Biliopancreatic Diversion-Duodenal Switch (BPD-DS)

The Biliopancreatic Diversion with Duodenal Switch goes by many names. Some refer to it by the initials BPD-DS; many call it the "Duodenal Switch" or just "The Switch." This surgery is only performed on people who are severely obese — body mass index (BMI) of 50 or higher — and haven't been able to lose weight any other way. The surgery also has helped to reduce obesity-related illnesses, including heart disease, high blood pressure, and especially type 2 diabetes.

In the BPD-DS, roughly one half of the stomach is permanently removed. The stomach goes from the shape of a small pineapple to the size and shape of a banana. It is a complex procedure that tackles weight loss in three different ways:

  • First, the surgery removes a large portion of the stomach to prevent overeating. With less stomach to fill, you will feel full more quickly and eat less food and fewer calories.
  • The second part of the procedure reroutes food away from the upper part of the small intestine, which is the natural path of digestion. This cuts back on how many calories and nutrients your body is able to absorb.
  • The third part of the BPD-DS procedure changes the normal way that bile and digestive juices break down food. This cuts back on how many calories you absorb, causing more weight loss. It allows food to bypass part of the small intestine so you absorb fewer calories.

Benefits of the Procedure

The BPD-DS can cause drastic, significant weight loss because it restricts how much food you can eat and reduces how many calories you can absorb.


BPD-DS has short-term and long-term risks, including:

  • Dumping Syndrome: This causes nausea, weakness, sweating, faintness, and possibly diarrhea soon after eating. These symptoms get worse if you eat highly refined, high-calorie foods like sweets. Sometimes you may become so weak that you have to lie down until the symptoms pass.
  • A higher risk of osteoporosis: This happens because your body can't absorb nutrients as well as it used to.
  • Poor Nutrition: Eating less and less absorption may mean that you are not getting enough nutrients, which can cause health problems. You will have to take vitamin and protein supplements for the rest of your life.

Like any surgery, the BPD-DS procedure carries certain risks:

  • Internal bleeding
  • Infection
  • Potentially fatal blood clots that can move to the lungs or heart
  • Hernias

Living with the BPD-DS

It is necessary to take a number of nutritional supplements after the operation, including:

  • Multivitamins (usually twice per day)
  • Iron supplements (usually twice per day)
  • Calcium (usually twice per day)
  • ADEKs (fat-soluble vitamins) usually 3 times per day

Your physician will discuss these with you and set up a supplement plan to follow.