SIPS: The New Kid on the Bariatric Block
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revisionDS
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I can't understand how these surgeons are billing for SADi, it is experimental so it is not covered. I fear they bill for DS and patient is rolled out with SADI, that's fraud.
Elizabeth N.
Herder of cats
Howdy
. So glad to start seeing word from some folks who are more than a few weeks postop with the variations on this new procedure. Please hang around and continue to report how you're doing. It's going to be a while before there are any long-term (two-plus years) stats to report due to the lag time in getting studies conducted and published, so the testimonials are going to be VERY important for a long, long time. (This is *still* true of the DS and it's been done, talked about and published about for over 20 years.) If you know others who have had SADI or SIPS or whatever their surgeon calls a similar procedure, could you send them here to at least report in?
star0210
Well-Known Member
There are several people on OH who have had the Sadi.
Howdy
If you know others who have had SADI or SIPS or whatever their surgeon calls a similar procedure, could you send them here to at least report in?
Hi. Sure i will send them over here. I no on OH there are several people and i will foward the information to connect here.
Im doing well with the surgery so far. im trying not to loose anymore weight! I went from 268 to 109 lbs. My taste In food choices has changed in a healthy and positive way. I don't remember ever being this thin!! : )
Hiddenrose
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Hello hello - I know I'm about 10 years late to this thread but I was hoping to pick the brains of some of you historically knowledgeable participants. I've done a lot of reading and research, over this forum and others, and am hoping for some clarification. I'm working with a surgeon in Arkansas who previously did a Roux-y for a friend of mine, and came across promising data regarding the SIPS. I seem to be a good candidate, having also a desire to if possible one day be able to take NSAIDs again without fear of developing a hernia; PCOS, a family history of GERD, and a BMI of around 60. I've been taking my Bariatric vitamins for a few months, quit smoking with the help of Chantix, and been doing my best to log all food and liquid intake using one of the Bariatric Apps. That said, I sent a message to my surgeon to have them clarify if the SADI-s they are going to try to get insurance to cover for me, in 2024, has a split intestine like the SIPS or if it has the split as described for the SADI-s. I actually would be happier if it didn't continue to have the fat malabsorption, myself, as my experience with friends having weight loss surgery (3/4) end up in a situation where they can't keep themselves UP to a weight they are comfortable with. I'm rocking a size 32 now; I'd be thrilled to hover around a size 16. Can anyone out there tell me more about what to expect, if insurance IS covering this yet and if not, why, ten years later? I'm so thankful and not gonna lie, hoping I might be honored by "Bad Cop" Diana chiming in here! Thanks for your time!! <3
Here I am.
This is my current opinion - which is worth what you paid for it.
When I was prepping for surgery 21 years ago, I said that while I acknowledged that the DS was my best option at age 50, as a scientist I was confident that research into why the DS worked so well would result in a medication that would do something similar to what the DS does to correct our f’ed up metabolism, making bariatric surgery obsolete.
When my tiny skinny daughter started piling on weight during over 10 years of attempting to get pregnant with stage 4 endometriosis, a septate uterus and many fibroids, enduring so many surgeries and hormone treatments to harvest eggs and transfer embryos, I told her that when she was done with that phase of her life, she should try to just do the sleeve first. But as she got even heavier (she’s now about 230 lbs at 5’1”), it became clear that would probably not work. She gave up on IVF late last year and had a hysterectomy (they are pursuing adoption), and she’s prediabetic, so her doctor prescribed Wegovy, which she will finally be starting as soon as they can find the starter doses for her.
I can’t tell how old you are, what your comorbidities are, what your insurance situation is, etc., but if your BMI is ~60, I would not even consider the SADI. I suspect your weight loss would be inadequate, and the modest fat malabsorption that the SADI induces will likely substantially decrease after a year or so when your small intestine accommodates and absorbs more, so you will never get to goal and will regain much of what you initially lose. And I would find a surgeon who is very experienced with super morbidly obese patients and has done many traditional DSs.
Having said that, I would still try Wegovy or Zepbound first, if your insurance would cover it.
This is my current opinion - which is worth what you paid for it.
When I was prepping for surgery 21 years ago, I said that while I acknowledged that the DS was my best option at age 50, as a scientist I was confident that research into why the DS worked so well would result in a medication that would do something similar to what the DS does to correct our f’ed up metabolism, making bariatric surgery obsolete.
