A 44-year-old female with severe obesity was referred to our institution for bariatric surgery. Her medical history was significant for binge eating disorder, type 2 diabetes mellitus, dyslipidemia, hypertension, hypothyroidism, polycystic ovary syndrome, bilateral knee osteoarthritis, obstructive sleep apnea and asthma. She met all NIH criteria for bariatric surgery and was started on 8-month nutritional interventions prior to bariatric surgery. Her initial HbA1c and BMI were recorded 7.8% and 59.06 kg/(m^2), respectively. During the pre-operative nutritional therapy, her BMI was reduced to 54 kg/(m^2). Given her extensive comorbidities and prior unsuccessful dietary trials, duodenal switch approach was deemed as the most appropriate surgical option. She tolerated the procedure very well and her upper gastrointestinal series on POD1 showed no signs of leak or obstruction. She was discharged subsequently on phase 2 of bariatric diet. At 1-month follow up visit, her BMI was decreased to 51 kg/(m^2) and HbA1c was recorded 5.0% demonstrating remission of type 2 diabetes mellitus.