Bariatric surgery vs. weight loss medications

What’s the deal with all of these weight loss options?

“Injectable weight loss medications are everywhere. They are on the news, in your social media feed, and you might even know someone taking them,” says Donald Yarbrough, MD, board-certified fellowship-trained bariatric and general surgeon in Derry, affiliated with Parkland Medical Center.

Online pharmacies, medical spas, and diet clinics take advantage of the fact that our country has alarming statistics on obesity and that the situation is truly an epidemic.

Dr. Yarbrough says more than one-third of adults — or 78.6 million people — are obese, often leading to an increased risk of chronic and life-threatening diseases like heart disease, kidney failure, stroke, and Type 2 diabetes.

“Much of this data was reported before the pandemic, and we all know how much the pandemic negatively impacted our health and weight,” Dr. Yarbrough says.

He says the key to finding what works for you is partnering with an experienced physician who can create a plan that will work with your body.

“Our team personalizes a plan for every patient that is specific to their weight loss goals and health history. We strive to provide our patients with a plan for lasting, long-term success,” says Bernard Benedetto, MD, board-certified and fellowship-trained bariatric and general surgeon, affiliated with Portsmouth Regional Hospital.

Short-term weight loss solutions

Diet pills and fad diets: Dr. Yarbrough says quick fixes like pills or fad diets aren’t the key to long-term, successful weight loss. “Our team works with patients to help them with lifestyle changes to approach their weight loss goals, including nutrition and physical activity,” he says.

Weight loss medications: Dr. Benedetto says weight loss medications do not work for everyone and they are not risk free which is why it’s important to work with a physician. “It’s key for patients to partner with their physician to ensure that the medications are being utilized properly as part of an overall weight loss plan that is based on the patient’s goals and overall health,” he says.

“Preoperatively and post operatively, weight loss medications, often in the form of injectables, can be prescribed to patients,” Dr. Yarbrough says. “These medications can help with meeting short-term goals and are often more effective than fad diets and pills.”

Dr. Benedetto says the medication in injectables immobilizes the muscles of the stomach wall for about three months and prevents them from contracting. This keeps food in the stomach longer, slowing digestion and helping you feel fuller faster and for a longer time.

Dr. Benedetto says weight loss injections may be a good option for adults who:

• Have moderate weight loss goals such as to lose weight before an elective surgery or to assist with fertility
• Have a body mass index (BMI) of 27 to 40
• Have not had success with lifestyle modifications such as diet and exercise
• Want to jump start a healthier lifestyle
• Want to reduce the risk of weight-related illness, such as high blood pressure, diabetes, stroke, sleep apnea, or heart disease.

Dr. Yarbrough and Dr. Benedetto both recommend strategic lifestyle changes like keeping a food journal, tracking daily steps, setting daily goals, and eating breakfast.

“I am passionate about helping patients meet their weight loss goals through an individualized care plan. We offer many options for weight loss at our practice and find that injectable medications can help patients in the short-term as they prepare for longer-term solutions,” Dr. Yarbrough says.

Dr. Benedetto also says creating a long-term plan is key.

“Evidence from clinical trial data proves that patients gain the weight back when they stop taking the injectable weight loss medications,” Dr. Benedetto says. “Through our program, we are able to work with patients one-on-one to help them determine the best path for them to meet their long-term goals, which sometimes includes surgery, nonsurgical intervention, or both.”

Long-term weight loss solutions

“We are able to help guide patients with next steps after they meet some of their short-term goals. Sometimes that can include weight loss surgery or other nonsurgical options,” Dr. Yarbrough says.

Based upon their specific needs and goals, there are several minimally invasive and robotic-assisted weight loss options, including gastric bypass and the sleeve gastrectomy. It just depends on the patient’s needs and risk factors to pick the right procedure for them.

Gastric bypass: This procedure does NOT remove anything; however, they do separate the stomach into a smaller section for the food intake. A new end of the intestines is attached in order to empty the food which then reconnects with the rest of the digestive juices a bit further downstream.

Sleeve gastrectomy: This procedure removes a significant portion of a patient’s stomach, reducing food intake capability. The normal stomach can hold about 1.5 liters of fluid, and it’s downsized to a four- to six-ounce capacity. A person undergoing gastric sleeve surgery has the potential to lose 50 to 80 percent of their excess body weight.

Dr. Benedetto says patients should know what to expect when it comes to their options. He explains, “Patients can expect to lose an estimated 10-15% of their total body weight while having a minimal impact on their comorbidities if they choose medications; whereas, patients who choose surgery can expect to lose an estimated 60-70% of their excess weight while seeing a significant impact on their comorbidities.”

Whether you choose weight loss injectables or weight loss surgery, Dr. Yarbrough says the right combination of tools and lifestyle change are essential to a successful weight loss treatment plan.

“The option for weight loss that a patient chooses isn’t the only factor that determines a patient’s success. A patient has to commit to changing and living a healthier life. We are here for our patients throughout the entire process,” Dr. Yarbrough says. “We take great pride in helping our patients live a healthier life and achieve their goals.”

At Appledore Medical Group, our caring and knowledgeable weight loss surgery team is here to help you take charge of your health. Our expert bariatric surgeons will provide you with advanced weight loss surgery options and recommend a coordinated treatment plan that is best for you. This plan includes education, nutrition counseling, meal planning, exercise planning and support programs.

Find out if you’re a candidate. Take our weight loss surgery health risk assessment.