What is Medical Treatment vs Weight Loss Surgery?
Medical treatment and weight loss surgery are two different approaches to managing obesity and achieving weight loss goals. Choosing between medical treatment and weight loss surgery for managing obesity involves considering various factors such as the individual's health status, the severity of obesity, and the effectiveness of previous weight loss efforts.
What Does Obesity/Weight Loss Management with Medical Treatment Involve?
Medical weight loss management is a treatment approach in which your physician prescribes drugs that interact with your body in specific ways that promote weight loss. Medications may be prescribed if lifestyle changes, such as diet and exercise, alone have been unsuccessful in reducing weight or treating obesity. Drugs work in various ways, such as suppressing appetite, reducing fat absorption, increasing the metabolic rate to help burn calories more efficiently, or increasing feelings of fullness. Commonly prescribed medications include:
- Orlistat (Xenical, Alli): Reduces the absorption of fat from food.
- Phentermine-topiramate (Qsymia): Combines an appetite suppressant with a medication that induces feelings of fullness.
- Naltrexone-bupropion (Contrave): A combination that affects the central nervous system to reduce hunger and cravings.
- Liraglutide (Saxenda): A daily injection that mimics a hormone to regulate appetite.
Benefits
- Non-invasive.
- Fewer risks and side effects compared to surgery.
- Can be customised to the individual's needs and adjusted as necessary.
Limitations
- May require long-term commitment and motivation.
- Weight loss can be gradual and might not be sufficient for individuals with severe obesity.
- Possible side effects from medications.
What Does Obesity/Weight Loss Management with Weight Loss Surgery Involve?
Weight loss surgery is a surgical procedure in which your surgeon makes changes to your digestive system to help you lose extra weight.
Common Surgeries
- Gastric Bypass: Creates a small stomach pouch and reroutes the intestines to this pouch, leading to reduced calorie absorption.
- Gastric Sleeve (Sleeve Gastrectomy): Removes a portion of the stomach, resulting in a smaller stomach size and reduced appetite.
- Adjustable Gastric Band: Places a band around the upper part of the stomach to create a small pouch and restrict food intake.
- Biliopancreatic Diversion with Duodenal Switch: Combines a sleeve gastrectomy with a more extensive intestinal bypass.
Benefits
- Significant and rapid weight loss.
- Improvement or resolution of obesity-related comorbidities (e.g., type 2 diabetes, hypertension).
- May improve the quality of life and increase lifespan for individuals with severe obesity.
Risks and Complications
- Surgical risks, including infection, bleeding, and complications from anaesthesia.
- Long-term risks such as nutritional deficiencies, dumping syndrome, and the need for additional surgeries.
- Requires lifelong lifestyle changes and follow-up care.
Comparing Medical Treatment and Weight Loss Surgery
Indications
- Medical Treatment: Suitable for individuals with mild to moderate obesity or those who prefer non-invasive methods. Often the first-line approach.
- Weight Loss Surgery: Recommended for individuals with severe obesity (BMI ≥ 40 or BMI ≥ 35 with obesity-related conditions) who have not achieved significant weight loss through medical treatment alone.
Effectiveness
- Medical Treatment: Effective for some, but weight loss may be limited and slower. Often involves continuous effort and may require medication adjustments.
- Weight Loss Surgery: Typically results in more significant and sustained weight loss. Can lead to a substantial reduction in obesity-related health issues.
Lifestyle Impact
- Medical Treatment: Involves ongoing lifestyle changes and medication adherence. Less disruptive initially but requires consistency.
- Weight Loss Surgery: Requires significant lifestyle adjustments post-surgery, including dietary changes and vitamin supplementation. Potentially more disruptive but can lead to profound health improvements.
Ultimately, the choice between medical treatment and weight loss surgery should be personalised, taking into account the individual's specific circumstances, preferences, and health goals.
