The benefits and risks of current weight loss options

Recent interest in medications like Ozempic® has celebrities, the media and the public talking more about weight loss. And the conversation is changing to acknowledge that weight loss is more complex than just “calories in and calories out.” Obesity is an illness that changes how the body metabolizes food and alters hormones that control appetite and hunger.

“Simplifying obesity as a disease of excess calories led to one of the biggest misconceptions in modern medicine and is responsible for everything from fat-shaming to horrible misinformation as well as inappropriate recommendations from physicians,” says Dr. Sunil Bhoyrul, medical director of bariatric surgery at Sharp Coronado Hospital.

It’s important that people understand the true nature of obesity and all the weight loss options available to them, Dr. Bhoyrul says. So they can find the long-term solution that’s right for them.

Benefits and risks of weight loss medications

In most cases, people who take weight loss medications without any other interventions lose around 5% to 10% of their body weight. However, medications only work for as long as they are taken. When medications are stopped, patients can experience weight gain and a resurgence of weight-related illnesses, such as diabetes.

“Some studies have shown that these medications have as low as 10% compliance rate after the first year,” says Dr. George Mueller, medical director of bariatric surgery at Sharp Memorial Hospital. “This means that people often stop taking them after that point, and their progress is undone.”

Not only are medications hard to keep up with, they may also come with side effects. These can include nausea, vomiting, heartburn, reflux, gastritis, abdominal pain and bloating.

“Although weight loss medications are highly effective and provide an important insight into the cause and treatment of obesity, the potential for serious side effects warrants careful supervision,” says Dr. Bhoyrul. “These medications are new, and physicians are still learning about their long-term impacts.”

Fortunately, weight loss drugs have been successful at opening the door for people to learn more about treatments. Instead of shame or negative self-talk, people with obesity and weight-related illnesses are seeing there are multiple solutions available.

“These medications have given a lot of people hope that there are treatment options and support available,” says Dr. Mueller. “Weight loss medications are not right for everyone, but by starting the discussion, they can find other options that work for them.”

Bariatric surgery has long-term benefits

One such option is bariatric, or weight-loss, surgery. Surgery is typically recommended for people with a body mass index (BMI) of 35 or higher, or if they have weight-related illnesses, such as diabetes, hypertension, sleep apnea or joint issues.

According to the National Institutes of Health, bariatric surgery is the most effective method for long-term significant weight loss. A major benefit of surgery is that it addresses the underlying issues that cause obesity.

“There’s a misconception that surgery is just about making the stomach smaller but, really, it changes your metabolism and hunger hormones,” says Dr. Mueller.

The earliest form of bariatric surgery — the gastric band or Lap-Band — did, in fact, make the stomach smaller. But more effective bariatric procedures now exist, including sleeve gastrectomy, Roux-en-Y gastric bypass, and the new single anastomosis duodeno-ileal bypass (SADI). In addition to impacting the size of the stomach, these modern procedures help decrease production of ghrelin, known as the “hunger hormone.”

A major benefit of nationally accredited bariatric surgery programs, such as those at Sharp Coronado and Sharp Memorial, is the education, support and lifelong follow-up that patients receive. Patients taking only medications don’t have the full support of a comprehensive bariatric program. From pre-surgery webinars and on-demand education, to after-surgery care and support groups, Sharp’s programs ensure that patients feel supported throughout their journey.

There is no magic solution

There is no one way to lose weight, and medications and surgery are not magic cures. They need to be combined with long-term, healthy lifestyle changes to ensure success.

“Surgery, medications and lifestyle choices have to be integrated as a comprehensive treatment plan in order to truly address the problem and effect a lifelong effective treatment plan,” says Dr. Bhoyrul.

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