Weight loss, which is right for you: Surgery or medication?

There is an obesity epidemic in the United States and around the world.

The World Health Organization estimates 1 in 8 people globally are obese.

“Losing weight is the best thing you can do for your health,” said Brian Cantor, M.D., F.A.C.S., F.A.S.M.B.S., a bariatric surgeon with Meritus Surgical Specialists. “It’s an underlying cause for health problems including high cholesterol, diabetes, high blood pressure, heart disease, sleep apnea.”

But losing weight is easier said than done. While diet and exercise are the logical routes, they often aren’t successful on their own, Dr. Cantor said.

If that’s the case, there are steps that can be taken medically to reduce weight. Options include bariatric surgery or using prescribed medication, such as Ozempic.

But how do you know which option is the best for you?

One of the biggest factors is your body-mass index. Those with a BMI between 27 and 30 typically are not candidates for surgery but could see benefits from medication.

Those with a BMI of 35 or higher who also have comorbidities, such as high cholesterol, high blood pressure, diabetes or others, would be a candidate for surgery. Those without comorbidities and a BMI of 40 also would likely qualify for surgery.

Medication might be a better option for those with a high BMI whose doctors have determined it would not be safe for them to have surgery, Dr. Cantor said. It might also work for those who are extremely overweight, who need to lose pounds before being considered for bariatric surgery.

“Or, we might find that the best course of action is to do the surgery first and then help maintain after that with medication,” Dr. Cantor said.

No matter the direction, it’s important to review all the details and understand each option.

Bariatric surgery has been around for decades and has been shown to reduce weight significantly and keep that weight off for years afterward with minimal side effects, Dr. Cantor said.

Medication hasn’t been around as long, so there’s less research available. And while it tends to act quickly, the weight can be gained back quickly once the medication is stopped.

“We would tailor the decision-making process to the individual,” Dr. Cantor said.

When it comes to the surgery option, multiple medical disciplines get involved. The patient will get a psychological evaluation. He or she will get support from a nutritionist. They will go through a sleep study. And the patient’s primary care provider would be involved from the start.

“We want to make sure you’re covered mentally, physically and spiritually,” he said.

The process for surgery takes between six and nine months, which also allows for a diet and exercise regemine to be put in place.

“That habit is then there after the surgery,” Dr. Cantor said. “It’ll be in place so that, after the surgery, there is something to fall back upon when stressors arise.”

A diet and exercise regemine are also recommended for those using medication.

In both cases, the end result is what Dr. Cantor called “the halo effect.”

“The whole family ends up following the same diet that the patient does,” he said. “So the people around them also become healthier, too.”

To learn more about weight loss options, visit www.meritushealth.com/Weightloss or call 301-714-4044.