Weight Loss Surgery vs. Weight Loss Medications
Sponsored by Memorial Hermann
By StoryStudio on January 1 , 2025
Fernando Miranda, MD
Fernando Miranda, MD, is a bariatric surgeon with Memorial Hermann Medical Group Southeast.
Dr. Miranda: There are many reasons why people can’t lose weight with just diet and exercise. Age plays a factor. When we were younger, many of us could eat whatever we wanted without gaining weight because we were constantly moving. As we get older, some of us adopt a sedentary lifestyle, without cutting down food intake, and this can lead to serious weight gain. Other factors include genetics and life events, such as a death in the family or job loss. Stress, and a lack of sleep can also play a role. These factors can cause one to stop going to the gym and instead reach for comfort foods that are usually high in fat and calories. Another factor is a lack of consistency when it comes to diet and exercise. If you just work out once a week or once every other week and still consume a great deal of food, you will most certainly never see any significant weight loss. Not drinking enough water and eating a lot of processed foods could also prevent you from losing weight.
According to the Centers for Disease Control and Prevention (CDC), more than 100 million Americans are considered obese. Many of these people also suffer from other chronic conditions such as diabetes and heart disease. In 2019, nearly $173 million in medical expenditures was spent on obesity-related health conditions. With more and more people trying to shed those extra pounds, Dr. Fernando Miranda breaks down the differences between weight loss surgery and weight loss drugs.
It is important to note that you must make lifestyle changes after undergoing bariatric surgery. It’s imperative to change your diet and exercise regimen."
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— Fernando Miranda, MD
Q: Why is it so difficult for some people to lose weight with diet and exercise alone?
Dr. Miranda: The short answer is no. Weight loss surgery is still recommended for those with a higher BMI (40+ or 35+ with obesity-related comorbidities). Weight loss medications might work for those people with mild obesity. The catch with these glucagon-like peptide-1 (GLP-1) medications, such as Semaglutide and Liraglutide, is that patients must stay on them indefinitely to maintain their weight and that can be quite expensive. The downside is that when someone gets off the drugs, there is usually a huge rebound effect. While someone might initially lose 50 to 60 pounds, many eventually gain that weight back, and sometimes more, which can be extremely disheartening. In addition, we don’t really know yet what the long-term effects on the body will be with some of these medications.
Meanwhile, bariatric surgery has been shown to be very successful. According to the American Society for Metabolic and Bariatric Surgery, most patients will lose more than 75% of their body weight in the first year after surgery and keep at least 50% of it off for the first five years. It is important to note that you must make lifestyle changes after undergoing bariatric surgery. It’s imperative to change your diet and exercise regimen. In some cases, medical providers may prescribe medication to continue a patient's weight loss journey to keep them on track.
Q: Are weight loss medications replacing the need for weight loss surgeries?
Dr. Miranda: Whether choosing medication or surgery, lifestyle changes and regular check-ins with your physician are imperative to long-term success. According to the CDC, physical activity is one of the keys to maintaining good health. Adults need at least 150 minutes of moderate-intensity physical activity a week, such as 30 minutes a day, five days a week. Try adding 500 steps a day to your exercise regimen until you can hit 10,000 a day. Also, it’s important to add a couple of days of strength training.
When it comes to calories it depends on things such as age and activity level. Generally, women need at least 1600 calories a day, while men can eat up to 2000 calories a day to maintain a healthy weight. Getting rid of sugary drinks, processed foods and replacing them with water and fruits and vegetables will help with calorie intake. These numbers can be modified depending on the amount of exercise you take part in each day. Try to avoid eating late at night and think about keeping a food journal. Knowing exactly what you are eating and how many calories you are consuming will help you on your weight loss journey.
Q: How do patients sustain their weight loss?
Dr. Miranda: Obesity is a medical condition that is treatable when you have the right weight loss specialist and an individualized plan. At Memorial Hermann, we work with you to determine the root cause of the problem and then create a path forward to help you live a healthier life with sustainable weight loss.
If you are struggling with losing weight and keeping it off, our comprehensive program provides an in-depth assessment to determine which factors are driving your weight gain along with a personalized treatment plan. Our goal is to help you experience a healthier and more active life.
Q: What sets Memorial Hermann apart from other institutions when it comes to treating obesity?
Memorial Hermann offers comprehensive weight loss solutions personalized for you.
To learn more about surgical weight loss and Memorial Hermann’s comprehensive services, visit Memorial Hermann New Start | Surgical Weight Loss and Medical Weight Management Programs.