I love cars and using car metaphors to describe how one thing is good, but something else is definitely better. In terms of medical weight loss, I would use the electric car or "Tesla" to describe therapy that includes prescription weight loss medication and behavior change. Semaglutide is about as innovative to weight loss as electric cars have been to the automobile industry. I would describe medical weight loss therapy that includes bariatric surgery and behavior change as the hypercar or "Bugatti" of medical weight loss. There is no better modality available to lose weight for people who qualify and there is an astonishingly higher success rate. I love math about as much as I love cars and I know that zero times any number gives you zero. No matter how good weight loss medications and bariatric surgery are, your results will be suboptimal if you don't do your part in terms of permanent behavior change. This means learning to eat and act like your ideal weight.
Despite being the hypercar or "Bugatti" of medical weight loss many people who qualify do not seek out bariatric surgery. There are several reasons for this. They include not knowing they qualify for the procedure through health insurance, not wanting to take the "easy way out", negative experiences they have heard about, and not wanting to alter their bodies. There are obviously other reasons but for the most part they are exaggerated or misguided as weight loss surgery is extremely safe and effective. If you are seeking health insurance coverage for the procedure, first make sure your carrier covers it and what the requirements are for obtaining approval. Health insurance companies will often require a period of time with a nutritionist or dietician to learn about healthy eating and eating after surgery. A psychological evaluation is usually standard to ensure you understand the procedure and don't have undiagnosed or undertreated mental health issues. Don't worry, if your insurance doesn't cover the procedure there is always the option of investing in yourself and paying out of pocket. Bariatric surgery gets to the root cause of obesity and is also considered metabolic surgery due to its positive effects on improving or curing type 2 diabetes in most cases. A tummy tuck can't do this.
Zero to sixty in less than 3 seconds and achieving speeds of over 200 miles per hour is no easy feat, but there are hypercar companies who have gotten very good at producing vehicles with these exact capabilities. The same is true with bariatric surgery. There are surgeons who have gotten very good at weight loss procedures, and most are now performed using minimally invasive techniques and robotic assistance. You may be wondering how bariatric procedures promote weight loss? There are 2 ways. First is restriction or limiting how much you can eat. The gastric sleeve is the best example of a restrictive procedure where 80-90 percent of the stomach is removed causing patients to feel satisfied much quicker when eating. Second is malabsorption. Surgery can intentionally limit the number of calories that are absorbed after eating food. Malabsorption is often combined with restrictive procedures to promote maximum weight loss and the gold standard for this and bariatric surgery is the gastric bypass procedure. Gastric bypass surgery combines restriction or removing over 90 percent of the stomach with malabsorption or bypassing the first part of the small intestine. Health goals after weight loss surgery are 3-fold: 1. Maximize weight loss, 2. Maximize hydration, and 3. Maximize nutrition. Remember permanent behavior change is the primary mechanism by which you reach and maintain your ideal weight after bariatric surgery.
