Duodenal Switch

Duodenal switch is a bariatric surgical procedure employed to combat obesity. This form of bariatric surgery helps obese patients control their weight and begin the path to a healthier, more active lifestyle. Not all obese individuals qualify for this form of surgery. Good candidates have a body mass index (BMI) of 40 or more. Candidates with a BMI of 35 qualify if they show signs of unhealthy, weight-related symptoms such as heart disease or diabetes.

How Does it Work?

The surgery consists of a restrictive and malabsorptive surgical procedure. The restrictive element is a partial gastrectomy that reshapes and removes a portion of the stomach. The remaining portion, where the food exits, resembles a banana and has a capacity of around six ounces. 

The malabsorptive element separates the flow of bile and pancreatic juices by rearranging the small intestines. Further down, the physician reconnects the two intestinal paths. The food and digestive juices combine in the last 18 to 24 inches of the small intestine. Limited fat absorption takes place as the food heads towards the large intestine.

Advantages of Duodenal Switch

People who choose duodenal switch surgery experience greater weight loss with a low risk of weight gain. The pyloric valve, the portion of the stomach connected to the duodenum, remains intact. As a result, patients do not experience the “dumping” syndrome commonly associated with the Roux-en-Y Gastric Bypass. The malabsorptive component is partially reversible for patients with malabsorption difficulties. Duodenal switch patients experience weight loss at a more rapid pace compared to those who choose the laparoscopic banding procedure. In addition the following are all potential advantages of the Duodenal Switch procedure:

  • Typically greater weight loss over a longer period of time
  • Weight loss of up to 60% to 80%
  • Patients can eat a more “normal” and less restrictive diet compared to gastric bypass or gastric banding
  • No “dumping syndrome”
  • Intestinal rerouting is reversible
  • People with very high BMI and extreme obesity who are not eligible for other weight loss surgeries may still qualify for the Duodenal Switch

Disadvantages of Duodenal Switch

Duodenal switch surgery carries more risks compared all other traditional weight loss surgeries. Complications occur more often in this form of surgery due to a higher BMI. Patients may lose too much weight. Duodenal switch patients may experience long-term nutritional deficiencies and be subject to a lifetime of medication and special foods. Other complications include anemia, infection, gallstones and hernias. Other potential disadvantages include:

  • Most complex of all the weight loss surgery options
  • Certain foods may become intolerable
  • Increased risk for intestinal problems or gallstones
  • Potential for malnutrition or vitamin deficiency
  • Potential for frequent gas, bloating or change in body odor

Risks & Complications

Because there is a higher complexity level to this surgery, there are an increased and higher rate of risks associated. Learn more about the potential risks and complications associated with a duodenal switch procedure.


Some insurance companies may cover the full procedure, provided the patient meets certain requirements. Participation in a supervised weight loss program may be a prerequisite. Medicare and Medicaid recipients may qualify if the patient suffers from one weight-related health problem, qualifies for the procedure and an approved surgeon performs the surgery. Patients paying out-of-pocket can expect to pay between $20,000 and $25,000. For more information about the cost and procedure, contact a professional bariatric surgical center.


Since the duodenal switch involves both restrictive and malabsorptive properties, potential patients of this surgery should be aware of the dietary and lifestyle changes that will occur after surgery. Not only will diet change but your pattern of eating and the cost will all be altered. Read more about what is involved with a diet for duodenal switch patients.