DS--What Do I NEED to Know?


New Member
I'm just beginning my research into this procedure after having VSG 2.5 years ago. VSG alone did not produce any weight loss after one month post-op, despite strict adherence to my surgeon/nutritionist's protocols. I have requested a consultation with Dr. Kashishian, but I'm looking for more information before I see him. I admit to knowing almost nothing. I've been reading many of the threads, and I don't have enough familiarity with everything to completely understand all that's being said. I thought I'd ask for a basic primer from you all, not a Cliff's Notes version per se, but some insight about the procedure and just what is required post-op. How do the requirements of a post-op DS patient differ from someone who has had VSG or RNY? It seems from the little I've been able to understand, that the differences are quite dramatic. I want to have my eyes wide open as I consider whether this is a viable option. I am perfectly content with major lifestyle changes; I'm not looking for a magic procedure. I've retained many of the good habits I learned prior to my VSG. I didn't happily waltz into surgery thinking I could eat anything I wanted and still lose weight. I made good choices initially but, unfortunately, I just didn't lose weight. Later, I did give up, then tried again, then gave up, etc. My BMI is 40. I've read elsewhere the procedure is not recommended for someone with a BMI under 50.

Any wisdom shared is appreciated.


Well-Known Member
Hi LAWoman and welcome!

I had my DS with a BMI of 43, after having a lap band and yoyoing around and never getting below 80kg. (I'm now in the low 60s with the DS.) The major difference is that the DS has the restriction element (with the sleeve) as well as the malabsorption (that you'd get with the RNY) but without losing the valve the controls how food moves from your stomach to your intestines (and so you won't be at risk for 'dumping syndrome').

The main lifestyle change is taking your vitamins for the rest of your life. Foodwise, minimal carbs help power your weight loss, but it's also the most forgiving of all the surgeries. After the band experience, it's a relief to have the option to eat anything without worries it'll get stuck (lap band life), and the negative consequences of a heavy carbs day for me is at most a little longer on the loo the next day. It's a truly human way of living that I don't think the other surgeries offer - you don't have to be a saint, and it allows you to still enjoy participating in the important social/cultural activities we wrap around food in our cultures.

I am now in the low 20s BMI-wise (I don't have scales as I'm travelling) and have been eating my way around Europe without any concern.


Full of Fairy Dust
OK! The DS is pretty much the best WLS out there. Bar none. It's pretty easy to live with for most. We could go out to dinner and you would never know I had surgery. I can eat anything. But keep in mind, I had surgery a LONG time ago. Immediately postop, your job is hydration. Then after you heal, you need to avoid every carb you can and lose as much as possible as fast as possible. Ideally you would lose down to 10% or so under your goal. Most do experience some kind of bounceback.

We eat a lot of protein and fat. Those are pretty much free foods. We avoid carbs. Do a lot of reading about low carb diets and you will know the drill. The results of the DS are a Bell Curve. All DS are not created equal. Some people can eat protein plus whatever for life. Many can't. I don't have a good DS. I still have to diet. But I just look like a quasi normal old bag. If you compare me to others in my age group I am OK. If you compare me to Angelina Jolie, I suck. There is no way to predict where you will end up on the Bell Curve.

The first few months are miserable for some and no big deal for others. But it does take time to adjust and learn how to eat again. You have to figure out how your new guts work. If you can, take more time off work instead of less. Not because you will be incapacitated. It's just to learn. My surgery was open and I had no issues. My insurance automatically gave me 6 weeks off and I took it. I could have gone back to work after 2 weeks but I just decided to enjoy the time off.

It will be work to get in the fluids and protein you need for the first few months. You need to carry fluids with you and sip constantly. You will not be able to just guzzle down a bottle of water but you are already living with the sleeve so there won't be a big difference for you.

We have to take a lot of supplements for life. It's not negotiable. If you are not willing to take a small handful of pills twice a day, the DS is not for you. Everyone has to figure out what works for them. I count out a week at a time and use two 7 day organizers. One is AM and 1 is PM. Most of us started with the vitalady.com DS list. Buy from wherever you want. BTW, I THINK we have an Amazon store here. If you are going to buy thru them purchase at our store please. It's the same price and it helps keep this site going and ad free! You will usually have labs done once a year and you will have adjust what you take over time. Some have issues and deficiencies and others do not. The most important thing to remember is just take the pills.

We all change over time. Our tastes change and our tolerances change. You have to be willing to adapt. You have to be willing to advocate for yourself. Most of the medical professionals you encounter will know much less about your surgery than you do. Most know very little about supplements. You have to know more than they do.


Well-Known Member
You cannot be stupid with the DS or you will kill yourself.

You make a life long commitment to follow your own labs, tweak your own vitamins to achieve good labs, and to always eat protein first.

If you can do those things, or are capable of learning, then go for it. Otherwise, just get the sleeve.