Ozempic And Weight-Loss Procedures: Benefits, Costs And Risks

The field of weight-loss treatments has seen a dramatic shift in recent years, with medications like Ozempic gaining widespread attention and adoption. It seems that everywhere you turn, someone is singing the praises of these medications, leaving many wondering if they should try the weekly injections to lose weight.

The cultural phenomenon surrounding GLP-1 medications like Ozempic has been fueled in part by the rapid “slimming” of Hollywood, contributing to societal hype and intrigue. From A-list actors to reality TV stars, high-profile individuals have either openly shared their success stories with GLP-1 medications, or speculation has run rampant about their covert use, sparking widespread interest and emulation among the general population. This celebrity “endorsement” not only highlights the potential effectiveness of these treatments but also reinforces the notion that weight loss is achievable with the right approach, further driving the demand for GLP-1 medications and shaping societal perceptions of obesity management.

The rise of GLP-1 medications has been further fueled by substantial marketing efforts, with pharmaceutical giants investing over a billion dollars into promoting their efficacy. And it's not without reason. These medications work by slowing gastric emptying, promoting satiety, and enhancing insulin production. In essence, they offer a multifaceted approach to weight loss that aligns closely with the mechanisms observed in certain weight loss surgeries.

But despite their efficacy, the decision to pursue GLP-1 medications over other weight loss interventions isn't always straightforward. Factors such as cost, long-term patient success, personal preferences, and medical history play crucial roles in determining the most suitable treatment approach. Also, if you have a minimal amount of weight to lose, it may be more appropriate to rely on a traditional approach for losing weight, such as working with a registered dietician for nutrition advice as well as hitting the gym to up your exercise level.

Comparing ESG Stomach Tightening, Gastric Balloon, Bariatric Surgery, and Semiglutide

The landscape of weight loss treatments is diverse, with options ranging from nonsurgical endoscopic procedures to surgical interventions to injectable medications, alongside diet and exercise modifications to help patients fulfill their weight loss goals. Each approach has its own set of benefits and considerations, making it essential for healthcare providers to tailor treatment plans to individual patient needs.

Patient education and shared decision-making is crucial in navigating these choices. Over the course of my 20+ years treating patients with obesity, I’ve found the best outcomes are achievable when patients are fully informed about their options, including potential risks and benefits of each treatment, and are actively involved in the decision-making process.

ESG Stomach Tightening

Endoscopic Sleeve Gastroplasty or ESG stomach tightening is a minimally-invasive, non-surgical procedure for weight loss, offering benefits such as reduced stomach volume and altered gut hormone signaling, leading to increased feelings of fullness and decreased appetite. Under anesthesia, a proceduralist inserts an endoscope - a thin, flexible tube with a camera and specialized instruments - through the mouth and into the stomach. Using a small suturing device that is attached to the endoscope, the physician places multiple stitches along the inner lining of the stomach. These sutures are strategically positioned to reduce the size and capacity of the stomach by 70 percent, creating a sleeve-like shape.

With ESG, average weight loss is 18 percent of body weight, and longer-term, patients can expect to maintain weight loss of 16% over at least five years, with ten-year data on the horizon. This nonsurgical intervention offers numerous benefits beyond weight loss, including improved metabolic health, reduced risk of obesity-related comorbidities such as Type 2 diabetes and cardiovascular disease, and enhanced quality of life. The risk of major complications is rare, occurring in less than 2% of cases, and include the possibility of gastric leaks or strictures.

The procedure itself takes 60 minutes or less and patients should expect to return to work and exercise routines in one to three days, which is instrumental in maintaining muscle mass as patients lose weight.

The cost of ESG is around $12,000. ESG offers a promising option for individuals seeking effective and minimally invasive weight loss solutions, particularly when combined with dietary and lifestyle modifications under the guidance of a healthcare professional.

Weighing all of these factors, I have found ESG is the best weight loss treatment option for patients, consistently delivering 18-20% weight loss that lasts. There are no incisions, and it can be reversed or repeated as needed. I also occasionally add the short-term use of a GLP-1 medication six months post ESG, to help patients achieve 25 % weight loss.

It’s important to note that I began clinical development of the ESG stomach tightening procedure at Harvard Medical School in 2008, performing the first ESG cases in the world with current technology in 2012. To date, I have performed over 6,000 endoscopic weight loss procedures and recently founded a weight loss company called Bariendo, which provides ESG and other procedures to help my patients lose weight.

