In the ongoing battle against obesity, patients are increasingly turning to both medical and surgical interventions when traditional diet and exercise regimens fall short. Everyone’s weight loss journey is different, and when lifestyle changes and other traditional fixes don’t seem to be working, there are more options available. 

Medical weight loss shots: A short-term boost

The latest trend in medical weight loss involves GLP-1 agonist shots. GLP-1 is a hormone that's produced by the body in response to eating food, and it is a hormone that allows the body to regulate its blood sugar by slowing down the emptying of the stomach. As the stomach empties more slowly, the patient’s appetite is reduced. 

These medications, originally designed for diabetics, have shown impressive short-term results with patients losing 10 to 20 pounds per month in the initial stages. However, the effects tend to plateau after a couple of months, and most patients regain the weight once they stop the medication.

While these shots can provide a helpful jumpstart for those needing to lose 20-30 pounds, they come with significant risks. Prolonged use can lead to gastroparesis (paralysis of the stomach), pancreatitis and persistent nausea. Additionally, the high cost for the drugs, between $2,000 to $4,000 per month, means most insurance plans do not cover them, and compounded generics may be less effective. 

Ultimately, the weight loss shots are recommended for individuals who are willing to make a lifestyle change but need a jump start to help set them on that path. 

Bariatric Surgery: A Long-Term Solution

For those seeking lasting results, bariatric surgery remains the gold standard. The process for surgery, generally, is that patients will go through a three-month medical weight loss period where they’re taught how to eat right, how to exercise and how to make the lifestyle changes necessary to lose weight. After three months of medical weight loss, their insurance approves the operation, and then they go to surgery. The two most common procedures in the U.S. are the vertical sleeve gastrectomy and the Roux-en-Y gastric bypass. 

In a vertical sleeve gastrectomy the surgeon removes about 80% of the stomach but does not bypass any of the intestines, so food and nutrients get absorbed normally. In a Roux-en-Y gastric bypass the surgeon creates a small stomach pouch and then they bypass the upper part of the intestines to get a modest amount of malabsorption and restriction. Both procedures are minimally invasive, with patients typically returning to normal activities within two weeks. Long-term, sleeve patients maintain about 65% of their excess weight loss, while bypass patients see about 70%.

Most insurance plans now cover these surgeries, and the risk of serious complications is low – about 1% in the first 30 days. Long-term risks include vitamin deficiencies and, rarely, the need for reoperation. 

Overcoming Stigma and Embracing Change

Despite the proven benefits, many patients hesitate to pursue surgery due to stigma or fear of lifestyle changes. Many people who could benefit never seriously consider it, often believing medication is safer. In reality, surgery offers greater safety and effectiveness in the long run, with many patients expressing only one regret: not having the procedure done sooner.

Over the past 20 years, societal and medical acceptance of bariatric surgery has grown, driven by its success in resolving related conditions like diabetes, sleep apnea and fatty liver disease. While new medications continue to emerge, none have matched the long-term results of surgery.

Next Steps and Resources

For those interested in learning more, the Cape Fear Valley Health weight loss surgery program offers extensive resources, including an online seminar detailing available procedures and their benefits. Patients can find more information on the Cape Fear Valley website.

Weight loss is a complex journey, but with the right support, patients can make informed decisions about their health. Whether considering medical or surgical options, understanding the risks, benefits and long-term outcomes is key to finding the best solution for you.