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Help me decide: BPD/DS vs SADI-S



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Hi all -

I weigh 305lbs and my surgeon has recommended that I have either BPD/DS or SADI. I don’t have any comorbidities. It’s a center of excellence and he has extensive experience with both. I’m a physician, have read up extensively and feel like I have a good handle on the expected weight loss and complications. However I don’t have a good sense of the differences in lifestyle and food choices between the two procedures.

Please, could those of you who have had these procedures help me understand:

- What foods do you avoid? (Fatty foods? Carbs? Can you tolerate small amounts?)

- Do you have diarrhea?

- How many Vitamins do you take? Have you experienced Vitamin deficiencies? Have you had to get infusions?

- Do you struggle to maintain your weight loss? Do you feel like you are constantly on a diet?

- Anything else you wish you had known before surgery?


Thanks so much!



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Welcome to the forums.

There are brilliant folks around here that can help provide you all the information on these. I am not one of these.

I'm here to say welcome, which I satisfied in the first sentence. The rest is just pleasant chit-chat.

Good Luck,

Tek

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Hello. I am about four months out from my DS surgery with sleeve and I can answer some of your questions -- but as always, your experience may vary.

Avoided Foods - I prioritize Protein over everything else, and that will be the rest of your life. As a DS patient, you'll need to get in at least 130g of protein in every day, which is no small amount. Fats are not as big a deal to avoid as carbs are. Carbs should be a no-no for you, with no more than 40-50g per day. You will get all of that just from yogurt and the foods with protein. It is definitely a diet-restrictive procedure. Be prepared for it. I can tolerate these foods, but every ounce of food I can stomach HAS to be protein or I miss my goals for the day.

Diarrhea - Not in any way. Prepare for constipation due to your diet. There are days I wish I had diarrhea.

Vitamins - I take one Bariatric Multivitamin with Iron per day. Be sure to use bariatric vitamins and not regular vitamins.

Weight loss - Since I am only four months post-op, I can't answer long term, but in the short term, I've lost over 100 pounds in four months. It will come off as long as you exercise and get your fluids and protein in. My friend is 18 months post-op and is at maintenance weight. He has had no issues with regain.

Anything else - I wish I had known how difficult getting protein in every day is. I can do it with shakes alone, but since you can't drink anything for 30 minutes prior to or an hour after eating solid food, you're limited in your options. Also, I can only eat 3 ounces of solid food at a time, so you can imagine how tough it is to get the protein in.

All in all, I am thrilled I got the surgery. I was immediately cured of diabetes and am feeling better than I have in 20 years. My non-scale victories are even better than the scale losses and I couldn't be happier. All my focus on food is gone and I eat only to accomplish a goal. If you're considering it, really be prepared for the challenges. Watch videos of people who have gone through it on Youtube. Those help.

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3 minutes ago, SAsurgery said:

Thanks Ricky. That’s super helpful.

Did you have the traditional duodenal switch or the SADI-S surgery?

I had the traditional DS.

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I am 6 years out from surgery.

I started out at 371. I am now at 234.
I’ll answer your questions in the order you asked them:

- What foods do you avoid? (Fatty foods? Carbs? Can you tolerate small amounts?)

Foods I avoid: Rice! and Carbonated beverages. Both have a very negative effect on my stomach even now. Rice seems to grow once it gets in my stomach causing it to feel overfull. Carbonated beverages are to be avoided anyway but occasionally it’s the only thing around to sip and never has there been a time that I didn’t regret it!

- Do you have diarrhea?

Occasionally but it’s rare and usually something I know is going to happen. constipation is a bigger issue and my go to remedy is a slice of plain cheesecake. Seriously. It works better than anything else. To help keep things moving I am sure to add real butter to any carbs I eat. Sometime I use MCT oil to help keep things moving but be careful cause it can cause very loose stool.

- How many Vitamins do you take? Have you experienced Vitamin deficiencies? Have you had to get infusions?

I use PERSONA now for Vitamins They do an assessment that determines your Vitamin needs for me that is one Bariatric Multi, 8 Calcium Citrates spaced out in three doses, Vitamin D, and a Probiotic. I was seriously anemic and had to do Iron infusions until I had a hysterectomy July 2019. Now I’m normal and won’t need them again. I take powdered collagen in my coffee everyday to keep my hair growing, my skin from drying, and my muscle from aching.

