As obesity becomes more prevalent, patients are looking to the medical community to help them lose weight and improve their health. For some, doctors may recommend bariatric surgery (weight-loss surgery) to help them reach a healthier weight. However, with the emergence of medications like Ozempic and Wegovy, which are used to treat type 2 diabetes and obesity, people can be left wondering if this is an easier, better alternative to undergoing weight-loss surgery.
In this blog, we'll compare the two treatment options, how they work, and explain who they may work best for.
Bariatric Surgery
Bariatric surgery is best for those who have BMIs greater than 35 and need substantial and rapid weight loss, but it requires a rigorous qualification to ensure your body and mind are fit for surgery. For people who are morbidly obese in particular, bariatric surgery can truly be a lifesaver due to how significant of a toll excess weight – and co-existing weight-related conditions – can put on your body.
Bariatric surgery comes in two forms: sleeve gastrectomy – more commonly referred to as gastric sleeve – and gastric bypass. For gastric sleeve surgeries, surgeons remove a large portion of the stomach, leaving behind a much smaller “sleeve” that helps restrict food intake and decrease hunger. In gastric bypass surgeries, surgeons create a smaller stomach pouch by dividing the top of the stomach from the rest and rerouting the digestive tract to bypass the larger, original stomach.
Surgeons at the Temple Bariatric Program have performed thousands of these procedures and seen great success from patients. As a result, individuals lose significant portions of their body weight, often fixing other weight-related conditions in the process, like type 2 diabetes, hypertension, and sleep apnea.
Support and Commitment are Key to Long-Term Weight-Loss Success
Whichever procedure you choose, a robust support system, including a care team like ours and friends and loved ones cheering you on at home, will help you achieve and sustain the weight loss you desire for a healthier life, free of diabetes, sleep apnea, and obesity’s other coexisting conditions.
Patients who remain committed to the personalized weight loss plan developed by their care team and adopt a healthy diet and a regular exercise regimen have the most successful outcomes. Proper nutrition also helps patients heal faster after surgery.
Weight-Management Medications
Weight-management medications generally work more gradually than bariatric surgery. While the extent of weight loss may be less, these medications can be very effective for individuals with moderate obesity.
You’ve likely heard about medications like Wegovy, Ozempic, Zepbound, and Mounjarno. These classes of drugs, called GLP-1 agonists and GLP-1/GIP receptor agonists, were initially developed to treat type 2 diabetes to help control blood sugar. Since then, they have been studied and approved to treat people who are overweight or obese because they mimic a hormone that helps to decrease appetite, slow digestion, and improve the body’s response to blood sugar. Some of these medications even have indications to lower cardiovascular risk.
These medications for weight management can help individuals lose weight more effectively than lifestyle changes alone. Studies have shown that weight-management medication can reduce body weight by up to 20%. Losing even a small amount of weight can have significant health benefits, such as reducing the risk of diabetes and heart disease.
Weight-management medications also require long-term use to maintain results. Their effectiveness may decrease over time, and stopping the medication can lead to weight regain. Like bariatric surgery, employing lifestyle changes, including a healthy diet and moderate exercise, is crucial to see success.
Finally, weight-management medications can often have adverse side effects, including nausea, constipation, and increased heart rate.
Which Path is Right for You?
Every person is different, so consulting your doctor is important when deciding if surgery or medications are best to meet your weight-loss goals and needs. Here’s a “cheat sheet” to help you weigh all your options across two important categories:
The Commitment
- Bariatric surgery is an incredibly powerful tool for weight loss, and it can help people lose between 40% and 70% of their excess weight. To achieve such significant, long-lasting outcomes, individuals must fully commit to the program's requirements, which include modifying their diet prior to surgery, exercising before and after surgery, and committing to a healthier lifestyle post-surgery.
- There is a widespread misconception about weight management medication: it is a “quick fix.” The reality is that these medications require lifestyle changes, including a healthy diet and regular exercise, to see results. Also, if the drug works for you, you’ll likely need to continue taking it for the rest of your life; once you stop, the weight usually comes back. With the high demand, obtaining the appropriate dosages when needed may be difficult.
Your BMI
- Bariatric surgery is generally recommended for individuals who struggle with obesity more significantly, with a body mass index (BMI) higher than 35.
- Weight-management medications offer promising results in individuals with a BMI of 30-35 or 27 or higher with obesity-related co-existing conditions.
Combining the Two Therapies is an Option
- For those who qualify for bariatric surgery, doctors can prescribe one of these weight-management medications to assist their weight loss prior to surgery. This combination therapy can be effective in some cases, as it provides a pre-surgery weight-loss boost. Additionally, if someone undergoes bariatric surgery and then notices their weight ticking up a bit over time, doctors can prescribe these medications as a supplemental tool to fight the weight regain.
Next Steps
A thorough discussion with your doctor or care team is essential. Whether you opt for the transformative power of bariatric surgery or the pharmaceutical support of weight loss medications, the key to long-term success lies in our comprehensive and personalized approach that includes lifestyle modifications, ongoing monitoring, and a commitment to health and well-being.
To learn more about bariatric surgery at Temple Health, view an online seminar or schedule an appointment with a bariatric surgeon today.
Helpful Resources
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