Difference in SIPS-DS lifestyle

Joined
Nov 3, 2015
Messages
17
Location
Longwood, FL
I'm new here and have read many of the posts re SADI/SIPS and DS procedures and have picked up a few differences re lifestyle changes, but am unclear on the full picture. Can anyone refer me to a resource that lays out what the differences may be in diet, exercise requirements, supplements, limitations, medications, etc? At this point, I'm ok with the difference in the surgeries and understand the potential different outcomes. I'm more concerned about the lifetime lifestyle changes and being able to handle those. Any assistance would be appreciated!
 
Greetings @Readyforchange and welcome. I don't have all the answers and I'm not in the medical field at all, but I did research the SIPS/SADI procedures as an alternative to the traditional DS. I could find absolutely nothing about the SADI vs DS diet; the only thing that tipped me off that the requirements will be somewhat different is that promotional materials keep saying "moderate" malabsorption and "patients report significantly less malabsorptive symptoms" because of the longer common channel, which is about twice that of standard DS. (http://www.centerforweightlosssurge...ss-surgery/single-anastomosis-duodenal-switch and other sites). Since that longer common channel will be able to absorb more nutrients as well as fats, I would think that SADI patients would need to limit their fat intake way more than traditional DS patients.

As for vitamin supplementation, the only thing I could find was in the conclusion of an journal article at http://www.omicsgroup.org/journals/...ional-outcome-2165-7904-1000268.php?aid=54710

It states that "Postoperative supplementation with iron, multivitamins, calcium and vitamin D may be required continuously to prevent nutritional deficiency especially for adults and females in the child bearing period."

Like I said, I am no medical authority but what I got out of my research is that there isn't any long-term data on weight loss maintenance with SADI/SIPS, and I'd still need to be on a regimen of vitamins to prevent deficiencies (albeit maybe not in as high amounts), and I'd lose the ability to consume fats as freely as with the traditional DS. That and the complication rates were nearly identical. For ME, the choice was clear... I didn't want to go with yet another surgery with no long term data (I'd had the lapband when there wasn't long term data and that was a mistake for me), and I knew that the traditional DS diet would work perfectly for me whereas I wasn't sure about the SADI/SIPS requirements. I wanted something I knew would work and that I could live with so traditional DS won out.

HOWEVER, this is a very individual thing. If you are comfortable with it and think that's the right choice for you, then that IS the right way to go. We don't have a lot of SADI/SIPS members here so if that's the way you decide to go, maybe you can help the ones who come after you who are researching this alternative.

I wish you the best of luck :)
 
Welcome @Readyforchange
Can anyone refer me to a resource that lays out what the differences may be in diet, exercise requirements, supplements, limitations, medications, etc? At this point, I'm ok with the difference in the surgeries and understand the potential different outcomes. I'm more concerned about the lifetime lifestyle changes and being able to handle those. Any assistance would be appreciated!
There isn't a whole lot out there yet.

The reasons:
1) The relative newness of the surgery. At most it's about 5 years out in Turkey...about 2 to 3 years out here in the US. The DS, OTOH has been around since 1988 so we have quite a few out there over 10-15 years out now.
2) Many are calling it "just like the DS but better" so all the potential patients read up on the DS and figured it was the same.
3) As a result of the 2nd item, many patients think they actually have the DS.

We do have a few who have had the surgery...but it's gonna be a few years before things are figured out and the patients discover what the SIPS lifestyle is like.

Good luck with your choice.
 
Thanks! Appreciate the feedback and welcome! I started looking into bariatric surgery last year, but had to put it off because of insurance requirements and work schedule. I have covered the insurance requirements and have to push to get this done now by the end of December because of work schedules. If I can't get it then, I will have to wait until next October. Last yeat, the practice didn't offer DS or SIPs, but Dr. Smith has since joined the practice in Celebration and I just found out about it on Monday. They explained the difference in the two as far as the procedure, risks, etc., but it wasn't until I l found this forum and started reading more that I realized there was no distinction made as far as dietary requirements, lifestyle over the long term. The DS does scare me a little more (it seems more extreme), but at the same time I know I am not as disciplined as I should be with sticking to a specific diet and can't guarantee becoming really active afterwards because of bad arthritis and back issues. Those 2 factors now have me considering the DS as the most likely to have a good long-term result. I'm not sure which way I'll go--they said I don't have to make my mind up until the day of the surgery, if need be. But I'm ruling out the RNY based on what I have learned here!

