Are anti-obesity medications the new standard treatment?

For obese and severely overweight individuals looking to lose a significant amount of weight and improve or resolve obesity-related conditions, bariatric surgery has long been considered the gold standard treatment. The procedure makes changes to the digestive system to limit the amount of food that can be consumed.

Over the past year, FDA approved anti-obesity medications (Wegovy, Saxenda, Zepbound) have become a trending topic. Glucagon-like peptides (GLP-1) medications work to suppress appetite and improve glucose, cholesterol and blood pressure levels — factors that contribute to weight loss. But are these medications safer and more effective than bariatric surgery? And are they accessible?

“GLP-1 medications are not as effective as bariatric surgery when it comes to weight loss and improving obesity-related conditions,” says Amy Paulus, a weight management nurse practitioner and bariatric coordinator at Advocate Health Care. “And they do not come without their own risks.”

Commonly reported side effects of these medications include nausea, diarrhea, vomiting, constipation, stomach pain, feeling bloated and heartburn.

Paulus says patients are referred to her by primary care providers, specialists or by word of mouth with expectations they will be prescribed GLP-1 medications. “It’s not that easy – not everyone qualifies for these medications, and less than 40 percent of insurance companies cover anti-obesity medications. There is often a lengthy, time-consuming prior-authorization process through the insurance company,” she notes.

Paulus explains the medications are intended to be used as a lifelong treatment for obesity. “GLP-1 medications can help people lose weight and assist when patients reach plateaus to optimize them and reduce risks prior to surgery. They are not a substitute for bariatric surgery. When it comes to obesity, surgery is the treatment. If patients are working their new surgical ‘tool,’ they will have lifelong success.”

To help you achieve your weight goals, find a comprehensive weight management program with a multidisciplinary team of providers, nurses, registered dietitians, clinical social workers, certified health/fitness coaches and dedicated coordinators. If you are not sure which weight management option is best for you, consult with an obesity-medicine certified nurse practitioner to get started.

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