The best ‘shot in the arm’ for weight loss.

By Dr George Balalis.

By the year 2030, it is expected that over 8 million Australians will be overweight or obese.¹

As the epidemic picks up pace and people seek to shed excess kilos and improve their health, many are turning to the use of weight loss medications.

According to recent research, the global market for obesity medications (including tablets and injections) is projected to reach $54 billion within this decade².

The surge in demand for medication and the buzz that surrounds it has seen a growing awareness of the health risks associated with obesity, including type 2 diabetes, heart disease, and certain types of cancer. All very positive things.

But is medication the solution?

The short answer is that medication is part of the solution, and something I prescribe almost daily to assist patients. Medications can assist by themselves, in conjunction with other treatments and can also be used for patients who need to lose weight either prior to or after other treatments.

But the stats are clear – bariatric surgery remains the most effective weight loss treatment available. As a bariatric surgeon some may say I’m expected to say this, but these are the facts.

While medication is relatively new to the weight loss scene, bariatric surgery has been around for decades and continues to innovate, with advancements such as endoscopic and robotic procedures, positively contributing to effective patient outcomes.

In terms of effectiveness, despite the impressive abilities of many weight loss medications, average results for patients indicate a 5-10% loss of total body weight³. There are further medications that are coming to Australia, with weight loss of around 15%, however in comparison, bariatric surgery has long demonstrated a total body weight loss average between 30-40%.

In fact, a recent study found that people who underwent bariatric surgery lost more weight and had better improvements in health outcomes such as blood pressure, cholesterol, and diabetes than those who used medications alone⁴.

Similarly, bariatric surgery is a proven weight loss treatment that has been shown to have long-term benefits. For now, the long-term effects of medications are still unknown, and it is unclear whether they can help people maintain weight loss over the long term.

But what we do know for many of the weight loss medications, is that once patients commence taking them, this needs to continue for the entire period they wish to receive the benefits. For many, this will be for life.

Despite its effectiveness, bariatric surgery is still underutilised, with many people opting for less effective weight loss treatments or fad diets, perhaps due in part to the perceived stigma associated with obesity and the misconception that weight loss is simply a matter of willpower.

With every patient that walks through the door, I will always work hard to understand their needs and desires, and then present the best recommendation for them. Sometimes that will be medication, for most of the patients I see, bariatric surgery will be that recommendation.

While no surgery should ever be considered lightly and is never without risks, the effectiveness of bariatric surgery remains evident. While many are turning to medications, I believe that the benefits of bariatric surgery will become even more pronounced with medications on the scene.

So, in my mind, bariatric is still the best ‘shot in the arm’ for weight loss.

References:

1. Australian Government Department of Health. (2020, October 11). Australia’s First National Obesity Strategy Launched on World Obesity Day. [Press release]. Retrieved May 5, 2023, from https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/australias-first-national-obesity-strategy-launched-on-world-obesity-day
2. Morgan Stanley. (2021, February 4). Obesity Drugs: Investment Opportunity. [Online article]. Retrieved May 5, 2023, from https://www.morganstanley.com/ideas/obesity-drugs-investment-opportunity
3. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. July 2, 2015. N Engl J Med 2015; 373:11-22. DOI: 10.1056/NEJMoa1411892 Xavier Pi-Sunyer, M.D., Arne Astrup, M.D., D.M.Sc., Ken Fujioka, M.D., Frank Greenway, M.D., Alfredo Halpern, M.D., Michel Krempf, M.D., Ph.D., David C.W. Lau, M.D., Ph.D., Carel W. le Roux, F.R.C.P., Ph.D., Rafael Violante Ortiz, M.D., Christine Bjørn Jensen, M.D., Ph.D., and John P.H. Wilding, D.M. for the SCALE Obesity and Prediabetes NN8022-1839 Study Group^* from https://www.nejm.org/doi/10.1056/NEJMoa1411892?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200www.ncbi.nlm.nih.gov
4. Gudzune, K. A., Doshi, R. S., Mehta, A. K., Chaudhry, Z. W., Jacobs, D. K., Vakil, R. M., … Bleich, S. N. (2020). Efficacy of Commercial Weight-Loss Programs: An Updated Systematic Review. New England Journal of Medicine, 382(10), 893–902. doi: 10.1056/NEJMoa2002449.

The opinions expressed in this article are solely those of the author. The information provided is intended for educational and informational purposes only, and readers should consult with a qualified professional before taking any action based on the information provided in this article.