Modern Obesity Treatments for Long-term Health

People living with obesity often need more than diet and exercise to improve their health. Modern medicine offers powerful and effective tools, including bariatric surgery and GLP-1 medications, that address the complex biological foundations of obesity.

"Obesity is your body’s fat mass not communicating the way it should with your body’s lean mass," explains Brandon Fadner, MD, a board-certified general surgeon. He is fellowship-trained in bariatric surgery and board-certified in obesity medicine. 

This "miscommunication" of metabolic signals is a cause of many obesity-related health issues, including type 2 diabetes, where the body's cells become resistant to insulin. Both bariatric surgery and GLP-1 medications offer solutions by helping to re-establish this communication.

Bariatric Surgery – A Powerful Reset for Your Metabolism

Bariatric surgery has changed significantly and is now one of the safest and most effective treatments for severe obesity and related conditions. It can reduce stomach size and fundamentally change metabolic signaling. As Dr. Fadner notes, "The secret sauce, if you will, at the molecular level, is the drug or surgery’s ability to straighten out the miscommunication between fat mass and lean mass."

Common types of bariatric surgery include:

• Sleeve gastrectomy: This procedure removes a large portion of the stomach. It reduces stomach capacity. Its primary benefit is long-term impact on metabolic hormone behavior. It leads to weight loss and improvements in metabolic health.

• Roux-en-Y gastric bypass: This operation creates a small stomach pouch and reroutes a section of the small intestine. This bypass helps improve insulin and GLP-1 sensitivity. It can resolve type 2 diabetes before significant weight loss occurs.

• Duodenal switch: Less commonly performed but highly effective, this procedure combines elements of both sleeve gastrectomy and intestinal bypass.

Bariatric surgery is safe and durable. Patients often experience significant weight loss, up to 30% of their total body weight within the first year. They also have lasting health benefits including reduced risk of cancer, cardiovascular disease and improved mental health.

GLP-1 Medications: Advancing the Treatment of Obesity

GLP-1 receptor agonists are a breakthrough in obesity medicine. These injectable medications mimic naturally occurring gut hormones. They regulate appetite, promote feelings of fullness and improve blood sugar control. The development of GLP-1 medications is directly linked to insights gained from bariatric surgery.

"GLP-1 meds themselves are a result of our experience with bariatric surgery," Dr. Fadner explains. He highlights how understanding the metabolic changes after surgery led to the development of these drugs. They target insensitivity to GLP-1, a symptom of obesity, helping to restore proper metabolic signaling.

GLP-1 medications are effective and well-tolerated. They lead to weight loss, often around 15-20% of total body weight in a year under controlled circumstances. They are a tool, used alone or with bariatric surgery. For example, for patients who are not ready for surgery or for those with a BMI above 35, GLP-1s can be a first step, or a long-term solution.

Choosing Your Health Path

The choice between bariatric surgery and GLP-1 medications is personal and should be made with a medical professional. Dr. Fadner encourages people with a BMI of 35 or more (class 2 obesity or above) to consider surgery for its long-term benefits. GLP-1s are an option for those who do not qualify for surgery or prefer a non-surgical approach. In many cases, these treatments can work together.

Ready to explore your options for lasting health? Our Bariatric team guides you through treatment with compassion and expertise. Schedule a consultation and discover how bariatric surgery or GLP-1 medications can help you achieve your health goals.