When my tiny skinny daughter started piling on weight during over 10 years of attempting to get pregnant with stage 4 endometriosis, a septate uterus and many fibroids, enduring so many surgeries and hormone treatments to harvest eggs and transfer embryos, I told her that when she was done with that phase of her life, she should try to just do the sleeve first. But as she got even heavier (she’s now about 230 lbs at 5’1”), it became clear that would probably not work. She gave up on IVF late last year and had a hysterectomy (they are pursuing adoption), and she’s prediabetic, so her doctor prescribed Wegovy, which she will finally be starting as soon as they can find the starter doses for her.
I can’t tell how old you are, what your comorbidities are, what your insurance situation is, etc., but if your BMI is ~60, I would not even consider the SADI. I suspect your weight loss would be inadequate, and the modest fat malabsorption that the SADI induces will likely substantially decrease after a year or so when your small intestine accommodates and absorbs more, so you will never get to goal and will regain much of what you initially lose. And I would find a surgeon who is very experienced with super morbidly obese patients and has done many traditional DSs.
Having said that, I would still try Wegovy or Zepbound first, if your insurance would cover it.
Hiddenrose
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Hello! Wow, I'm so honored that you took the time to reply to my thread; and so quickly! You are clearly a very educated individual, so your input is worth a LOT to me, actually! I'm 44 years old and my BMI is at 62 right now. My highest weight was 435, so being 'down' to 366 feels a significant amount better, I can promise you! That said - I've managed to drop almost 25 lbs by doing food logs since I started this most recent journey toward getting surgery. When I was younger I was a 'fluffy' girl from the age of approx 12+, and when I had my first child at age 19 I weighed 252. I had another child when I was just shy of 22, and then went on the Depro-Vera. That birth control shot was my downfall; as I gained about 125 lbs on it in a YEAR between depression and hormonal eating. I've never since been able to get my weight back down a manageable place, and from what I've read and am seeing as far as weight loss I feel like even though it is STILL considered obese I would be absolutely thrilled (I think I previously stated somewhere) to get down to between a size 16-18 and be able to stay there.
My insurance is NOT the greatest - I'm limited to state insurance and Medicare right now as my other degenerative conditions have made me temporarily settle for Disability - which I desperately want to get away from. The amount of pay out for Disability is NOT livable, and I certainly don't want to be stuck on it for the rest of my life! Problem is -- with my weight as significant as it is, any surgeries that might help me become more mobile and less medication dependent always seem to fixate on my age and my BMI. Knee replacement, for example - I have an awful family medical history and already have tricompartmental degeneration in all three facets of both knees - but insurance says "NO" before the age of 50, only potentially overcome with significant weight loss. This and my spinal degeneration are why I really would love to keep the option of NSAIDs on the table, if I could.
Insurance has been VERY unwilling to cover any kind of weight loss medication; heaven knows I've been trying for MANY years to make that happen. It's so confusing, especially since some of those medications offer a trial / partial expense covered - just not for those who HAVE insurance, even if your insurance won't cover it. Absolutely maddening. I own my poor dietary habits and their outcomes, a combination of blind eating, emotional eating, hormonal eating, and mobility issues have certainly taken their toll. It is interesting to me that you mention the weight loss potentially being inadequate; that didn't seem to be a concern to my surgeon - or at least not one he brought up. I felt like he would have been happy to do either the basic sleeve or the Roux-y surgery, just didn't want to fuss with the SADI-s because he said 'It wasn't all that different' and 'insurance still considers it experimental'. I'm definitely thinking through your response and again - am grateful to you for taking the time to discuss this with me!
My insurance is NOT the greatest - I'm limited to state insurance and Medicare right now as my other degenerative conditions have made me temporarily settle for Disability - which I desperately want to get away from. The amount of pay out for Disability is NOT livable, and I certainly don't want to be stuck on it for the rest of my life! Problem is -- with my weight as significant as it is, any surgeries that might help me become more mobile and less medication dependent always seem to fixate on my age and my BMI. Knee replacement, for example - I have an awful family medical history and already have tricompartmental degeneration in all three facets of both knees - but insurance says "NO" before the age of 50, only potentially overcome with significant weight loss. This and my spinal degeneration are why I really would love to keep the option of NSAIDs on the table, if I could.
