Is the promise of rapid weight loss worth having 80% of your stomach removed?
It was for Remi Bader. The influencer made headlines on Wednesday after revealing that a cutting-edge weight-loss procedure helped her shed over 100 pounds in under a year — though it came with a “brutal” recovery process.
The Post spoke to Dr. Christine Ren-Fielding, chief of the division of bariatric surgery at NYU Langone Health, to get the full rundown on single anastomosis duodenal-ileal bypass.
What is the SADI-S weight loss procedure?
SADI-S is a type of bariatric surgery that combines two procedures: sleeve gastrectomy and duodenal switch.
During the surgery, Ren-Fielding explained, doctors first remove a portion of the stomach. Then they cut a section of the intestine, disconnect it and reconnect a part of the intestine that’s located further down the digestive tract.
“You’re shortening the distance that food has to travel from your stomach into your colon so that you’re not absorbing as many calories,” she said. “You’re not digesting as much and you’re eating less.”
Who is the ideal candidate for SADI-S surgery?
In an interview with Self magazine, Bader revealed that her surgeon recommended SADI-S due to her binge-eating disorder.
Ren-Fielding said that SADI-S is “one of the better options” for people with binge eating disorders, as it helps reduce food intake and limits calorie absorption during a binge.
“It’s also good for people who have hundreds of pounds to lose because it offers the absorption aspect,” she said.
For patients with severe weight issues, Ren-Fielding noted that other procedures, like sleeve gastrectomy (where part of the stomach is removed), may not be sufficient due to their low metabolism.
“What you need to do is add a component where the intestines aren’t absorbing as many calories in terms of fat,” she said.
How much weight can you expect to lose after SADI-S?
Ren-Fielding said patients typically lose about 50% of their total body weight after undergoing the procedure.
“It’s double what Ozempic would give you, and it lasts for many years,” she said. “It’s very, very durable.”
How does SADI-S compare to other weight loss surgeries?
Ren-Fielding said that SADI-S outperforms other bariatric surgeries, such as gastric bypass and sleeve gastrectomy, when it comes to weight loss.
“It’s like gastric bypass plus, or sleeve gastrectomy plus,” she said.
However, she said it does have some downsides, particularly in terms of malabsorption.
“Not only are you not absorbing fat, you’re not absorbing as much protein and you’re not absorbing as many vitamins,” Ren-Fielding said.
This can be problematic for patients who aren’t diligent about their protein and vitamin intake, she noted.
SADI-S can also cause changes to your bowel movements.
“When you shorten the distance of your intestinal length, then you’re not digesting fat very well,” Ren-Fielding said. “When that undigested fat goes through your colon, it comes out and it smells very bad. It can be oily and greasy, and it could be frequent.”
What is the recovery process like?
Ren-Fielding said that recovery from SADI-S is generally “fairly easy,” with most patients staying in the hospital for just two or three days.
Once home, she recommended that patients gradually reintroduce food, starting with high-protein liquids for two to three weeks, followed by pureed foods, and eventually softer foods to prevent complications.
“If someone goes home and starts trying to eat a hamburger or sandwich, they’re going to have terrible problems,” Ren-Fielding said. “Most people aren’t eating solids for a couple of weeks.”
It wasn’t all smooth sailing for Bader.
After she got the surgery, the model told Self that she spent “hours, hours, hours, hours, throwing up” while in recovery.
Despite being discharged from the hospital three days after going under the knife, Bader said she continued vomiting for six weeks, during which she struggled to eat or drink.
“I actually can’t explain how horrible it was,” Bader said, noting that after the surgery, she fell into a “very, very deep depression” and “wanted to die.”
One year post-op, Bader said her binge eating has improved.
“I’m still struggling and I have those thoughts, but I can’t physically binge as much because I don’t have the room for it. You cannot drink and eat within the same 30 minutes,” she said
What lifestyle changes are needed after SADI-S?
“It requires a little bit more self-care afterwards in order to avoid potential nutritional complications and deficiencies,” Ren-Fielding said.
After the procedure, she said patients need to take a multivitamin, iron, calcium, vitamin B-complex and vitamin DAKE.
Patients also need to be conscious about their diet.
“I had a patient who had something vary similar to this … she lost her job, couldn’t afford the vitamins and her source of protein was McDonald’s hamburgers,” Ren-Fielding said. “She thought she was going the right thing, but when she came in she had such bad vitamin A deficiency … she had night blindness.”
She continued, “[SADI-S] is a tool to help people adopt healthier lifestyles and routines, it just takes long-term management and responsibility.”
