Gastric Bypass vs Duodenal Switch

Duodenal switch surgery may be a better surgical procedure for achieving weight loss and control of comorbidity conditions, especially among the super-obese, according to a study published in the September issue of the Archives of Surgery.

The following chart provides a side-by-side comparison between the two procedures:

	RNY Gastric Bypass	Duodenal Switch

Surgical Risk	Moderate	High
Rate of Weight Loss	Rapid	Rapid
Average Weight Loss	60-85% of excess body weight within 12-18 months	75-90% of excess body weight within 18 months
Operating Time	1-2 hours	3-4 hours
Recovery Time	9-12 weeks	3-4 weeks
Hospital Stay	3 nights	2 nights
Time off Work	2-3 weeks	3 weeks
Reversible	Could be, but high risk	No
Medical Implant	No	No
How it Promotes Weight Loss	Restrictive & Malabsorption Limits food intake Reduces absorption of calories and nutrients	Restrictive & Malabsorption Limits food intake Food bypasses 45-60% of the small intestine, resulting in higher malabsorption and greater weight loss
Change to Intestine	Small intestine is cut and bypassed during RNY gastric bypass surgery	Reroutes "switch" a portion of the small intestine during duodenal switch surgery
Change to Stomach	New Stomach Created Stomach is divided into a small upper pouch 1 oz (20-30 cc) and a larger lower pouch	Stomach Size is Reduced 70-80% of the stomach is removed, creating a new small stomach (similar to gastric sleeve)
Bariatric Diet & Dietary Guidelines	800 calories per day during weight loss (12-18 months) 3 small protein meals per day Avoid sugar and fats to prevent dumping Avoid carbonated drinks Drink 6-8 cups of water a day Eat 1000-1200 calories per day after 18 months
New Eating Habits After Bariatric Surgery	Eat small portions daily Chew food throughly to puree consistency before swallowing Eat slowly Eat high-protein foods No drinking with meals, drink water 30 minutes before or after meals	Eat small portions daily Eat 4-6 times a day Chew food throughly to puree consistency before swallowing Eat slowly Eat high-protein foods No drinking with meals, drink water 30 minutes before or after meals
Bariatric Vitamins, Minerals & Nutritional Supplements	Multivitamin Calcium Iron Vitamin B12	Multivitamin Calcium Iron Vitamin A, D, E, K
Pros, Benefits, Advantages of Weight Loss Surgery	Rapid weight loss during the first 6 months Reduces food intake Reduces calorie intake Proven long-term effectiveness maintaining weight loss Most common and widely accepted weight loss surgery	Most powerful weight loss operation Most effective procedure for improving or eliminating diabetes (99% cure rate) Patients report longer lasting fullness Stomach surgery may reduce hunger by removing hunger-causing hormones About 200-400 calories may be lost via malabsorption
Cons, Risks, Disadvantages of Weight Loss Surgery	Blood clots Bowel obstruction Dumping syndrome Infection Leaks Nutrient deficiencies Reflux (GERD) Ulcers	Diarrhea Intestine blockage Protein and vitamin deficiency Highly technical operation Stomach removal is permanent, but intestinal bypass may be reversed Preoperative weight loss is critical to complete the procedure laparoscopically
Am I a Candidate for Weight Loss Surgery?	Gastric bypass is most effective for patients with a BMI of 35-55	Duodenal switch is best for patients with BMI > 50 Patients with BMI < 45 may lose too much weight
Bariatric Surgery Method	Laparoscopic Bariatric Surgery	Laparoscopic Bariatric Surgery
Learn More About Different Types of Bariatric Surgery	Types of Bariatric Surgery	Types of Bariatric Surgery

Gastric Bypass Surgery

Gastric Bypass Surgery is widely considered the “gold standard” and most common bariatric procedure in North America. Patients who choose gastric bypass vs duodenal switch typically have lower BMIs and are exposed to lower surgical risks compared with duodenal switch surgery.

Duodenal Switch Surgery

Duodenal Switch Surgery is a highly effective surgical weight loss option for morbidly obese patients with BMIs > 50. Studies show that duodenal switch results in superior long-term weight reduction and greater resolution or improvement in obesity-related comorbidities compared with gastric bypass surgery. However, the risk profile is higher for duodenal switch vs gastric bypass.

Considering Gastric Bypass or Duodenal Switch

No matter what type of bariatric surgery you choose – duodenal switch versus gastric bypass… making a serious commitment to behavior and diet modifications is critical to sustained weight loss.

Compare Differences Between Types of Bariatric Surgery