Bariatric, or weight-loss, surgery stands out as a highly effective treatment option for individuals who qualify, enabling them to attain a healthier weight. This transformative journey requires unwavering commitment to long-term lifestyle modifications and behavioral changes that foster overall wellness.
Research indicates that individuals needing to shed 50 pounds or more experience significantly higher success rates with surgical interventions, potentially combined with medications, compared to relying solely on pharmacological treatments.
“Surgery has been shown to have greater success in keeping more weight off long term,” explains MultiCare bariatric surgeon Benedict Hui, MD. “While medications often necessitate lifelong adherence to maintain weight loss, making it likely for the weight to return once the medications are discontinued, surgery is generally conceived as a one-time transformative event.”
Prior to undergoing bariatric surgery, potential candidates must fulfill specific criteria, which commonly include undergoing a series of tests and blood work, consulting with a psychologist to address any mental health concerns, and meeting with a dietitian to develop a comprehensive dietary plan.
Reasons for medication use
In some cases, patients may be required to lose a designated amount of weight before surgery, as this preoperative weight loss offers several important benefits. It significantly lowers the chances of complications during and after surgery, enhances the surgeon’s access and visibility to the operating area, and may result in greater total weight loss after the procedure.
The most common scenarios that necessitate weight loss before surgery include instances where a person’s body mass index (BMI) exceeds 50 or where such a requirement is stipulated by health insurance providers.
A surgeon may also establish a specific preoperative weight-loss goal tailored to the type of bariatric surgery being performed.
“I view the relationship between weight-loss medications and weight-loss surgery similar to the treatment of cancer,” states Dr. Hui. “Chemotherapy plays a role in treatment prior to or after surgery for the removal of the cancer. In a comparable manner, for patients battling obesity, weight-loss medications can significantly enhance the positive outcomes associated with weight-loss surgery.”
Tools and support to help reach weight-loss goals
For every patient considering bariatric surgery, a fundamental aspect of the MultiCare Center for Weight Loss & Wellness is providing extensive lifestyle support and personalized educational resources. This comprehensive approach includes ongoing consultations with a dedicated dietitian who equips patients with essential tools and guidance to facilitate effective weight loss prior to surgery.
If you are required to lose weight before surgery but encounter challenges in doing so, your surgeon will refer you to one of MultiCare’s knowledgeable bariatricians or medical weight loss specialists, who are well-equipped to assist you in achieving your weight-loss objectives.
“For those who experience difficulty making progress with losing preoperative weight, we can offer medication options,” says MultiCare medical weight loss specialist Carrie Wong, MD.
People who need to lose 50 pounds or more will typically be more successful with surgery, or surgery with medications, versus medications alone.
Medical weight loss specialists like Dr. Wong thoroughly evaluate the types of medications available, carefully selecting the most suitable option for your unique circumstances.
Types of weight-loss medications
Among the medications that can be utilized to facilitate weight loss prior to bariatric surgery are GLP-1s and appetite suppressants, both of which play distinct roles in the weight loss process.
GLP-1s are advanced medications that imitate a gut hormone known as glucagon-like peptide-1 (GLP-1), which enhances insulin secretion after meals. This insulin release not only helps to stabilize glucose levels but also induces feelings of fullness by slowing gut motility and lowers appetite by acting on brain receptors.
Commonly prescribed appetite suppressants include phentermine-topiramate (Qsymia), a stimulant, and naltrexone-bupropion (Contrave), which offer more economical alternatives to GLP-1s while still effectively aiding in weight loss efforts.
Choosing the most appropriate medication is a multifaceted process that not only considers the medication’s effectiveness but also accounts for your health history, the potential for tolerance, and insurance coverage, among other key factors. This highlights the importance of collaborating with a healthcare provider who specializes in the management of these medications, ensuring that critical discussions encompass:
- Are there health conditions that preclude the patient from taking the medication?
- Does the medication interact with other medications the patient is taking?
- What are the side effects?
- Is taking an oral tablet preferable to injections?
- Is the medication covered by insurance?
