As bariatric surgeons and obesity medicine specialists, we often get asked: “Are weight loss drugs better than weight loss surgery?” It’s a complex question with no easy answer, and the best approach depends heavily on individual circumstances.
Let’s break down the facts and compare the latest weight loss medications with established surgical procedures.
Understanding the Weight Loss Landscape With Medication or Surgery
We’ve seen a surge in popularity for medications like Ozempic, Wegovy, Mounjaro and Zepbound – falling under the category of GLP-1 or dual GLP-1/GIP receptor agonists. These drugs mimic a natural hormone in the body that helps regulate appetite and blood sugar.
On the other hand, bariatric and metabolic surgeries like the Roux-en-y gastric bypass and sleeve gastrectomy impact GLP-1 levels as well as many other GI hormones to promote weight loss by physically altering the digestive tract.
Weight Loss Medications: The Non-Surgical Option
- How They Work:
- GLP-1 medications increase feelings of fullness, slowing down how quickly your stomach empties.
- They can also impact brain regions involved in appetite control.
- They help to improve blood sugar control, which is extremely helpful for patients with type 2 diabetes.
- Benefits:
- Non-invasive, no surgery required.
- Potentially significant weight loss, often 10 to 15 percent of initial body weight.
- Improved blood sugar and cardiovascular health in many cases.
- No recovery needed.
- Drawbacks:
- Potential side effects like nausea, vomiting, diarrhea, bloating, constipation, pancreatitis, gastroparesis like symptoms and reflux.
- Medications can be expensive, and insurance coverage varies.
- Weight regain is possible if medication is stopped.
- Long-term effects are still being researched.
- Requires consistent injections or daily pills.
- Patients need continual follow up with their provider to monitor medication and dosage.
When it comes to the question, are medications better than weight loss surgery?, there is no easy answer. For those who are not morbidly obese, or who cannot have surgery for other reasons, medications can help provide effective weight loss. However, when comparing the two options, bariatric surgery typically provides significantly more weight loss than medications like Ozempic.
Weight Loss Surgery: A Long-Term Solution
- Surgical Options and How They Work:
- These surgeries alter levels of many hormones in addition to GLP-1, impacting appetite, glucose levels and metabolism.
- Surgeries like gastric bypass and sleeve gastrectomy change the size of the stomach. The primary mechanism for weight loss is not restriction – it is to change the body’s metabolism through several gut hormones that affect weight.
- Benefits of Weight Loss Surgery:
- Significant and sustained weight loss, often 25-35% or more of initial body weight, typically estimated around 60-80% of excess body weight.
- Dramatic improvements in or resolution of obesity-related conditions like type 2 diabetes, sleep apnea and high blood pressure.\
- Surgery also reduces the risk of developing heart disease, strokes and multiple types of cancer including colorectal, breast and endometrial and increases the average life span.
- Long-term weight maintenance is more successful than with medication alone.
- Drawbacks:
- Surgical procedures come with associated risks like bleeding, infection and complications. Long-term complications can include vitamin deficiencies.
- Requires significant lifestyle changes, including dietary adjustments and recommended regular exercise.
Making the Right Choice: Factors to Consider
Since every individual has different health issues, there are many factors to consider when comparing weight loss medications to weight-loss surgery, including:
- Severity of Obesity: Individuals with Body Mass Index (BMI) over 35 or 40 and obesity-related health problems may benefit more from surgery.
- Medical History: Certain medical conditions may increase surgical risk and require additional evaluations prior to surgery.
- Lifestyle: Successful weight loss, whether through medication or surgery, requires a long-term commitment to healthy habits.
- Cost and Insurance Coverage: Both medications and surgery can be expensive, and insurance coverages can vary.
- Personal Preferences: Some individuals may prefer the non-invasive nature of medication, while others may opt for the more dramatic and durable results of surgery.
- Weight loss medication can be a great first step for many, but for others, weight loss surgery is the best option.
The Doctor’s Perspective
Ultimately, the decision between weight loss medication and surgery should be made in consultation with a healthcare professional. We can assess your individual risk factors, discuss your goals and help you determine the most appropriate approach.
It’s important to remember that neither medication nor surgery is a magic bullet. Long-term success requires a commitment to a healthy lifestyle, including a balanced diet and regular exercise.
Don’t hesitate to reach out to your healthcare provider to discuss your weight loss options and find the path that’s right for you. At MVHS Bariatric Group, our dedicated team of experienced professionals is here to assist you throughout your weight loss journey. Complete the contact form on our website or call 315-235-2540 to learn more about our program and to register for a consult.
Authors
William Graber, MD, FACS, Bariatric surgeon
Tiffany Lee, MD, Bariatric surgeon
Nandita Rao, MD, FACS, DABOM, Bariatric surgeon
