Weight Loss Surgery Still Beats Ozempic

The Ozempic craze shows no signs of abating.Widely used for weight loss, the demand for this drug is very high monumental it’s already change diet industry and spur “Marketing Jackpot” Among Dozens of Telemedicine Startups prescribe now that. A much-hyped advertising campaign by a startup, Ro, is based on a simple drug premise: “once-a-week injections for weight loss.”

Never before has a weight loss treatment been so hyped and I was able to keep my promise. Ozempic itself is technically a diabetes drug, but its active ingredient, semaglutide, is FDA-approved for weight loss under the brand name Wegovy, and can help you lose weight at maximum. 20 percent Through weekly injections. An even stronger drug known as tirzepatide or munjaro may soon be approved for weight loss. Many new drugs are in the pipelineAll signs suggest America is on the brink of a weight loss revolution.

However, semaglutide is not even the most effective weight loss treatment for obese people. Bariatric surgery that has been around for decades is still far more powerful. Broadly speaking, this class of procedure that reconfigures the digestive system to make you feel less hungry and more full is considered the “gold standard” for treating obesity. Most people experience 50% weight loss and up to 80% weight loss in one treatment. Cleveland Clinic.

And bold despite the new crop of weight-loss drugs’ impressive capabilities Assertion someday such a drug replacement surgery Some doctors have told me that even if drugs improve, surgery will likely remain the first-line treatment for obesity. Maybe, but in the long run, gain Professor Shauna Levy, who specializes in bariatric surgery at the Tulane University School of Medicine, told me. New drugs, no matter how powerful, may be powerful tools to treat obesity rather than breakthrough solutions.

Unlike semaglutide, bariatric surgery, first introduced in the 1950s, decades To be accepted by the medical community.At the first attempt people got very sick and sometimes surgery was needed. had to reverse. the term bariatric surgery Refers to several different procedures that reshape the gastrointestinal tract to absorb less nutrients, retain less food, or both. Stomach reduction surgery called Luan Wai. walnut— so people need less food to feel satisfied and reconnect to the small intestine in a Y-shape rather than in a straight line. The body has less chance to harvest nutrients. banana-size “sleeve” and toss the rest. another common type The gut must be rerouted in a way that minimizes the area from which calories can be absorbed.

But bariatric surgery does more than just reduce the gastrointestinal area.It exerts less pronounced but equally potent effects on many different hormones that control hunger. remove the intestine This produces the ‘hunger hormone’ ghrelin, which reroutes food through Roux-en-Y. increase the release of “Incretin” Hormones It creates a feeling of satiety after eating.

In a way, the new weight-loss drug is essentially trying to replicate the effects of bariatric surgery. But these are just two of her hormones. Bariatric surgery is “more comprehensive” because it “affects several different hormones and different pathways,” Levy said. In one study, Munjaro, considered the most powerful of the current medicines, 20 percent 57% of people lost weight or more An impressive feat, but far from what is possible with surgery. Similarly, Ozempic and Mounjaro, which are technically diabetes drugs, have a powerful effect on blood sugar levels over time, but many surgical patients “dispose of their diabetes in remission,” Levy said. says.

In addition to sheer potency, surgery is much more affordable than these weight loss drugs. covered by Medicare If the patient meets certain criteria, such as a BMI of 35 or greater and at least one obesity-related comorbidity.many private insurance companies cover it too, albeit to varying degrees.Self-pay, operation cost $15,000 to $25,000— not cheap, but still cheaper than shelling metersore than $1,000/month indefinitely. “Patients need to understand that they have to stay on the drug forever,” Lofton said.People who typically stop taking semaglutide regain lost weightLofton told me about one patient who had to pay rent just to pay for her medicine.

Of course, neither treatment is without potential drawbacks.Semaglutide can cause temporary but troublesome side effects such as nausea, vomiting and diarrhea and is considered safe for treating obesity, but long-term data on this use are lacking. 2 yearsMany surgeries are performed laparoscopically, so only small incisions are used.Mortality is extremely lowand many patients go home afterwards two or three dayscomplete recovery usually takes 4-6 weeks. Complications such as hernias, gallstones, and hypoglycemia can occur in the long term.

But there’s a reason bariatric surgery hasn’t sparked the weight-loss revolution currently associated with semaglutide.Despite its dramatic effects, obesity Prevalence throughout the United Statesthat’s all 1 percent 80% of people eligible for surgery actually do. People hesitate for medical and other reasons, but the most prevalent problem is the lack of awareness that surgery is a safe and even viable option for weight loss. are plagued by prejudice. In the 1990s, “Barbaric” “Many primary care physicians don’t talk enough about surgery,” Levy says. It doesn’t help that bariatric surgery wasn’t a media sensation. Al Roker and Mariah CareyIn contrast, there are plenty of celebrity stories about weight loss drugs.

The advantages of surgery over weight-loss drugs may change as drugs become more potent and ultimately cheaper. In fact, these new drugs could serve as a conduit to surgery itself. Levy predicts that its popularity will cause a temporary decline in bariatric surgery rates, but prices The problem remains that obese people can’t reach their weight loss goals with medication alone, so “they may start to open up” to surgery. “

Indeed, in some patients, weight loss drugs alone may lead to sustained weight loss. More broadly, however, these drugs are likely to be used in conjunction with bariatric surgery to produce more dramatic and long-term results, experts told me. Fatima Cody Stanford, a physician, said, “I don’t think of this as one or the other. I think of it as surgery and medicine.”

Drugs help fill the gaps left by the surgery. Weight may return after surgery. Hormones that have been depleted by bariatric surgery may “begin to come back violently,” Stanford said.about Fifth of people, and probably even more, a significant amount (15% or more) of body weight is recovered 2 to 5 years after surgery. All the doctors I spoke with said medication could be a powerful tool for preventing weight rebound after surgery. However, it is not necessarily semaglutide. Older drugs are often sufficient. Medications can also be used to help prepare for surgery, Lofton said.some doctors encourage the patient to lose weight to reduce before risk of complications Blood clots, heart attacks, infections, etc.

Despite the hype, weight loss drugs have never been a perfect cure for obesity. Neither is bariatric surgery for that matter. “It’s not a cure,” Lofton told me. The treatment she described would ensure that hunger doesn’t return and fat cells don’t get bigger. Characteristics of obesity: “Nothing does it”—more powerful next-generation drugs cannot provide a permanent solution. she said.

The lack of a cure for obesity is evidence that obesity is complex. All the experts I spoke with pointed out that obesity has long been misunderstood as a lack of personal will, such as laziness or overeating. Many people who later regain weight Feel Even if human biology is to blame, their doctors “wasted the surgery,” Stanford said. Ozempic and other weight loss drugs view obesity as a condition, or disease, that can be treated with medication. Patients taking these drugsHey, maybe I’m not the only one who’s been lazy all along — maybe it has something to do with science and actual disease‘ said Levi. Understanding obesity collectively, not as a problem of personal inadequacy, but as a disease that exists alongside heart disease and cancer, will have a much more severe impact on obese people than drugs alone.