Gastric Balloon

Gastric balloon placement offers another non-surgical approach to weight loss, providing benefits such as reduced stomach capacity, increased feelings of fullness, and improved portion control. This minimally invasive, 15-minute procedure typically involves inserting a deflated balloon into the stomach, which is then filled with saline solution to occupy space and promote satiety.

Patients should expect an average weight loss of 10% of their body weight. Long-term success with gastric balloons depends on significant lifestyle changes and adherence to dietary recommendations. The device is typically removed after six months, and patients are at risk for regaining a large percentage of their weight by 12 months following balloon removal, and a plan is needed to minimize this.

As with ESG procedures, the risk of major complications is rare with gastric balloons, occurring in less than 2% of cases. However, potential short-term side effects may include nausea, vomiting, and abdominal discomfort, particularly during the adjustment period.

Recovery time is also minimal, running 1-3 days. In terms of cost, gastric balloon placement may not be covered by insurance and can vary significantly depending on the provider and location.

Bariatric Surgery

Bariatric surgery represents the most powerful and invasive tool for significant and sustained weight loss. Bariatric sleeve gastrectomy surgery involves removing a large portion of the stomach to create a smaller, sleeve-shaped pouch. This restricts the amount of food that can be consumed and reduces the production of hunger-inducing hormones.

Patients often lose 25-30% of their body weight. Like non-surgical ESG stomach tightening, this surgical intervention also improves metabolic health, reduces the risk of obesity-related co-morbidities, and can enhance the quality of life.

While bariatric surgery can produce profound results, it is not without risks. In the long-term, complications such as infection, bleeding, gastrointestinal leaks, reflux, and narrowing of the sleeve can occur in up to 20% of cases, and the procedure is not reversible. Lifelong adherence to dietary and lifestyle modifications is essential for long-term success.

Patients should expect to spend up to three days in the hospital post-surgery and will need to factor in up to four weeks of leave from work for recovery.

Costs associated with bariatric surgery can vary widely depending on factors such as the type of procedure, hospital fees, and post-operative care, and may not always be covered by insurance.

However, despite the potential risks and costs, bariatric surgery offers a transformative opportunity for individuals struggling with significant obesity to achieve sustained weight loss, improved health outcomes, and enhanced overall well-being.

Semaglutide

Semaglutide is a medication belonging to the class of drugs known as glucagon-like peptide-1 receptor agonists or GLP-1s and are sold under brand names such as Ozempic and Wegovy. These drugs work by mimicking the action of the hormone GLP-1, which is naturally produced in the body and plays a role in regulating blood sugar levels, insulin secretion, and feelings of fullness after eating.

Semaglutide presents a compelling option for weight loss, slowing gastric emptying, promoting satiety, and enhancing insulin production. These mechanisms contribute to produce approximately 15% weight loss on average, when tolerated, and improved metabolic markers, making them an attractive choice for individuals struggling with obesity.

However, like any medication, GLP-1 drugs come with potential risks and side effects, including nausea and vomiting. Ozempic face and muscle loss have also been noted in many patients stressing the importance of using these medications under the guidance of a weight loss medical professional. Nevertheless, the long-term implications of prolonged GLP-1 medication use remain a topic of ongoing research and debate.

Most patients are thought to regain weight after stopping their injections, which suggests the need to stay on the medication potentially for a lifetime.

Affordability is another consideration, as these medications can cost $1,200 a month and may not be covered by insurance plans. Patients could expect to pay $24,000 a year out-of-pocket for the medications, which they should expect to stay on in perpetuity, potentially posing a barrier to access for some individuals.

Navigating the plethora of available options—from endoscopic procedures to surgical interventions to injectable medications—requires careful consideration and patient involvement. Each approach offers its own set of benefits and considerations, underscoring the importance of personalized treatment plans tailored to individual patient needs. Whether it's ESG stomach tightening, gastric balloons, bariatric surgery, or Semaglutide, the ultimate goal remains the same: improving patient health and well-being in the fight against obesity. It is also important to consider the socioeconomic impact of these treatments, the cost of not treating this disease, and the potential health disparities that are very relevant to this discussion. Ultimately, by prioritizing patient education and shared decision-making, healthcare providers can empower individuals to make informed choices and embark on successful weight loss journeys.