Which Weight Loss Surgery to Choose?

Question

I'm a 23 y/o woman, 5'3", and weight 330lbs. I'm having trouble choosing which weight loss surgery to get. I'm between the sleeve and duodenal switch. I know I have a lot of weight to lose, which makes the sleeve not as ideal, but I also want to maintain as much of a "normal" diet as possible. I want to occasionally go out for ice cream with friends or eat churros when I travel to Spain, which makes me hesitant to choose duodenal switch.

Ali Solmaz, MD · Answer

If you want to prioritize food flexibility (enjoying ice cream or churros on occasion) and avoid strict lifelong supplement regimens, the gastric sleeve might be a better option. Yes, it may not produce as dramatic weight loss as the duodenal switch, but with good dietary habits and consistent follow-up, many people still achieve excellent results. If you’re open to being patient with your weight loss journey and okay with the possibility of needing a follow-up procedure, the sleeve could fit your lifestyle best.
However, if you’re committed to losing as much weight as possible and want to avoid the chance of needing a second surgery, the duodenal switch might be the better option. Just keep in mind that your diet will be stricter, and you'll need to follow a strict supplement regimen for life. Since you mentioned wanting to maintain a sense of "normal" in your diet, this might feel a little restrictive.
Therefore, both options have pros and cons, but it comes down to your priorities. If you value dietary freedom and a simpler procedure, the gastric sleeve may be a better match. But if your main goal is to lose as much weight as possible with less risk of regain, the duodenal switch offers a more powerful solution. It's also worth having a consultation with a bariatric surgeon, as they can assess your overall health, lifestyle, and goals to guide you in the right direction.

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