The Ozempic frenzy shows no signs of slowing down.Demand for this widely used drug for weight loss is very high monumental that it already exists change diet industry and, “Marketing Success” Among dozens of telemedicine startups, prescribe now that. An advertising campaign promoted by a startup, Ro, confirms the drug’s simple premise: take it weekly to lose weight.
Never before has a weight loss treatment been so hyped and I was able to keep that promise. While Ozempic itself is technically a diabetes drug, its active ingredient, semaglutide, is FDA-approved for weight loss under the trade name Wegovy and can reduce a person’s maximum weight. 20 percent by weekly injections. An even more potent drug known as tirzepatide or munjaro could soon be approved for weight loss purposes, and a number of new drugs are entering the pipeline. All signs suggest America is on the brink of a weight loss revolution.
But for obese people, semaglutide isn’t even the most effective weight-loss treatment, or even close to it. Bariatric surgery, which has been around for decades, is still far more powerful. Broadly speaking, this type of procedure, which reconfigures the digestive system so that people feel less hungry and more full, is the “gold of gold” in obesity treatment, says Holly Lofton, an obesity physician at New York University. It is considered to be the standard,” he said. Most people experience 50% weight loss, and up to 80% weight loss in a single procedure. Cleveland Clinic.
Despite the new weight-loss drug’s amazing capabilities, and bold Assertion I never thought that such a drug would be available someday replace surgery Frankly, some doctors have told me that surgery will likely continue to be the first-line treatment for obesity, even with advances in medicine. Because new drugs are so popular, people may seek treatment with new drugs, but “in the long run, gain Shauna Levy, professor of bariatric surgery at Tulane University School of Medicine, told me. The new drug, however powerful, could be a powerful tool to treat obesity rather than a revolutionary solution to it, and is one of many drugs that already exist.
Unlike semaglutide, bariatric surgery, first introduced in the 1950s, was slow. decades To become accepted in the medical community.The first attempts made people sick and sometimes required surgery. had to reverse.the term bariatric surgery “refers to a number of different procedures that alter the shape of the gastrointestinal tract so that it can absorb less nutrients, hold less food, or both.” A commonly performed surgery is called Luen Wai surgery, which reduces the stomach to a smaller size. walnutThat is, a person needs less food to feel satisfied and reconnects it to the small intestine in a Y-shape instead of a straight line. This gastric bypass causes food to bypass most of the stomach, reducing the chances of the body getting nutrients. In another common surgery, a surgeon sculpts and shapes the stomach. banana-size “sleeve” and toss the rest. another common type You need to reroute your intestines in a way that minimizes the area from which calories are absorbed.
But bariatric surgery does more than just reduce the gastrointestinal area. Although less visible, it has equally powerful effects on various hormones that control hunger.some procedures remove the intestine It produces ghrelin, the “hunger hormone”, and at the same time reroutes food through Lu An Yi. enhance the release of “Incretin” Hormones that produce a feeling of satiety after eating.
In a way, new weight-loss drugs are essentially trying to replicate the effects of bariatric surgery. The success of these drugs is due to their ability to mimic incretin hormones and make people feel satisfied while eating less. Semaglutide impersonates the hormone GLP-1, whereas Mounjaro impersonates both her GLP-1 and GIP. But these are just two of her hormones. Bariatric surgery “touches several different hormones and different pathways” and is therefore “more comprehensive,” Levy said. In one study, Munjaro, thought to be the most potent of the current drugs, 20 percent Over 57% lost weight Who received the highest dose? This is a great feat, but it is still far from what is possible with surgery. Similarly, technically speaking, the diabetes drugs Ozempic and Munjaro have strong effects on blood sugar levels over the long term, but many surgical patients are “already discharged from the hospital in diabetes remission,” Levy said. Stated.
Besides the strong effects, surgery is also much more affordable than these weight loss drugs.Unlike drugs, bariatric surgery covered by Medicare If the patient meets certain criteria (such as a BMI of 35 or greater and at least one comorbidity related to obesity).many private insurance companies please cover that tooEven if there is a difference in degree.Out-of-pocket expenses for surgery $15,000 to $25,000— not cheap, but still cheaper than paying big bucks metersmore than ore $1,000/month indefinitely. “Patients have to understand that they have to be on medication forever,” says Lofton.People who have stopped taking semaglutide in general regain lost weight. Lofton told the story of a patient who had to pay rent just to pay for her medicine. Considering insurance, it means, “If you pay for medicine for three months, you can have surgery for the same amount after that.”
