Duodenal switch surgery is more effective than other weight loss procedures, but it also involves more risk.

Duodenal switch surgery combines two complex weight loss procedures — a sleeve gastrectomy and an intestinal bypass — to form the most reliable weight loss procedure with long-term results.

Your surgeon will start by removing more than half of your existing stomach. This will limit how much food your stomach can hold.

Next, they’ll attach the first part of your small intestine (duodenum) to a lower portion of the small intestine. This limits how much nutrition your body can absorb.

As a result, your body will produce fewer “hunger hormones.”

Traditional duodenal switch surgery involves a large incision across the abdomen.

Duodenal switch surgery can now be performed laparoscopically. Laparoscopic procedures are less invasive and use smaller incisions. This typically speeds up the recovery time.

In a traditional duodenal switch surgery, the intestine is split at the duodenum and is reattached in two different places.

The updated modified (loop) duodenal switch surgery splits at the duodenum but only requires one reattachment. The modified loop technique also bypasses less of the small intestine, potentially resulting in fewer side effects.

Duodenal switch surgery is typically recommended for people with a body mass index (BMI) of 50 or greater.

People with a BMI of 40 or more may also be eligible for the procedure if they have an underlying condition related to obesity, such as:

The surgery may be particularly beneficial for people with type 2 diabetes, high blood pressure, and heart disease.

If you have previously undergone another bariatric procedure, including a sleeve gastrectomy or gastric bypass, talk with a healthcare professional. You may still be a candidate for duodenal switch surgery.

Insurance providers, including Medicare and Medicaid, may cover some or all of the cost of duodenal switch surgery.

Most insurance providers have a list of requirements that you must meet before they approve coverage.

This typically includes:

  • at least one letter of recommendation from a doctor or other healthcare professional
  • a well documented medical history demonstrating that you have tried other treatments for weight loss
  • having one or more underlying conditions related to obesity

According to the Bariatric & Metabolic Center of Colorado, duodenal switch surgery costs approximately $23,000 out of pocket. If you don’t have insurance, or your insurance won’t cover it, you’re responsible for the full cost of the procedure.

Many centers have financial assistance programs, including payment plans and other aid.

Duodenal switch surgery significantly reduces the amount of essential nutrients your body can absorb, increasing your risk of malnutrition.

People who get duodenal switch surgery are more likely to develop deficiencies in:

Long-term deficiencies could lead to anemia, kidney stones, and osteoporosis.

In severe cases, people who get duodenal switch surgery develop a form of protein-energy malnutrition due to malabsorption. If left untreated, this can develop into a life threatening condition called kwashiorkor.

The procedure also carries the same risks as other surgeries, including:

Your clinician will likely recommend outpatient testing about 3 weeks before surgery. This typically includes blood work, an X-ray, and an electrocardiogram.

About 2 weeks before surgery, you’ll likely start a liquid protein diet.

You’ll typically be asked to discontinue any over-the-counter medications known to increase bleeding in the week leading up to surgery. This usually includes ibuprofen and aspirin.

If you take prescription medications that thin the blood, don’t abruptly discontinue use. Consult with your clinician to determine if you should continue to take the medication or decrease use.

Your clinician may also ask you to avoid eating or drinking for at least 12 hours before surgery.

A doctor or other healthcare professional will administer general anesthesia before the procedure begins. The procedure may take up to 3 hours.

The first part of duodenal switch surgery requires reducing the stomach to a narrow sleeve. This modification restricts food intake and creates the feeling of fullness more quickly.

The second part of the procedure typically involves a cut at the duodenum and a cut near the lower intestine. The section of the lower intestine is brought up to the first cut and attached to the new stomach sleeve.

You’ll typically remain in the hospital for 2 to 3 days after surgery.

You may be able to return to work and other daily activities in as little as 2 to 4 weeks. Full recovery may take up to 6 weeks.

You’ll be on an all-liquid diet for the first 2 weeks following surgery. You’ll be able to incorporate soft foods into your diet during weeks 3 and 4. You’ll likely be able to eat solid foods by the end of week 4.

The American Society for Metabolic and Bariatric Surgery (ASMBS) recommends a daily supplement regimen to help prevent nutritional deficiencies.

Your clinician can offer more personalized guidance on:

  • which vitamins and minerals to supplement with
  • when you should start taking supplements
  • what dosage to take
  • how to monitor vitamin, mineral, and protein levels

Duodenal switch surgery requires a lifelong change in food habits. Eating foods high in fat and sugar, for example, may cause stomach cramping, excessive gas, and diarrhea.

Eating small but nutritious meals high in protein can help you maintain the results. Whole grains, vegetables, fruits, and foods high in omega-3 fatty acids may help you feel full faster and for longer.

How does duodenal switch surgery compare with other weight loss surgeries?

Duodenal switch surgery is considered the most reliable weight loss procedure with long-term results. It combines two different procedures — a sleeve gastrectomy and a gastric bypass — to aid in weight loss.

People who undergo duodenal switch surgery typically maintain their weight loss for many years after.

A 2008 study found that 50% of people who had a gastric bypass started to regain excess weight within 2 years of the procedure.

How quickly do you see the results or lose weight after duodenal switch surgery?

Maximum weight loss typically occurs within the first 3 years after surgery.

How much weight can you lose with duodenal switch surgery?

In a 2003 study, people who received duodenal switch surgery lost approximately:

  • 69% of their excess body weight in the first year
  • 73% of their excess body weight in 3 years
  • 66% of their excess body weight in 5 or more years

What’s the difference between duodenal switch surgery and gastric bypass surgery?

Duodenal switch surgery and gastric bypass surgery rely on a combination of restriction and malabsorption to lose weight, but they do so in differing degrees.

A greater portion of the stomach is removed during gastric bypass surgery. A larger portion of the small intestine is removed during duodenal switch surgery.

What’s the difference between duodenal switch surgery and gastric sleeve surgery?

Duodenal switch surgery is a combination of two different bariatric surgeries — one being gastric sleeve surgery.

People who undergo gastric sleeve surgery only experience a decrease in stomach size.

People who undergo duodenal switch surgery experience a decrease in stomach size and a decrease in small intestine size.

Duodenal switch surgery is a complex weight loss procedure. It’s designed to treat severe obesity and obesity-related conditions, such as type 2 diabetes.

Duodenal switch surgery is more effective than other bariatric procedures, but it also involves more risk. Consult with a doctor or other healthcare professional to learn more about your individual risk of complications.

Catasha Gordon is a sexuality educator from Spencer, Oklahoma. She’s the owner and founder of Expression Over Repression, a company built around sexual expression and knowledge. You can typically find her creating sex education materials or building some kinky hardware in a fresh set of coffin nails. She enjoys catfish (tail on), gardening, eating off her husband’s plate, and Beyoncé. Follow her everywhere.