Introduction
The SADI-S procedure (Single Anastomosis Duodeno-Ileal Bypass with Sleeve) is one of the newest and most effective bariatric surgeries available today. It combines the benefits of a sleeve gastrectomy with a simplified intestinal bypass. While it provides excellent weight loss and metabolic improvements, it also changes how your body absorbs nutrients—which means your diet and supplement routine will look different for life.
What Is SADI-S?
SADI-S is a two-part procedure:
- Sleeve Gastrectomy – Reduces stomach size to limit food intake.
- Single Anastomosis Bypass – Connects the first part of the small intestine (duodenum) to a lower section (ileum), bypassing a large portion of the small intestine.
This combination makes it one of the most powerful surgeries for both weight loss and improving obesity-related conditions like type 2 diabetes.
How SADI-S Changes Nutrient Absorption
Unlike restrictive-only procedures (such as gastric sleeve), SADI-S is also malabsorptive. This means fewer calories and nutrients are absorbed from the food you eat.
- Proteins – Still absorbed, but patients must prioritize high-protein diets to prevent muscle loss.
- Fats – Absorption is reduced significantly, leading to lower calorie intake but also possible fat-soluble vitamin deficiencies.
- Carbohydrates – Less affected, but portion control remains essential.
- Vitamins & Minerals – Nutrient malabsorption can cause deficiencies without proper supplementation, especially in vitamins A, D, E, K, iron, calcium, zinc, and B12.
Long-Term Diet After SADI-S
Because of these absorption changes, long-term diet management is critical:
- Protein First
- Aim for 80–100 grams of protein per day.
- Sources: lean meats, fish, eggs, dairy, or supplements.
- Healthy Fats in Moderation
- Necessary for energy and vitamin absorption.
- Choose avocados, nuts, olive oil, fatty fish.
- Complex Carbohydrates
- Whole grains, vegetables, and legumes for fiber and sustained energy.
- Avoid processed sugars to reduce dumping-like symptoms and weight regain risk.
- Hydration
- Drink water throughout the day, but avoid fluids with meals to prevent discomfort.
Lifelong Supplementation
SADI-S patients require daily supplements for life due to reduced absorption. Typically, these include:
- A bariatric-specific multivitamin.
- Calcium with vitamin D.
- Iron and vitamin B12.
- Additional fat-soluble vitamins (A, D, E, K).
Regular blood tests ensure nutrient levels remain within a healthy range.
Potential Long-Term Complications Without Supplements
Skipping vitamins and not following dietary guidelines can lead to serious issues such as:
- Anemia (iron, B12 deficiency).
- Bone weakness or osteoporosis (calcium and vitamin D deficiency).
- Vision or immune system problems (vitamin A deficiency).
- Neurological issues (B12 deficiency).
Benefits vs. Responsibilities
Benefits of SADI-S:
- Significant and sustained weight loss.
- High remission rates of type 2 diabetes.
- Lower risk of complications compared to traditional duodenal switch.
Responsibilities:
- Lifelong follow-up care.
- Daily supplement use.
- Consistent, balanced eating habits.
Conclusion
SADI-S is a powerful tool for weight loss and improved health, but it permanently alters nutrient absorption. With the right dietary habits, supplements, and medical follow-up, patients can enjoy lasting results while staying healthy.
At VIVE Bariatrics, our team provides education, nutritional guidance, and long-term support to help patients succeed after SADI-S.