- Do you struggle to maintain your weight loss? Do you feel like you are constantly on a diet?

Weight loss is a constant struggle, you will not lose on a smooth downhill slide. It will fluctuate and drop suddenly then rise and fall like ocean waves. Keeping the weight off is the challenge and with the DS weight gain is less likely it still is very possible if Carbohydrates are your source of comfort in times of struggle and stress. You won’t feel like you are on a diet, you will feel like you are a slave to your stomach. You’ll spend an hour making the most delicious meal and take two bites and be full. You’ll find that foods you once loved now don’t make your new stomach all that happy. But with all that you lose and all that is frustrating comes so much amazing stuff like feeling average sized. Shopping in a average clothing store, sitting in theater seats or airplane seats or really any seats and not worrying about what the person next to you might think. Saving so much money cause you can split meals with friends.

 - Anything else you wish you had known before surgery?

My words of advice: find a local support group or an online one if you can’t find one in your area and stay faithful to going to meetings and events for at least one full year but two would be better. Your family and friends will have no idea what you are going through and will say things that will be surprisingly hurtful but they won’t mean it that way, like “Wow, you look how small you’ve gotten!” (Internal thought: I must have been huge) You’ll need people who know not to say those things and instead say “You are making great progress! I am so glad to see you again!”

Good Luck!

It gets better!

Walk Sip Walk Sip

Never Trust a Fart! 😜

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11 hours ago, SAsurgery said:

Please, could those of you who have had these procedures help me understand:

- What foods do you avoid? (Fatty foods? Carbs? Can you tolerate small amounts?)

- Do you have diarrhea?

- How many Vitamins do you take? Have you experienced Vitamin deficiencies? Have you had to get infusions?

- Do you struggle to maintain your weight loss? Do you feel like you are constantly on a diet?

- Anything else you wish you had known before surgery?


Thanks so much!

I'm 8 months out from the Loop DS (or SADI-S). My surgery weight was 321 and right now I'm 222 so a 99 pound weight loss so far.

-I avoid wheat products like the plague. They tell you that you won't get dumping syndrome and I call bullsh*t because wheat makes me dump. I try and avoid overly carb-y foods but I still get about 60 carbs in a day. I also try and avoid overly fatty foods because it does bring about diarrhea if I have too much.

-I do occasionally have issues with diarrhea. Usually when I've had a little bit too much fat in my diet (I love my cheese a little more than I should). I used to take three bariatric multi's with Iron a day but I process iron a little too well so I would get massive constipation issues and they suggested I lower to two but I still had that issue so now I do the switch as listed below.

-For Vitamins I take one bariatric multi with iron and two bariatric multi's without iron one day and then the next I switch it to two bariatric multi's with iron and one without. Also take two calcium citrate a day. And due to having a Vitamin A deficiency I take extra Vitamin A as well.

-I don't struggle to maintain my loss. It's more frustration when I hit stalls. Mine happen probably more frequently than the average person due to hypothyroidism and it gets really frustrating. I've had my meds upped three times already and I really feel they need to be upped again but my doctor won't test my thyroid until November... And yeah, you are AWARE you are on a diet. But you have to change your way of thinking. It's a LIFESTYLE change. There will be times you want to cheat and if you do don't beat yourself up about it if you have a cookie or something.In my own experience though your taste buds change and you crave different things. For some reason I'm constantly craving fruit. Though I do get chocolate cravings and I bought Protein Bars and sugar free pudding for that particular craving.

-Things I wish I knew before surgery? Well, I wish I knew about how frustrating and frequent the stalls can be with someone who has hypothyroidism. I also wish my doctor had warned me that it's a POSSIBILITY that you can vomit blood the first few days following surgery. It was scary when I first vomited blood and I thought something was wrong and then the nurse was like "honey, it's just old blood, it's totally normal" -_-' It's probably either because of my vitamin regiment or my dairy intake but every two days my system decides to empty EVERYTHING in it so I spend an hour or so locked in the restroom (TMI, sorry). And I'm sure there's more that I wish I'd known, but my brain is stalling lol. If I can think of something else I'll add to this post later.

Oh, a person a few posts up said that you need 130g of Protein BUT my surgeon said between 80-100 (but I'm a girl so...). I usually get around 90-95g of protein a day. And that's with only one 30g Protein Shake in my diet. So it's possible to do it with only one protein shake eventually. Also my labs said my protein intake was perfect so...