Health history is a determining factor
“Health history is one of the most important aspects of this determination, as there are medical reasons we can’t offer certain medications,” explains Dr. Wong. “For instance, if someone has a history of pancreatitis or thyroid cancer, we wouldn’t give them a GLP-1.”
Phentermine provides another instance of these considerations. If a patient has a documented history of insomnia, anxiety, or heart-related issues including arrhythmias or uncontrolled blood pressure, this medication may exacerbate those existing conditions.
Upon selecting the appropriate medication, the medical weight loss specialist will meticulously monitor the patient while they are undergoing treatment, ensuring optimal results within a safe framework.
These pre-surgery requirements offer an additional advantage of igniting sustainable lifestyle changes.
“Losing weight before surgery isn’t just about reaching a goal,” Dr. Wong adds. “It’s an opportunity for a person who has made the decision to undergo a life-changing surgery to start making changes now that will serve them post-surgery as well.”
What are the main benefits of bariatric surgery for individuals with obesity?
**Interview with Dr. Benedict Hui: Understanding Bariatric Surgery and Weight-Loss Medications**
**Editor:** Today, we’re joined by Dr. Benedict Hui, a bariatric surgeon at MultiCare, to discuss the effectiveness of bariatric surgery as a weight-loss treatment option and the role of medications in this process. Thank you for being here, Dr. Hui.
**Dr. Hui:** Thank you for having me!
**Editor:** To start, could you explain why bariatric surgery is considered a highly effective treatment for those struggling with obesity?
**Dr. Hui:** Absolutely. Bariatric surgery has proven to be a transformative option for individuals who qualify, particularly those who need to lose 50 pounds or more. Research shows that surgical interventions have significantly higher long-term success rates compared to relying solely on medications. The surgery acts as a one-time event that can lead to substantial, lasting weight loss, especially when combined with lifestyle changes.
**Editor:** That’s interesting. What should individuals know about the commitment involved in this journey?
**Dr. Hui:** It’s crucial for patients to understand that while surgery is a profound step forward, it requires unwavering commitment to long-term lifestyle modifications and behavioral changes. These changes are essential for achieving overall wellness and maintaining weight loss over time.
**Editor:** Before undergoing surgery, what criteria must candidates meet?
**Dr. Hui:** Candidates typically undergo a comprehensive process, including various tests and blood work, a psychological evaluation to assess mental health, and consultations with dietitians. These requirements help ensure that patients are physically and mentally prepared for the surgery.
**Editor:** Are there instances where patients must lose weight before surgery? If so, why is that important?
**Dr. Hui:** Yes, in some cases, patients with a body mass index (BMI) over 50 or those with specific insurance requirements may need to lose a designated amount of weight preoperatively. This pre-surgery weight loss can lower the risk of complications during and after the procedure and can enhance the surgeon’s ability to operate effectively.
**Editor:** You mentioned that medications can play a role in the weight-loss journey. How do they fit into the picture?
**Dr. Hui:** I liken the relationship between weight-loss medications and bariatric surgery to cancer treatments involving chemotherapy. Just as chemotherapy can enhance surgical outcomes for cancer patients, weight-loss medications can significantly improve results for those choosing surgery to combat obesity. They can help patients who may struggle to achieve the required weight loss before surgery.
**Editor:** What types of medications are typically offered to patients?
**Dr. Hui:** We have several options, including GLP-1s—advanced medications that help regulate blood sugar and induce feelings of fullness—and appetite suppressants like phentermine-topiramate and naltrexone-bupropion. Each patient’s situation is unique, so it’s important to evaluate these medications based on the individual’s health history and needs.
**Editor:** Thank you, Dr. Hui, for shedding light on the important aspects of bariatric surgery and the role of medications in weight loss. Any final thoughts for our readers?
**Dr. Hui:** I just want to emphasize that seeking help is a vital first step for anyone struggling with obesity. Bariatric surgery, combined with medication and a strong support system, can lead to significant health improvements and a better quality of life.
**Editor:** Thank you once again for your insights, Dr. Hui.
**Dr. Hui:** Thank you! It’s been a pleasure.
