Weight Loss

Weight loss after surgery can be very dramatic. The fastest rate of weight loss will happen during the first 3 months post-op. After Duodenal Switch you can expect to lose 0.5 to 1 lb per day or 40 to 90 lbs by 3 months post-op. [51] Rapid weight loss decreases by 6 to 9 months after the procedure and peak weight loss is achieved at 12 to 18 months post-op.

For many people the scale becomes a bit of an obsession after surgery. A tiny increase in weight can cause unfounded and unnecessary panic. There are so many possibilities for small weight increases: how much you have had to drink, what you have eaten, when you have your bowel movements. Do not be upset if you gain a pound or two, wait a day and it will be gone again. Try weighing yourself once a week. Better yet; get rid of your scale and follow-up with your doctor monthly to be weighed.

If you are a member of any surgery support forums you will probably be comparing your weight loss with others. As we said above, in the first 3 months you can lose anywhere between 40 to 90 lbs. That is a very big range. Unfortunately the people on the lower end of that range feel they are not losing as quickly as they should and compare themselves to others who are losing on the high end. Everyone in that range is losing what their body is capable of losing. Don't get discouraged if you are on the lower end of the range, accept that this is how your body needs to lose the weight.

It's not POUNDS, it's PERCENTAGES!

Two people, both 6 months post-op. One has lost only 63 pounds and feels bad about her "slow" weight loss. The other has lost 96 pounds and thinks she's doing great.

They are both wrong.

Person A had only 105 excess pounds, so she has already lost 60% of her excess weight. She is actually ahead of the game at 6 months out and is on track to lose it ALL.

Person B had 265 excess pounds. At 6 months out she has only lost 36% of her excess weight. At this rate, she will end up retaining 28% of her excess weight, enough to keep her in the obese category.

See what I mean? Don't compare pounds to pounds, that's like apples and oranges.

Percent of excess weight lost: pounds lost divided by total excess pounds
Use a BMI of 25 as a goal weight

On track to lose it all is 25% lost after 2 months, 50% after 6 months, and 80% at one year.

Please note: These are averages. Your mileage may vary.

Weight Loss Goals for the Super Morbidly Obese

For many of us who were super morbidly obese (BMI 50+) we will not reach 100% of estimated weight loss without plastic surgery. Both my DS surgeon and my plastic surgeon feel that the morbid obese will be left with 6-8% excess skin, connective tissue, deflated fat cells, excess veins, arteries, and our heavier bones from carrying all that fat around. For the super morbid obese it is closer to 10-12% excess left.

This is why many people end up at 88-90% of weight loss before plastics.

The opposite problem happens for some people. They fight to get to 100% off before plastics, and they actually get too "thin". I know I sound like a heretic to say that. Yet as a doctor I can tell you that you can be under-fat, and it wreaks havoc with our endocrine systems and immune systems.

My plastic surgeon prefers people to be at 90-95% of estimated loss before extensive lower body work. Not only that but she required you to be at a stable weight for 6-9 months. She feels it puts us at our best nutritional standing before surgery and that we will heal better.

Duodenal Switch Lab Rat Data