Medical Intervention for Weight Loss

Written by: Emily Russo, MS, RD, CDN

Bariatric surgery is considered a safe and successful weight loss solution, and is statistically as safe as gallbladder removal. So why isn’t it the right choice for everyone? And how do these new weight loss drugs fit into the picture?

Bariatric surgery is considered a safe and successful weight loss solution and is statistically as safe as gallbladder removal. So why isn’t it the right choice for everyone? And how do these new weight loss drugs fit into the picture?

Weight is typically at the center of the discussion around being healthy.

When we talk about being in shape, or feeling good, or taking care of ourselves, oftentimes we have weight, body confidence, or how our clothes fit on the brain. It’s hard to separate the two.

Weight loss drugs…
The medical and pharmaceutical communities have most recently reinforced this way of thinking with Semaglutide (Ozempic or Wegovy), a weight loss medication that celebrities and those who can afford it are increasingly seeking out. The commercials I’ve seen sell the idea that weight loss will lead to social approval, slim-fitting dresses, and a more robust dating life. They know we all want that, and we are eating it up – literally.

Even Weight Watchers has hopped on board, with its recent purchase a company of telehealth providers who can prescribe these medications to WW members. Health and weight loss have become so intertwined and are such a part of our culture that we often don’t even question it.

…and bariatric surgery
Though bariatric surgery feels different than medications (and in many ways is), there is a commonality. Both serve as a tipping point where weighing the risks and benefits of more aggressive weight loss intervention strategies becomes critical.

And because the alternative (obesity) is considered the bigger problem, the side effects caused by these drugs or by weight loss surgeries are often deemed manageable. As a point of interest, weight loss medications are often used in conjunction post-bariatric surgery to sustain weight loss.

Can larger-bodied people be healthy?
It is my opinion that being thin and being healthy are not one in the same. People can be thin and unhealthy – or vice versa, larger-bodied and healthy. There are plenty of thin people who have poor eating habits and don’t exercise, but their “health” is rarely called into question.

By the same token, losing weight does not automatically make people healthier. In fact, when we start to eat a more varied, well-rounded diet and increase our movement, studies show that disease markers like blood sugar and blood pressure decrease even if we don’t lose weight.

So even though bariatric surgery will likely lead to weight loss, does it equate to being healthier or having a better quality of life?

Not necessarily.

My experience with bariatric surgeries
I used to cover the post-operative bariatric surgery units in a large university hospital.

As a dietitian, this included routine post-op nutrition education for patients during their short in-patient recovery, and more complex nutrition interventions for others who were readmitted for severe malnutrition, requiring intravenous (or parenteral) nutrition when their surgeries left them permanently unable to eat food by mouth. It was difficult to predict when, and to whom, this would happen.

It’s become a hot topic recently in light of the new American Academy of Pediatrics (AAP) guidelines, which support bariatric surgery as a viable option for adolescents. Some people may find this shocking, for others it feels like an appropriate position.

Are there folks who benefit from bariatric surgery? Absolutely. Do I think there are others who are misguided in their decision to pursue surgery based on a false pretense that as long as they lose weight a better life is in store? Yes. I think both truths can exist.

Regardless of our own personal thoughts on weight and health, since more and more people will be pursuing bariatric surgery (adults and kids alike), it seemed like a good time to address misconceptions about it, as there are many. The more informed we are, the better decisions we can make for ourselves.

Check out Part 2 of this article, which provides details about the surgical process and other information on bariatric surgery. 

💛As always, we love hearing from readers. Please share your comments below!

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  1. Sandra

    On reading this article I have a friend who was told by two doctors that she should need this surgery and she is going to get itbdone.What I worry about her changing her eating habits,she doesn’t cook but she exercises meaning that she goes skating 3 times a day.She could do more but she has a grown disabled child who she cares for.I know diet will be a plus

    1. Emily Post author

      Sandra, thanks for sharing. I agree it is a complicated situation. I wish your friend the best of luck!