bariatric procedures like gastric bypass or sleeve gastrectomy. Patients can lose up to 70-80% of their excess weight within two years post-surgery.


  1. Better Long-Term Maintenance

Studies show that patients maintain their weight loss more effectively over the long term with DS compared to other procedures. This is crucial for individuals with high BMI who are at greater risk of regaining weight.


  1. Improved Metabolic Outcomes

DS has a significant impact on metabolic health, improving conditions such as type 2 diabetes, hyperlipidemia, and hypertension. It’s particularly effective at improving insulin resistance and glycemic control, often leading to remission of type 2 diabetes.


  1. Dual Mechanism of Action

The procedure combines two techniques: a sleeve gastrectomy and a bypass of a large portion of the small intestine. This dual mechanism not only restricts food intake but also reduces the number of calories and nutrients absorbed by the body, enhancing weight loss and metabolic benefits.


  1. Reduction in Comorbidities

Obesity-related conditions such as sleep apnea, arthritis, and cardiovascular diseases see significant improvement or even resolution after DS. This can greatly enhance the quality of life and longevity for patients with a high BMI.


  1. Durability

DS tends to have more durable results in terms of weight loss and health improvements, reducing the likelihood of requiring additional procedures or revisions compared to some other bariatric surgeries.


Considerations and Risks

Despite its benefits, DS is a more complex and extensive surgery with higher potential risks and complications, including:

Nutritional Deficiencies

 Due to the malabsorptive component, patients must commit to lifelong vitamin and mineral supplementation and regular monitoring to prevent deficiencies.

 Surgical Risks

The procedure carries higher surgical risks and a longer recovery time compared to other bariatric surgeries. Potential complications include infections, leaks, and bowel obstructions.

Lifestyle Commitment

Post-surgery, patients need to adhere to strict dietary guidelines, including high protein intake and avoidance of certain foods. Regular follow-up with healthcare providers is essential.


So what’s the takeaway? For individuals with a BMI over 40, the duodenal switch offers substantial and sustained weight loss along with significant improvements in obesity-related comorbidities, making it a highly effective option. These benefits must be weighed against the risks and the need for a lifelong commitment to dietary and medical follow-up. Any decision on weight loss surgery should start with a consultation with a qualified bariatric surgeon, specifically one trained and experienced in duodenal switch surgeries.

Dr. Folahan Ayoola of Weight Loss Specialists of North Texas is a nationally recognized bariatric surgeon who regularly trains other surgeons on how to perform robot-assisted duodenal switch procedures and he’s ready to help you. His approach is to offer compassionate care that gets results with no blame and no shame. Reach out today to schedule a visit.