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, although long-term data on this duration of use are scant. . 2 years. This is because many surgeries are done laparoscopically using only small incisions.Mortality is surprisingly lowand many patients go home afterwards two or three daysfull 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 led to the kind of weight-loss revolution now associated with semaglutide. Despite its dramatic effects and obesity, Spread across Americathat’s all 1 percent Percentage of people eligible for surgery actually undergo surgery. People are hesitant for a variety of medical and other reasons, but the most prevalent problem is the lack of awareness that surgery is a safe or viable option for weight loss. Bariatric surgery is plagued with stigma, even within the medical community. Bariatric surgery was ignored as a problem in the 1990s. “Barbaric” It’s a way of coping with problems that many believed could be cured with diet and exercise. “A lot of primary care doctors don’t talk enough about surgery,” says Levy, because they’ve been trained in the old way of thinking. It doesn’t help that bariatric surgery hasn’t become a media sensation, and there are few high-profile patient advocates. Al Roker and Mariah Carey. In contrast, stories abound of celebrities taking weight loss pills. Unlike surgery, semaglutide may be taken recreationally.
The benefits of surgery over weight loss drugs may change as drugs become more potent and ultimately cheaper. But for now, doctors told me, semaglutide won’t dramatically change how obesity is treated. In fact, these new drugs could serve as a conduit to surgery itself. Levy expects its popularity to lead to a temporary decline in bariatric surgery rates, but the price problem remains and obese people cannot reach their weight loss goals with drugs alone. “They may start to open up,” he said. to surgery. “
Indeed, in some patients, weight-loss drugs alone can result in sustained weight loss. And people who are overweight but ineligible for surgery may also benefit. But more broadly, these drugs are likely to be used alongside bariatric surgery to produce more dramatic and long-lasting effects, experts told me. “I don’t see this as an either/or,” Fatima Cody Stanford, an obesity physician at Massachusetts General Hospital and Harvard Medical School, told me. “I think of this as surgery and medicine.”
Drugs help fill the gaps left by the surgery. The body has a way of rebalancing itself, so the weight may rebound after the procedure. Professor Stanford said hormones suppressed by bariatric surgery could “begin to reappear in a frenzy”.about Fifth of people and probably more, 2 to 5 years after surgery, body weight is significantly regained by more than 15%. All the doctors I spoke with said that drugs could be a powerful way to prevent post-operative weight rebound. However, in order to keep the weight under control, the drug must be taken permanently. Dr. Stanford estimates that more than 90% of his patients take weight-loss drugs after surgery, not necessarily semaglutide. Older drugs are often sufficient. Lofton said the drug could also be used to help prepare for surgery.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 were never the perfect cure for obesity. Moreover, it is not bariatric surgery. “It’s not a cure,” Lofton told me. The treatment, she explained, is to keep hunger from returning and fat cells from growing. Characteristics of obesity: “There is nothing that does it.” — Even stronger next-generation drugs cannot provide a permanent solution. But the combined effect of surgery and medication could come close, she says.
The lack of a cure for obesity is evidence of its complexity. All the experts I spoke to pointed out that obesity has long been misinterpreted as a failure of personal will, laziness and overeating. That misunderstanding leads to inadequate care. Many people who regain weight after bariatric surgery are made me feel Stanford University said doctors accused it of “wasteful surgery,” even if it was due to human biological responsibility. Ozempic and other weight-loss drugs frame obesity as a condition, or disease, that can be treated with drugs. Patients taking these drugs may perceive that:Hey, maybe I’m not the only one who’s been lazy all the time – maybe there’s a science to it and an actual disease“It’s about understanding obesity holistically, not as a problem of individual inadequacy, but as a parallel disease (that is routinely treated with medication and surgery) that runs alongside heart disease and cancer,” Levy said. will have a much more severe effect on obese patients than the drug alone.