Edited by NovaLuna

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5 hours ago, dsdesigna said:

I am 6 years out from surgery.

- Do you have diarrhea?

Occasionally but it’s rare and usually something I know is going to happen. constipation is a bigger issue and my go to remedy is a slice of plain cheesecake. Seriously. It works better than anything else.

dsdesigna - thank you! This was incredibly helpful. Did you have traditional DS surgery (BPD/DS)?

Can I pick your brain a bit more. I’ve seen every people say (jokingly) “never trust a fart” - are “accidents” common after DS surgery?

Also I’m going to update my original post to ask: do you fart a lot? Only after eating certain foods? Does it cause embarrassment at home or work?

THANK YOU!

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1 hour ago, NovaLuna said:

I'm 8 months out from the Loop DS (or SADI-S). My surgery weight was 321 and right now I'm 222 so a 99 pound weight loss so far.

NovaLuna - congratulations on your amazing weight loss! Thank you for taking the time to respond.

I have heard from others that people with DS and SADI can dump even if they aren’t “supposed to”.

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I can’t figure out how to edit the original post.

One more question:

Do you fart a lot? Only after eating certain foods? Does it cause you embarrassment at home or work?

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25 minutes ago, SAsurgery said:

I can’t figure out how to edit the original post.

One more question:

Do you fart a lot? Only after eating certain foods? Does it cause you embarrassment at home or work?

Only if I have any excessive amount of sugar alcohol. If it's just a tiny amount I'm good, but any more than a little and it's pretty bad. I'm pretty good about avoiding it though so it's a rarity that I go over the amount that my body can handle.

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@SAsurgery

Hi. I'm 15 1/2 years out from a traditional DS.

- What foods do you avoid? (Fatty foods? Carbs? Can you tolerate small amounts?) I eat fatty foods. It helps to "grease the wheels" so to speak. For instance, I buy 80% chopped ground beef as I need the fat. It does generally takes me 2 sittings to finish a meal.

- Do you have diarrhea? Sometimes. My doctors classify diarrhea as going too much and/or going liquid. I'm more in the too much area. This will occur if I eat junk and/or too many simple carbs. That's why I eat them pretty much only at home. If you have diarrhea and you're not sure why, it can signify it's time for a dose of Flagyl. Many DSers I know take it yearly and I probably should, too. Just to keep things even.

- How many Vitamins do you take? Have you experienced Vitamin deficiencies? Have you had to get infusions? I take over 40 a day. It's second nature. As a matter of fact, when I wasn't permitted to take them while going through gb surgery, I went a little nutty. I'm just so used to it after so long.

I've had some issues with my bloods. Sometimes the numbers are too high, other times too low. My surgical group has me do them every 6 mos. so tweaks can be made to what I take.

The only infusion I take is Reclast. But I know a good many DSers who need Iron infusions. That's never been an issue for me.

- Do you struggle to maintain your weight loss? Do you feel like you are constantly on a diet? No and no (and we don't count calories). I kept a food log for the first 6 mos., now I have a Protein ticker in the back of my head that just checks off protein grams. I eat 125-150gr/day so I'm constantly eating protein. Just had my mid-morning snack which was cheese and nuts. I also keep it low on the simple carbs. I don't want the weight gain or the gas/stool issues. I'll probably grab a triple cheeseburger w/catsup from McD later if I'm hungry in the afternoon. I just eat the meat. First, bc the bun is too filling and I always eat protein first. Second, bc I don't want what will come with the carbs.

- Anything else you wish you had known before surgery?

Do a Dexa scan preop. So you can have a baseline.

Keep all your blood work. I have it since preop. It allows me to look for trends (esp. the last 3 draws) and also can help out if there's an issue. Some DSers I know have made a spread sheet for their blood work.

I've never missed a day of supplements. I expect as a Dr. you won't either. 😊

Edited by Postop

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55 minutes ago, Postop said:

@SAsurgery

Hi. I'm 15 1/2 years out from a traditional DS.

Dear Postop

Thank you for sharing your journey with me. It’s so helpful to hear from folks who are several years out. It sounds like you have been successful with only minor complications or quality of life issues. That’s what I am hoping for.

I hope this isn’t too personal of a question. Do you experience a lot of gas? Is it associated with simple carbs? Does it cause any problems in your home or work?

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