Thanks to all for your insights!
 
If your surgery is being covered by insurance, you also need to consider whether or not their coverage for the Ds includes coverage for SIPS, which is largely considered experimental and generally not covered by insurance. What we've seen in some cases is surgeons using the DS code for SIPS, and insurers being more than a tad bit upset when they figure this out afterwards (with some nasty results for at least one patient being billed after the fact) and other surgeons using very creative combinations of codes to get SIPS covered, which again is something that could come back to bite you in the butt later.
And if you are interpreting the things said here to mean that the post-op diet is the same, I believe you are not getting the part about selective fat malabsorption with the DS. We absorb only about 20 % of the fat we consume, which allows for using all forms of protein and not just lean protein, using cooking methods that include fat or oil, etc. With SIPS, while we don't have good data, it would seem that with the much longer common channel there would be much more at absorption, and thus the diet would need to be much more careful about fat consumption.

For me, the lack of long term data alone would be a deal breaker. But you must make your own decision.
 
If your surgery is being covered by insurance, you also need to consider whether or not their coverage for the Ds includes coverage for SIPS, which is largely considered experimental and generally not covered by insurance. What we've seen in some cases is surgeons using the DS code for SIPS, and insurers being more than a tad bit upset when they figure this out afterwards (with some nasty results for at least one patient being billed after the fact) and other surgeons using very creative combinations of codes to get SIPS covered, which again is something that could come back to bite you in the butt later.
And if you are interpreting the things said here to mean that the post-op diet is the same, I believe you are not getting the part about selective fat malabsorption with the DS. We absorb only about 20 % of the fat we consume, which allows for using all forms of protein and not just lean protein, using cooking methods that include fat or oil, etc. With SIPS, while we don't have good data, it would seem that with the much longer common channel there would be much more at absorption, and thus the diet would need to be much more careful about fat consumption.

For me, the lack of long term data alone would be a deal breaker. But you must make your own decision.
Thanks, Larra. I hadn't considered the insurance aspect, and will check into it. I certainly appreciate the flexibility the DS offers re the fat intake and greater assurance of weight loss maintenance and overall success. The greater risk of problems with chronic diarrhea and larger diversion of the intestine seems scary. But hearing the success stories here and learning more about it is reassuring. I'm glad I stumbled across this forum!
 
Keep reading and learning. I hope SIPS replaces that nasty RNY. But I don't believe SIPS is going to give the DS a run for it's money long term. The DS simply gives you your best shot at getting thin and staying thin. Keep on reading and researching! Think twice, cut once!
 
Thanks! Appreciate the feedback and welcome! I started looking into bariatric surgery last year, but had to put it off because of insurance requirements and work schedule. I have covered the insurance requirements and have to push to get this done now by the end of December because of work schedules. If I can't get it then, I will have to wait until next October. Last yeat, the practice didn't offer DS or SIPs, but Dr. Smith has since joined the practice in Celebration and I just found out about it on Monday. They explained the difference in the two as far as the procedure, risks, etc., but it wasn't until I l found this forum and started reading more that I realized there was no distinction made as far as dietary requirements, lifestyle over the long term. The DS does scare me a little more (it seems more extreme), but at the same time I know I am not as disciplined as I should be with sticking to a specific diet and can't guarantee becoming really active afterwards because of bad arthritis and back issues. Those 2 factors now have me considering the DS as the most likely to have a good long-term result. I'm not sure which way I'll go--they said I don't have to make my mind up until the day of the surgery, if need be. But I'm ruling out the RNY based on what I have learned here!

Thanks to all for your insights!
Hi there! New here and in same boat as you and just learned dr. Smith was nearby. He does perform SIPS?
 
Hi there! New here and in same boat as you and just learned dr. Smith was nearby. He does perform SIPS?
Not to my knowledge.