Insurance has been VERY unwilling to cover any kind of weight loss medication; heaven knows I've been trying for MANY years to make that happen. It's so confusing, especially since some of those medications offer a trial / partial expense covered - just not for those who HAVE insurance, even if your insurance won't cover it. Absolutely maddening. I own my poor dietary habits and their outcomes, a combination of blind eating, emotional eating, hormonal eating, and mobility issues have certainly taken their toll. It is interesting to me that you mention the weight loss potentially being inadequate; that didn't seem to be a concern to my surgeon - or at least not one he brought up. I felt like he would have been happy to do either the basic sleeve or the Roux-y surgery, just didn't want to fuss with the SADI-s because he said 'It wasn't all that different' and 'insurance still considers it experimental'. I'm definitely thinking through your response and again - am grateful to you for taking the time to discuss this with me!
Hiddenrose
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That's the thing - I'm not diabetic. I've actually got really good labwork, especially given my BMI. For whatever unlikely reason my body has been quite a trooper in contending with this extra weight thus far other than muscular / arthritic types of conditions. I'm fortunate (mixed blessing!) not to have any cardiac, pulmonary, or diabetic conditions. I have mild sleep apnea, chronic pain conditions; i.e. degenerative arthritis in multiple areas - both knees, hip, etc, fibromyalgia, PCOS, and the beginning of facet compression they keep wanting to give me spinal shots for with no long term solution (beyond weight loss, physical therapy, and a nerve wracking suggestion of a reverse tension treatment to try to slowly slow or reverse the opposite curvature going in my neck).
I somehow keep finding myself in a coverage window whenever I try to improve my health. It wasn't *the DS he said was experimental, he said the SADI-s was - or rather that insurance was still treating it that way. To his credit (or not, depending on which opinion a person holds) he actually said something to the effect of "Which, if I'm honest, I think says something. It's been around for quite some time and still hasn't become popular, although I think that's likely the direction bariatric surgeries are headed in the future". *To be clear, he didn't suggest the SADI-s, he left the choice of surgery up to me and I wasn't feeling confident in the Roux-y and didn't think a basic gastric sleeve would give me the results I was looking for.
I've been reading up on the differences between the DS and other options out there. I can certainly understand why so many of you are pointing me in the direction of the DS, and a specialist for it, at that. I appreciate the candor on this group. You are all phenomenal people, and I am grateful for the information you've all shared thus far!
I somehow keep finding myself in a coverage window whenever I try to improve my health. It wasn't *the DS he said was experimental, he said the SADI-s was - or rather that insurance was still treating it that way. To his credit (or not, depending on which opinion a person holds) he actually said something to the effect of "Which, if I'm honest, I think says something. It's been around for quite some time and still hasn't become popular, although I think that's likely the direction bariatric surgeries are headed in the future". *To be clear, he didn't suggest the SADI-s, he left the choice of surgery up to me and I wasn't feeling confident in the Roux-y and didn't think a basic gastric sleeve would give me the results I was looking for.
I've been reading up on the differences between the DS and other options out there. I can certainly understand why so many of you are pointing me in the direction of the DS, and a specialist for it, at that. I appreciate the candor on this group. You are all phenomenal people, and I am grateful for the information you've all shared thus far!
Larra
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I'm not up to date on whether or not Medicare covers SADI (I doubt it, but I could be wrong), but Medicare has covered the real, traditional DS for many years and it is NOT considered experimental. So, if you can find a surgeon who does the DS and accepts Medicare, that might get you over the insurance hurdle. I say might because of that old business of each insurer arguing that the other one should pay for it.
Also, I agree that, at a bmi of 60 even after significant weight loss, a sleeve alone will not be adequate to get you and KEEP you at anything approaching a healthy weight, and gastric bypass also is less effective AND will prevent you from taking NSAID's for the rest of your life. I would recommend searching your part of the country for a DS surgeon and being open to traveling further from home to get the care you really need. The extra effort is worth it.
Also, I agree that, at a bmi of 60 even after significant weight loss, a sleeve alone will not be adequate to get you and KEEP you at anything approaching a healthy weight, and gastric bypass also is less effective AND will prevent you from taking NSAID's for the rest of your life. I would recommend searching your part of the country for a DS surgeon and being open to traveling further from home to get the care you really need. The extra effort is worth it.
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