The Metabolic Benefits of Bariatric Surgery Over Weight Loss Drugs
You’re struggling with obesity, and you know you’re ready to lose the weight and keep it off. You’ve probably heard a lot of hype about second-generation weight loss medications (Mounjaro, Ozempic, Wegovy, and Zepbound) and you’re not sure if you should try these medications or if you should go with bariatric surgery.
In this article we’ll look at an under-discussed component of the choice between weight loss medications and weight loss surgery: the metabolic benefits of each one.
Understanding the Metabolic Impact of Obesity
Obesity can have a profoundly negative impact on your metabolic system. One reason is that fat tissue (called adipose tissue) is actually an endocrine organ that produces various hormones. These hormones, including leptin, visfatin, and adiponectin, play a powerful role in weight regulation in the body as well as affecting other systems. When your body has more fat tissue, it produces more of these hormones leading to hormonal imbalances. These hormonal and other imbalances don’t just contribute to additional weight gain; they’re also part of what causes the comorbidities that are associated with obesity, including insulin resistance, type 2 diabetes, hypertension, and sleep apnea.
These metabolic changes can also make it very hard for patients to lose weight with diet and exercise alone. When you start to lose weight, your body goes into ‘starvation mode’ and works overtime to keep the weight on. One reason is that when your body produces more of neuropeptide Y, you become hungrier and your metabolism slows down. Your body produces more of this peptide when you’re actively burning fat, which is part of why losing weight and keeping it off when you suffer from obesity is so hard.
The Metabolic Benefits of Bariatric Surgery
The metabolic benefits of bariatric surgery are profound: bariatric surgery has proven to be very successful at undoing the damage done to patients’ metabolic system by obesity. Part of this is because bariatric surgery helps patients to lose weight and keep it off; and the reduction in adipose tissue can help to re-regulate and properly balance patients’ hormones. But bariatric surgery also affects the gut, brain, liver, pancreas, and kidney; as well as affecting your muscle and even your bone. In fact, bariatric surgery is so successful at rewiring patients’ metabolic system that it is sometimes referred to as ‘metabolic surgery.’
Certain types of bariatric surgery have proven to be very successful at curing type 2 diabetes. Duodenal switch patients see cures in up to 98% of cases. One reason is that bariatric surgery increases production of PYY and adiponectin, which reduce insulin resistance after surgery. This is also part of why bariatric surgery lowers patients’ risk of heart attacks.
There’s even evidence that bariatric surgery improves your basal metabolic rate, meaning that your body burns more calories.
The Metabolic Impact of Weight Loss Drugs
Second-generation weight loss medications such as Semaglutide (the active ingredient in Ozempic and Wegovy) and Tirzepatide (the active ingredient in Mounjaro and Zepbound) also have modest impacts on patients’ metabolic systems. The biggest impact is on insulin resistance. Both Semaglutide and Tirzepatide are GLP-1 agonists, meaning that they were designed to combat diabetes by managing blood sugar levels. As the SUSTAIN 1-3 trials showed, Semaglutide reduces the amount of sugar that the liver secretes, decreases insulin resistance, and also stimulates insulin production.
By reducing patients’ hunger and making them feel full longer, these medications can also reduce patients’ body fat levels, which can help with hormonal regulation. However, the ability of these medications versus bariatric surgery to reduce body fat is limited. Mounjaro, Ozempic, Wegovy, and Zepbound can help some patients to lose up to 20% of their total body weight (though many patients lose much less). By contrast, at the Bariatric and Metabolic Center of Colorado many of our patients lose 90% of their excess body weight or even more and keep it off.
These medications have little effect on patients’ resting metabolic rate or on other aspects of their body and hormonal profile. They are generally unsuccessful at treating many comorbidities of obesity that can be successfully treated by bariatric surgery.
What Are the Key Differences In Metabolic Benefits Between Bariatric Surgery and Weight Loss Drugs?
The biggest difference is that bariatric surgery creates far more full-body change in your metabolic system than do weight loss drugs. Bariatric surgery has positive impacts on your gut, brain, liver, pancreas, kidney, muscle, and bone. This is one reason that bariatric surgery is so effective at relieving the comorbidities associated with obesity such as sleep apnea and cardiovascular risk, as well as type 2 diabetes. It can also help patients to dramatically reduce their levels of adipose tissue, which can help with hormonal regulation. By contrast, weight loss drugs primarily reduce appetite and help with type 2 diabetes.
Bariatric Surgery: A Powerful Weight-Loss Solution
Bariatric surgery has helped many patients to reverse the damaging metabolic impacts of obesity on their bodies. It has helped them to resolve a wide range of comorbidities, from type 2 diabetes to sleep apnea to the risk of heart attacks.
Bariatric surgery is also very safe. Second-generation weight loss medications carry the risk of substantial side effects. By contrast, at a certified ASMBS comprehensive MBSAQIP center like the Bariatric and Metabolic Center of Colorado, weight loss surgery is no more dangerous than any minor outpatient surgery such as gallbladder surgery. For most of our patients, surgery is an outpatient procedure, and they leave the hospital the same day as the surgery. Most patients are back at work within a few weeks, with more energy and very few if any complications.
Finally, bariatric surgery is an extremely powerful weight loss tool. Paired with diet and exercise, weight loss surgery has helped thousands of patients just like you to lose weight and keep it off. Most of our patients lose 90% of their excess weight or even more. Imagine how that would feel.
Our patients routinely say that the decision to undergo bariatric surgery was the best decision they ever made.
“Today, 2 years later and 105 pounds less I am a new person. No walker, no cane, no Oxygen. I am completely cured of diabetes and off all those meds.”–Colleen White, gastric bypass patient.
If you’re suffering, don’t wait. Contact our Denver office today.
