GLP-1 Medications – A New Chapter In Weight Management

For many, reaching a healthier weight could be a  complicated process. However, new medical advancements offer new hope. One advancement is GLP-1 receptor agonist medications, known as GLP-1s.

People may have heard of these medications. They are gaining attention for their role in weight management. But how do they fit into obesity treatment, especially when compared to bariatric surgery. Rishabh Shah, MD, a bariatric surgeon, and Sara Ward, FNP-C, a nurse practitioner specializing in medical weight loss, share information.

GLP-1s – Another Tool in the Obesity Treatment Toolbox

Dr. Shah emphasizes that “obesity is a chronic disease and, just like any other chronic disease, needs multiple treatment options.” He compares its treatment to coronary artery disease, which doctors manage with lifestyle changes, medications, stents or surgery. Similarly, obesity treatments range from lifestyle changes to medications and, for some, bariatric surgery.

“Bariatric surgery is an option for significant and long-lasting weight loss,” states Dr. Shah. “But GLP-1 medications are an option for people with less weight to lose or for whom surgery is not a good option.” This highlights that GLP-1s are not a replacement for surgery. They are an additional option designed for different patient health needs.

Navigating the Choice – Medication vs. Surgery

Deciding between medication and surgery is a personalized process. Dr. Shah explains, “We go through a detailed medical history of every patient who seeks our help for weight loss.” Key factors influencing this decision include:

• Amount of weight loss needed – How much weight does the patient aim to lose to achieve their health goals?

• Other medical conditions – Are there co-existing health issues that affect treatment choice?

• Ability to tolerate anesthesia – An important consideration for surgical candidates.

• Mental readiness – The commitment to lifestyle changes required for successful outcomes, whether surgical or medical.

• Patient preference – What the person wants for their weight loss journey.

Understanding Long-term Outcomes

When considering any weight loss intervention, understanding long-term results is important. Dr. Shah shares , “Surgery helps people lose around 25 to 30% of their total weight, whereas medication is around 15 to 20%.” He notes that surgery has a longer track record with data showing “80% of patients maintain weight loss long term.”

For GLP-1 medications, the long-term data is still developing. Studies indicate that about “65% of people stop the medication after one year and 80% after two years.” This can be due to cost, side effects, medication availability or not wanting to continue injections. Dr. Shah cautions that “short term data does show that the majority of people regain weight after stopping GLP-1 medications.” This demonstrates the importance of continuing a long-term management plan.

Addressing common misunderstandings and improving outcomes

Nurse practitioner Sara Ward frequently encounters a significant misunderstanding about GLP-1s. “The biggest misunderstanding I hear from patients about GLP-1 medications is that you do not have to change your habits while taking the medications.” While GLP-1s can lead to weight loss, not making lifestyle changes can result in unhealthy weight loss and potentially increased side effects.

“When you pair positive lifestyle changes with the medications, you improve health benefits and potential weight loss,” she advises. This is why working with a registered dietitian is an important part of a treatment plan.

GLP-1s in Conjunction with Bariatric Surgery

GLP-1 medications can also play a role in the surgical journey.  “Typically, when the medications are used prior to bariatric surgery, it is to help with preoperative weight loss or to gain better control over diabetes,” explains Ward. Preoperative weight loss can lower body mass index (BMI) and reduce surgical risks, especially for those with higher BMI. Controlling diabetes is also important for reducing post-surgical complications.

GLP-1s can also be a tool for patients who experience a plateau in weight loss after bariatric surgery and need to lose more weight.

The Critical Role of Nutrition and Muscle Preservation

When using GLP-1s, nutrition and muscle preservation are important. Ward shares, “Dietary changes are the foundation of healthy weight loss while using these medications.” While GLP-1s can decrease appetite, it can also lead to inadequate nutritional intake and muscle loss if not managed properly.

“The goal is to lose fat while maintaining muscle,” she says. To achieve this, eating enough protein, combined with physical activity, is important. Additionally, “eating enough fiber and drinking enough water to improve gut health and try to offset gastrointestinal side effects” is key. Dietitians are resources, helping patients learn about protein and fiber sources and integrate them into their diet. This ensures a healthy weight loss journey.

GLP-1 medications are a development in the treatment of obesity. They offer a path for many. They are most effective when integrated into a comprehensive approach prioritizing healthy lifestyle changes and personalized medical guidance. Whether used alone, in preparation for surgery or after surgery, understanding their role and improving their benefits with good nutrition and activity is key to long-term success.

To find out if a medical weight loss program or bariatric surgery is right for you, contact CommonSpirit Medical Group - Medical Weight Loss and Bariatric Surgery - Chattanooga. Learn more about weight management treatments available at CommonSpirit - Memorial Hospital.