In this episode of Weight Loss by Design, Dr. Michael Feiz and Dr. Sean Rim dive into malabsorptive procedures for weight loss, focusing on the SADI-S operation (Single Anastomosis Duodenoileal Bypass with Sleeve). The discussion covers how SADI-S works, compares it to traditional gastric bypass and sleeve gastrectomy, and explores patient selection and the long-term effectiveness of surgical interventions.

• What is SADI-S?
  Dr. Sean Rim introduces the SADI-S as a newer, unique bariatric surgery that combines the restrictive power of the sleeve gastrectomy with a potent malabsorptive component, limiting calorie absorption for effective weight loss 00:00:16.

• Digestive Physiology Explained
  Dr. Michael Feiz provides a detailed explanation of how digestion and absorption occur in the stomach and small intestine—highlighting why targeting these areas leads to surgical weight loss 00:01:10.

• How SADI-S Compares to Gastric Bypass
  The hosts discuss the fundamental difference in how much and which part of the small intestine is bypassed in SADI-S versus traditional gastric bypass, emphasizing the enhanced malabsorptive effect of SADI-S 00:04:13.

• Restriction vs. Malabsorption
  Dr. Sean Rim discusses the roles of restriction and malabsorption in bariatric procedures and debunks common misconceptions about long-term hunger regulation after surgery 00:05:09.

• Effectiveness and Longevity of Weight Loss Surgery
  Dr. Michael Feiz and Dr. Sean Rim address the long-term results of procedures like sleeve gastrectomy, gastric bypass, and SADI-S, noting high rates of sustainable weight loss relative to diet and exercise alone 00:09:01.

• Choosing the Right Procedure
  The conversation covers how surgeons help patients decide on the best surgical option based on individual factors such as previous surgeries, BMI, eating habits, and patient preferences 00:12:04.

• Revision Surgeries and Super Obesity
  SADI-S is highlighted as a strong option for patients needing revisional surgery after sleeve gastrectomy or for individuals in the "super obese" category, where greater weight loss is necessary 00:19:04.

"No surgery is going to be all and end all of success... surgery or medication without behavioral and psychological modification, without changing your relationship with food, you will ultimately have a higher chance of being unsuccessful."
— Dr. Michael Feiz 00:18:33

"Our job is to provide the facts and what sort of lifestyle changes come with each operation, and I think most patients would agree that in general, less is better."
— Dr. Sean Rim 00:15:31

• SADI-S (Single Anastomosis Duodenoileal Bypass with Sleeve)

• Gastric Bypass

• Sleeve Gastrectomy

• Dumping Syndrome

• The concepts of restrictive and malabsorptive procedures

• SADI-S is an advanced, highly effective bariatric surgery, suitable for both primary and revisional procedures.

• Surgical weight loss delivers far more sustained results than diet and exercise alone, especially for patients with higher BMI or prior weight loss surgery.

• Success with any surgery still depends on lifestyle, behavioral, and psychological changes.

• Tailoring the surgical approach to each patient's unique situation maximizes long-term success.

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Weight Loss By Design with Dr. Michael Feiz and Dr. Sean Rim, leaders in bariatric surgery, here to guide and inspire you through every stage of your weight loss journey. New episodes biweekly. Learn more at ⁠⁠drfeiz.com⁠⁠. Find us on Instagram at ⁠https://www.instagram.com/drfeiz/