Is Natural Weight Loss Better or Does Weight Loss Surgery Have More Advantages?

What I think you might be alluding to, though, Dr. Jampolis, is what you don’t want everyone out there to hear is, “It’s no big deal, “I’ll put the weight on and when the time comes, “I’ll just get the surgery.” Or that surgery works better, regardless. That’s what I don’t want people to hear, and I think the findings, while they’re robust, they are still about weight loss. The authors say in the last sentence, before the conclusion, that less than 10% of these patients were optimized with medical therapy for diabetes control, with the newer classes of medications that we call GLP-1 agonist and SGLT2 inhibitors, and, so, I think there’s an opportunity to learn form this study. I think they need to do the study where they compare equivalent weight loss, but I agree with you 100%, Doctor, in this, in that in many of these patients, it’s a last resort, but that’s still how I want it to be perceived. So, I think, there’s an opportunity to, yes, perhaps consider more people for surgery, but I also think that as cardiologists, especially, I see so many who really are not having a serious conversation about weight loss with their patients, and they just keep putting them on more and more meds and then referring them to surgery. And the research shouldn’t end here. Dr.Nidsun, with that being said, right now, based on the study you performed, which patients should target the conversation with their physicians? Well, first of all, weight loss surgery’s not for everybody. This is not for somebody that’s ten, or twenty, or even thirty pounds overweight, these are people who are really, massively, overweight, they’re suffering early death, early heart disease, and we have shown, I think, that some of that can be reversed. A quarter of a million Americans had this surgery last year, we think that probably is a little bit too low, and probably more people ought to consider it. When you say weight loss surgery, just for everybody at home, did your participants have a particular procedure, or did they have a variety of different procedures? They had several different procedures. The two most common: one is called a gastrectomy or a sleeve gastrectomy, where the sleeve of the stomach is made smaller, and that’s very popular now, and the other is what’s known as Roux-en-Y, it’s kind of a bypass, it’s a gastric bypass procedure. By the way, let’s not get this wrong, surgery has complications. Some people will get into some difficulty. The problem is that if you look at the rate of heart disease over eight years, in the group that didn’t get surgery, it was about 48%, and the death rate was 17.8%. Those rates went from 48% down to 30% and the death rate went from 17.8% down to 10%. Those are huge reductions. Reductions we can’t see with any of the medications we now have available to treat diabetes or obesity. And, I think, for everyone watching, we always talk on this show, “Let food be your medicine, not your poison,” and the endpoint here, regardless of whether someone has the surgery or does not, is still ultimately going to also be a change in lifestyle. And, there are no easy quick fixes, but I do think this is a very important study, and Dr. Nidsun we really appreciate you sharing it with us. I also just want to give a shout out to your Dr. Jampolis for all the work you do, and teaching people how they can change their diet to, not only improve how they feel, but helping them lose weight, decrease their use of other medications, because ultimately we should all be able to come together here, figure out for each individual patient what is right for you. So, have that conversation with your doctor. If they’re not familiar with these studies, please ask them to read up on it, because we need to treat everyone as an individual and you figure out the best advice for you.


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