Surgical or Medical Weight Loss?

Medical Weight Loss vs Surgical Weight Loss. Which option is right for you?

It is important to consider your weight loss goals and your current health status when deciding which approach is best for you—especially if you have conditions like diabetes, high blood pressure or sleep apnea.

Take time to evaluate the potential risks and benefits of each approach and understand the long-term commitment and lifestyle changes associated with each option. It's also important to review your insurance coverage and consider both out-of-pocket costs and potential long-term savings.

Making an informed decision starts with understanding your options. 

How much weight would you like to lose? Option A or B?

A. LESS than 20%  of your total body weight (50 lbs. or less) MEDICAL Weight Loss Option

Example: Ali is a healthy 38-year-old with class 1 obesity, BMI 30, weighs 170lbs. Her goal is to lose about 25 lbs (15% weight loss) and be more physically active to enjoy activities with her family

Services Offered: 

A non-surgical approach with the Four Pillars of treatment:

• Nutrition
• Physical activity
• Behavior modification
• Possible use of weight loss medications if you meet BMI criteria FDA Approved Medications for weight loss:
• Oral medication: Qsymia, Contrave, Diethylpropion, Adipex
• GLP-1’S: Wegovy, Zepbound, Saxenda

What to Expect: 

• Regular visits with provider, dietician and /or specialists
• May include weight loss medications
• Follow nutritional recommendations
• Commit to be physically active
• Track food and exercise

Lifelong commitment to lifestyle changes and use of medications

Cost/Insurance Coverage:

• Medications may not be covered by insurance.
• Insurance Prior authorization process can be > 1 month
• GLP-1’s out of pocket costs can be $500-$1600/month
• Non-GLP-1’s out of pocket cost $25- $100/month
• Some medications can be short supply

Risks/Benefits:

Medication side effects may include:

• Nausea/Vomiting
• Constipation
• Diarrhea
• Fatigue
• Headaches
• Dizziness
• Bloating
• Acid reflux
• Lean mass loss

Risk of weight regain after stopping medications 
Efficacy: % Total Weight Loss (TWL) over time 
Lifestyle changes 5-7% TWL
Nutritional therapy 10% TWL
Medications 20% TWL

Benefits:

• Weight loss without surgery
• Curb cravings
• Eat less
• Improvement in diabetes, high blood pressure, sleep apnea, high cholesterol, Fatty liver disease, Joint pain

B. MORE than 20%  of your total body weight (More than 50 lbs.) SURGICAL Weight Loss Option

Example: Jim is a 42-year-old with class 2 obesity, BMI 40, weighs 270 lbs with, hypertension and Type 2 diabetes. His goal is to lose about 70 lbs (26% weight loss) and lower his blood pressure and improve his diabetes.

Services Offered:
A surgical approach involving lifestyle and behavior modification
Bariatric procedures which change the digestive system to help with weight loss

• Sleeve Gastrectomy
• Roux en Y Gastric Bypass

What to Expect:

• 3-6 months preparation period for surgery with regular visits with multidisciplinary team
• May require consultations with other specialties as needed
• Insurance specific requirements for authorization
• Understand your goals and preferences to choose the surgery that is right for you
• Surgery is laparoscopic or robotic with 1 night hospital stay
• Long term commitment to lifestyle changes, vitamin supplementation and follow up with bariatric clinic

Cost/Insurance Coverage:

• May not be covered by your insurance plan.
• Contact your insurance to verify your benefits
  • Sleeve gastrectomy CBT code 43775
  • Roux en Y Gastric Bypass CBT code 43644
• Out of pocket cost of surgery without insurance $22,000-$26,000.

Risks/Benefits:

Risks: Every surgery carries risk of complications including death.  Mortality rate less than 0.1%.  Risk of major complication 2-3%.  Includes:

• Bleeding
• Leak
• Blot clot
• Obstruction
• Lean mass loss

Long term may have risk of post-surgical weight regain Efficacy: % Total weight loss (TWL) over time

• Sleeve gastrectomy 20-30% Total body weight loss
• Roux en Y Gastric Bypass 25-35% Total body weight loss 

Benefits:

• Most successful treatment for long term weight loss with quicker and more substantial weight loss
• Greater improvement/resolution rates for diabetes, high blood pressure, high cholesterol, sleep apnea, reflux, infertility and non-alcoholic fatty liver disease
• Curb cravings
• Eat less

For More Information

If you have additional questions or would like to schedule a consultation with one of our providers, contact us directly at 425-467-3957.