When it comes to managing obesity and achieving sustainable weight loss, surgery can be a transformative step, especially for people who have struggled for years with limited results from diet and exercise alone. While options like gastric bypass and sleeve gastrectomy are widely known procedures among people in the UK, another procedure that many are not aware of and only a few clinics currently offer is the SADI-S procedure.
SADI-S, short for Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy, might sound technical, but its concept is straightforward. It is a modified version of the traditional duodenal switch surgery, designed to be less complex while still delivering powerful results. If you have never heard of it before or only vaguely recall it, do not worry. If you are considering weight loss surgery in the UK, especially if you have a higher BMI, this could be the option that finally works for you or the one your consultant may recommend.
How SADI-S Works
SADI-S combines two powerful mechanisms for weight loss: restriction and reduced absorption.
The procedure begins with a sleeve gastrectomy, where a large portion of the stomach is removed, leaving a smaller banana -shaped pouch.
This limits how much food you can eat and significantly reduces hunger hormones such as ghrelin.
Next, a single intestinal bypass is performed. The small intestine is rerouted so that food bypasses part of the digestive tract, reducing calorie and fat absorption.
SADI-S can result in 80% to 90% excess weight loss, especially in patients with a BMI over 50 (in comparison with about 75% excess weight loss in gastric bypass).
While sleeve gastrectomy and gastric bypass are the most widely offered surgeries through the NHS and private providers, SADI-S is available only at a few specialist clinics. It is often used for patients needing revision surgery or a stronger metabolic impact.
Step-by-Step SADI-S Procedure: Stomach Sleeve Creation, Duodenum Division, and Small Intestine Bypass
Image Source: IFSO
Ideal Candidates for SADI-S Surgery
The most common candidates for SADI-S include:
- People looking to enhance weight loss or who have experienced weight regain after gastric sleeve surgery
- Patients with a BMI over 50 or a BMI of 35 to 49 with conditions such as type 2 diabetes, metabolic syndrome, or cardiovascular disease
- SADI-S is particularly effective for people with type 2 diabetes, offering improved glucose regulation compared to other bariatric procedures.
It is also important to note that patients of Asian or Afro-Caribbean descent may be eligible at slightly lower BMI thresholds due to differences in metabolic risk.
SADI-S Benefits Beyond the Scale
SADI-S delivers more than just weight loss. Many patients experience remission of type 2 diabetes, improved blood pressure and cholesterol levels, better sleep quality, and relief from joint pain. These improvements result from both the reduction in body weight and changes in digestive hormones after surgery.
Over the long term, people who choose SADI-S surgery often have better success keeping the weight off compared to those who undergo a traditional sleeve or gastric bypass. Research also suggests that SADI-S leads to more sustained weight loss and comes with fewer side effects, such as food intolerance or dumping syndrome.
What You Should Know Before Considering SADI-S
Like all bariatric procedures, SADI-S comes with long-term responsibilities. Patients are expected to take daily vitamin and mineral supplements and attend regular follow-up appointments to monitor their nutritional health. Some people may experience changes in bowel habits, particularly in the early stages after surgery. However, with our structured aftercare programme, which includes personalised nutritional support and access to psychological guidance, these challenges can be managed effectively.
Access to SADI-S is steadily available via weight loss surgery clinics in the UK, such as Phoenix Health. Here, we offer comprehensive preoperative assessments and personalised care pathways for patients who meet the clinical criteria.
Is SADI-S Right for You?
If you have struggled with obesity and found little success with previous treatments or surgeries, SADI-S may provide a much-needed solution. It delivers strong weight loss results, improves health conditions like type 2 diabetes, and simplifies the surgical process compared to more invasive options. Whether you are exploring bariatric surgery for the first time or seeking a revisional surgery after another procedure, SADI-S could be the key to sustainable weight loss and improved quality of life.
A consultation with a qualified bariatric specialist is the best way to determine if this procedure is right for you. With expert guidance and a personalised plan, SADI-S may be your next step toward lasting health and confidence.
Medically Reviewed by Mr. Qutayba Almerie, MD, MSc, FRCS
Consultant Upper GI & Bariatric Surgeon, Medical Director at Phoenix Health.
References:
Balamurugan, G. et al. (2023, May 4). Comparison of bariatric procedures: RYGB vs OAGB vs SADI-S. Obesity Surgery. Retrieved from https://link.springer.com/article/10.1007/s11695-023-06602-6
Ataya, K. et al. (2023). SADI as a second step after failed sleeve gastrectomy: a systematic review and meta-analysis. J Metab Bariatr Surg, 12(2), 35–43. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC10771976/
NICE. (2016). SADI-S for treating obesity: procedure overview. Retrieved from https://www.nice.org.uk/guidance/ipg569
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