Is there a reason for wanting the SIPS rather than the DS? Esp since the SIPS is still experimental (still in clinical trials) and will most likely be years before being covered as a standard of care with insurance companies?
 
I am still researching my options, not sure which direction I am going yet other than I know I don't want RnY. So I am looking at one extreme (sleeve) to the other (DS) and it feels like the sips is somewhere in between. But I am still learning/researching.
 
Not to my knowledge.

Is there a reason for wanting the SIPS rather than the DS? Esp since the SIPS is still experimental (still in clinical trials) and will most likely be years before being covered as a standard of care with insurance companies?
Yes, Dr Smith does both SIPS and DS. He's part of a data research project for SIPS. You don't have to be part of it to have the surgery and there is no financial incentive for participating in it.
I'm tentatively scheduled to do the DS with on the Dec 17th or 31st pending insurance approval and pre-op scheduling. I decided after looking at more information on the two that I would rather go with the DS than the SIPS. I want to the procedure with the greatest likelihood of success and long-term retention of weight loss. The DS scared me at first, seeming to be more drastic, but after further research and consideration, I decided that for me, the risks did not outweigh the benefits and the complications from SIPS seemed just as worrisome. Because I went with the DS, we didn't find out if my insurance will approve SIPS or not, but that definitely would have been a consideration for me. Hope that helps!
 
I want to the procedure with the greatest likelihood of success and long-term retention of weight loss. The DS scared me at first, seeming to be more drastic, but after further research and consideration, I decided that for me, the risks did not outweigh the benefits and the complications from SIPS seemed just as worrisome. Because I went with the DS, we didn't find out if my insurance will approve SIPS or not, but that definitely would have been a consideration for me. Hope that helps!
It does, :)
 
My surgeon is the head of GI surgery at Duke, and runs the programs for the bariatric fellows. He only does sleeve, SIPS, and DS. His opinion is that the number of complications and weight regain with bypass and band procedures doesn't merit including them. I would say the key is to get the right surgery for you. I came to my doctor with a BMI under 36 specifically interested in a DS. We talked about it, and his guidance was that I was probably a little thin for a DS. Duke was beginning a study of DS/sleeve/Sips patients, and I was the first SIPS patient at Duke, which has its own complications..(story for another day). I've been very successful. I do work out a good deal, but I just bought size 2 pants. I was almost an 18 when I went in for my surgery in February. All of my tests and bloodwork have been on the money without a super complicated supplement regimen. I am down a total of 130 lb. I lost the first 50 myself before surgery. I was diabetic or particularly unhealthy, but despite losing the 50 lb on my own, my blood sugar and cholesterol numbers were headed in the wrong direction, so I wanted a more durable procedure. I will be in this study for a total of 4 years, so there should be some decent data by the end.
 
My surgeon is the head of GI surgery at Duke, and runs the programs for the bariatric fellows. He only does sleeve, SIPS, and DS. His opinion is that the number of complications and weight regain with bypass and band procedures doesn't merit including them. I would say the key is to get the right surgery for you. I came to my doctor with a BMI under 36 specifically interested in a DS. We talked about it, and his guidance was that I was probably a little thin for a DS. Duke was beginning a study of DS/sleeve/Sips patients, and I was the first SIPS patient at Duke, which has its own complications..(story for another day). I've been very successful. I do work out a good deal, but I just bought size 2 pants. I was almost an 18 when I went in for my surgery in February. All of my tests and bloodwork have been on the money without a super complicated supplement regimen. I am down a total of 130 lb. I lost the first 50 myself before surgery. I was diabetic or particularly unhealthy, but despite losing the 50 lb on my own, my blood sugar and cholesterol numbers were headed in the wrong direction, so I wanted a more durable procedure. I will be in this study for a total of 4 years, so there should be some decent data by the end.
Thanks for sharing your story! A congrats on the weight loss - that's an inspiration! Unfortunately, my BMI is much higher (54) and, while I have been able to lose as much as 50 lbs, I have never been able to keep it off. I want to make sure I do the right surgery, but am now concerned the SIPS will be enough to keep any weight I lose off. I'd love to hear more about your experience, Esp any complications you've had. Thanks again!
 

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