How Weight-Loss Medications and Bariatric Surgery Can Work Together

man on scale with weight being measured

Obesity—generally defined as having a BMI of 30 or more—is a complex and chronic disease that can't be cured. The good news is it can be successfully managed with a variety of surgical, medical, and lifestyle options, the latest being a class of type 2 diabetes drugs recently FDA-approved for weight loss. While bariatric surgery is still the most powerful and permanent tool to manage obesity, these highly effective medications can play a significant role in helping some patients achieve lasting results.

Based on your individual health picture, BMI, and weight-loss goals, your primary care doctor or a weight management specialist is the best source to explain which treatments might be right for you. The information below is designed to help you make the most of that conversation.

Diabetes drugs now approved and re-named for weight loss

You can't turn on the TV or scroll through your social media feed without seeing something about the popularity of prescription diabetes drugs that are now being used specifically for weight loss. How and when they are best used can be confusing. Let's break it down.

People at various stages of their weight loss journeys—including those who had weight-loss surgery and either regained weight or want to lose more—can benefit from the drugs liraglutide and semaglutide, traditionally used to treat type 2 diabetes. Several of these medications are now FDA-approved for weight loss under brand names Saxenda® (liraglutide) and Wegovy® (semaglutide). By the time you read this, others may be approved as well. This class of medications—called glucagon-like peptide-1 (GLP-1) agonists—are showing promising results for many patients.

GLP-1 agonists are taken daily or weekly by shot/injection, and work by suppressing your appetite so you eat less. They act like the gut hormone GLP-1 which is released after you eat, slowing down food movement. This helps you stay full for longer periods of time.

Side effects of diabetes drugs for weight loss

Gastrointestinal issues are the most common side effect for people just starting to take GLP-1s for weight loss. This can often be minimized by beginning at a lower dose and gradually increasing. Side effects may also include dizziness, fatigue, and headache.

Bariatric surgery and weight-loss medications

Bariatric surgery, like any weight-loss tool, needs to be used correctly. Even after vertical sleeve gastrectomy or Roux-en-Y gastric bypass surgery, patients can experience weight gain. In fact, five years after their surgery, people who don't consistently follow up with their weight-loss surgery team and stick to healthy lifestyle choices, sometimes regain as much as 50 percent of the weight they lost.

Combining surgery with the newly approved weight-loss drugs and a healthy lifestyle is proving especially promising in helping people who are morbidly obese (a BMI of 40+) maintain their weight loss. As you continue to work toward your goals, keep these important tips in mind:

  • Eat a healthy diet
  • Make activity part of your daily routine
  • Take care of your mental health
  • Build a relationship with your weight-loss team

Follow-up and GLP-1 medications

Patients who follow up for five years post-surgery have the best chance of maintaining the healthier weight they achieved. If you begin to regain weight or would like to lose more to hit your goal, discuss this with your weight management doctor during one of your appointments. They may suggest adding one of the weight-loss medications—usually about two years after surgery. For best results, most people need to stay on a GLP-1 for at least two years. Because their use in treating obesity is new, further research will determine just how long patients need to take GLP-1s to maintain their desired weight.

A promising time for obesity treatment

Obesity is a complex disease and managing it requires commitment, hard work, and open and honest communication with your health-care team. The diabetes drugs now FDA-approved and branded for weight loss, offer new, highly effective tools that along with bariatric surgery, healthy lifestyle choices, and diligent follow-up, can help people achieve and maintain a healthy weight.

Learn more about the Healthy Weight Management and Bariatric Surgery program at Penn Medicine Lancaster General Health.

author name

Joseph R. McPhee, MD

Joseph R. McPhee, MD, is a physician specializing in bariatric surgery with Healthy Weight Management & Bariatric Surgery.

Education: A graduate of New York University and Mt. Sinai School of Medicine, Dr. McPhee completed a fellowship in minimally invasive surgery at Eastern Virginia Medical School and his residency at North Shore University Hospital.

Call: 717-544-2935

About LG Health Hub

The LG Health Hub features breaking medical news and straightforward advice to help individuals of all ages make healthy choices and reach their wellness goals. The blog puts articles by trusted Lancaster General Health clinical experts, good 'n healthy recipes, videos, patient stories, and health risk assessments at your fingertips.

 

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