RICHMOND, Va. --
A new year often means new health goals, and for many, weight loss can be at the top of the list. GLP-1 medications continue to make headlines, but how do they compare to surgical solutions? Dr. Ghilherme Mazzini with VCU Health, recognized as one of America’s best weight loss clinics, answers these four questions to help you understand your options.
How do GLP-1 medications fit into the big picture as compared to surgery?
GLP-1 medications are a great advancement, but I don’t see this as a surgery vs. medication issue. Obesity is a chronic disease, and we need to assess the patients and match the tools that we have to meet their needs. When we talk about surgery it doesn't apply to a person who is just overweight or mild obesity, so have an online tool on our website to calculate body mass or body mass index. If you BMI is equal to or greater than 35, that’s when surgery becomes an option.
We know that surgery leads to a more sustained and greater weight loss than medications, but medications usually do work while the patients are taking them. It’s our job to assess the patient and match their medical needs and long-term goals to do the best we can for them.
Do many patients start with GLP-1 medications first and then come to talk to you about surgery?
Some of our patients do, but this is not a rule. Some patients may want to explore a less invasive treatment before going into surgery, but it is important to say that surgery is not a last resort. For many patients it can be the first option, especially if they have more weight to lose or if they are already suffering from complications like diabetes, high blood pressure, chronic kidney disease, fatty liver or acid reflux.
The key thing to remember is most of the time, these strategies work together, and we may use GLP-1s before the surgery to decrease surgical risk or after the surgery to help with some weight regain. It depends on the patient and what they need.
What does surgery provide that maybe the GLP-1 medications don’t?
I am passionate about this because, with obesity, the goal is to lose the excess fat so your metabolism can improve. The GLP-1 medications promote significant weight loss, but with surgery, this weight loss is greater and lasts longer. The focus is what we can achieve in the long-term. For example, 75% of our patients with diabetes go into remission within a year and no longer need medication. Not only that, 90% of fatty liver disease resolves, high
blood pressure improves, and many studies have demonstrated patients have viewer heart attacks, fewer cancers and they live longer.
If someone is considering surgery, what can you tell them about the process and what they can expect afterwards?
First of all, nobody does this alone. At VCU Health, we have a comprehensive team with surgeons, nurse practitioners, dietitians and psychologists because in this setting, long-term success requires much more than just the operation. Nothing makes us happier than seeing our patients thrive and meet their goals—which can be anything from being able to play with their kids, have the diabetes improve or avoid the health problems their parents had dealt with in the past.
The bottom line is each patient has their own journey, so come talk to us. We are open to talk to any patient to explore their options. Just because you are seeing a surgeon doesn’t mean you need surgery. Our team is ready to consult with any patient and offer the best treatment option and most importantly, do so without any judgment.
This segment is sponsored by VCU Health.
