Which bariatric surgery is known to provide the most pronounced weight loss and is effective for high Body Mass Index (BMI)?

Biliopancreatic diversion with duodenal switch (BPD/DS) is recognized for its ability to facilitate significant weight loss, particularly in individuals with a high body mass index (BMI). This surgical procedure combines a sleeve gastrectomy component with a diversion of bile and pancreatic secretions to a distal segment of the intestine.

The unique aspects of the BPD/DS approach enable not only a reduction in stomach size, which limits food intake, but also a significant alteration in nutrient absorption due to the bypassing of a large portion of the small intestine. As a result, patients are able to experience profound and sustained weight loss, making it particularly effective for those with higher BMI levels.

Additionally, the surgery has demonstrated favorable outcomes concerning obesity-related comorbidities, including type 2 diabetes and hypertension. The combination of restrictive and malabsorptive mechanisms sets BPD/DS apart from other bariatric procedures that predominantly focus on either restriction or malabsorption alone.

In contrast, other surgical options, while effective, either do not achieve the same level of pronounced weight loss or may not be as suitable for patients with very high BMIs. For instance, procedures like RYGB and laparoscopic sleeve gastrectomy are effective