With global interest in weight loss drugs rising, a question being asked is whether they are a better solution for weight loss than surgery. Dr Kuzinkovas explores the difference between weight loss drugs such as Ozempic and bariatric surgery to help individuals choose the best option for their weight loss journey.
What is Ozempic?
Ozempic (Semaglutide) is a medication used to treat type 2 diabetes. It is administered via a weekly injection and it helps the body manage blood sugar levels by stimulating insulin creation in the pancreas.
At the time of writing, the TGA only approves Ozempic for lowering blood sugar in adults with type 2 diabetes. There is also a non PBS-listed variant of Semaglutide that is approved for weight loss. Despite this, Australia has experienced a shortage of Ozempic due to ‘off-label prescriptions” for the drug for weight loss.
Outside of Australia, Semaglutide can be prescribed for weight loss under the name of Wegowy.
How does Semaglutide work?
Semaglutide’s primary function is to trigger insulin production in the pancreas. This helps the body process glucose (blood sugar) and is why Ozempic is a TGA-approved medicine for type 2 diabetics. It also works by creating a feeling of satiety and reducing appetite which can help with weight loss.
Unlike Semaglutide, surgical weight loss works by reducing the amount of food an individual can eat. Depending on the procedure, weight loss surgery can also reduce the amount of calories that can be consumed from each meal by changing the digestive system. Gastric sleeve and gastric bypass procedures will also affect hormone production affecting cravings and appetite.
How do you maintain weight loss on Semaglutide?
Semaglutide must be permanently taken by patients to achieve and maintain long-term weight loss. Unlike weight loss surgery, the effects of weight loss drugs on appetite suppression and insulin production stop when the individual stops taking the drug. Individuals who stop taking Semaglutide will regain the lost weight.
Weight loss surgery doesn’t rely on ongoing medication to perform its key function of helping an individual lose weight. It is important to note that lifestyle changes are beneficial for both medical and surgical weight loss treatments.
How much weight can be lost using Semaglutide?
Many factors contribute to the amount of weight loss that can be achieved using Semaglutide. While studies are in their infancy, current estimates suggest that individuals can expect to lose between approximately 5% to 20% of total body weight. Initial findings suggest individuals with type 2 diabetes experience lower levels of weight loss.
In contrast, weight loss following surgical treatment is estimated at between 30-60% of total body weight. The weight loss does vary according to the procedure with Lap Band surgery achieving 40-50% of excess weight loss. Gastric bypass offers the most significant weight loss at 80% of excess weight.
Semaglutide side effects
The most commonly reported side effects of Semaglutide are nausea, vomiting, diarrhea, constipation and significant lean body mass (muscle) loss. Incidents of pancreatitis have also been reported.
All surgical procedures carry general risks. Gastric (Lap) Band surgery is known to have the highest incidents of complications ranging from food intolerance to issues relating to band movement and band erosion into the stomach tissue.
Gastric sleeve has a lower rate of complications compared to Lap Band surgery. Gastric acid reflux is the most often reported side effect after gastric sleeve surgery but incidents are rare. Gastric bypass is the most complex of procedures and requires more follow-up than the other procedures. Gastric ulcers, dumping syndrome and internal hernia are the most commonly reported complications.
Resolution of related conditions
When comparing the effectiveness of various weight loss treatments, it is important to consider the effects of the treatment on related conditions. It is often noted that even low levels of weight loss can have a positive effect on comorbidities. Patients with hypertension, sleep apnea and type 2 diabetes will often experience improvement in symptoms.
Ozempic and type 2 diabetes
Ozempic improves the symptoms of type 2 diabetes by improving insulin sensitivity. In the event Ozempic is not taken, these symptoms are expected to return.
Unlike Semaglutide, Individuals with type 2 diabetes who have undergone gastric bypass surgery may experience partial or even full resolution of type 2 diabetes.
Choosing the best treatment for weight loss
Surgical weight loss offers significant advantages over weight loss drugs with the primary benefit being capacity for total weight loss. Weight loss surgery also allows for a faster rate of weight loss. Changes in appetite, hunger and satiety remain with the individual following surgery and do not require continued use of any drug or medicine.
If you’d like help choosing the most appropriate weight loss treatment for your individual circumstances, please get in touch with our team and book a complimentary consultation with Dr Kuzinkovas by contacting our clinic on 1300 551 533.
