What To Know Before Considering Bariatric Surgery or Weight-Loss Drugs

Are you ready to have bariatric surgery or take a GLP-1 drug to lose weight? Before you decide, it’s important to understand the changes you will have to make to set yourself up for success.

Bariatric surgery — an operation that changes the digestive system — has been around for decades or more, and there’s a rigorous preparation process for this life-changing intervention. GLP-1 drugs approved for weight loss have only been around about a decade, so there isn’t always the same tried-and-true structure around their use.

Do You Qualify?

For bariatric surgery, insurers typically require a body mass index, or BMI, of over 40, or 35 with an obesity-related co-morbidity like high blood pressure, type 2 diabetes, high cholesterol or cardiac disease. For GLP-1 drugs, qualifications vary according to your doctor or insurance company, but generally it’s a BMI over 30, or about 27 with a co-morbidity.

For GLP-1 drugs you’ll be asked about your medical and family history — any history of pancreatic, thyroid or endocrine diseases is usually an automatic disqualifier because of the way these drugs work. A history of inflammatory bowel disease or irritable bowel syndrome also is a red flag.

If you’re opting for bariatric surgery, you likely will have a multi-disciplinary team that will look at your medical history, do psychological screenings and nutritional assessments, and work with you throughout the experience. Bariatric surgery literally changes your anatomy, so your team will try to examine all factors that could impact your readiness. GLP-1 drugs also change the way you process food, so look for a provider that offers adequate screening, evaluation and supportive after-care to help combat problems like regaining the weight or losing muscle mass.

Understand the Changes You’ll Make

Nobody comes to bariatric surgery without having tried a host of other weight-loss methods. For GLP-1 drugs, that might or might not be true. It’s understandable if the gravity of what you’re signing up for gets lost in the excitement of anticipating results. But it’s important to consider how deep these changes are going to go.

With bariatric surgery, you must avoid soft drinks (and all carbonation), caffeine and tobacco for the rest of your life. For six weeks after surgery, you’ll be on clear liquids only. Portion control will be a daily necessity; you’ll also be on supplements for your lifetime because of changes to the way your body absorbs nutrients.

GLP-1 drugs carry different challenges. While these drugs are valued because they suppress appetite and can help you clear out “food noise,” that can make it harder to meet basic calorie and protein needs. If your body doesn’t get adequate nutrition, you start to lose lean body and muscle mass, which is tough to rebuild. You’ll have to commit to eating even when you sometimes don’t feel hungry, and to an exercise program that includes muscle strengthening. There also are common gastrointestinal side effects like diarrhea, constipation, nausea and vomiting, especially right after your injection.

Lose the Diet Mindset

As you prepare for these interventions and think about sustainable eating patterns, try to give up the idea that eating less will make you smaller. It’s rarely that simple. Becoming a healthier you isn’t about discipline and denial, it’s about learning to listen to your body and understand its cues. Most people don’t need to be told that junk food isn’t healthy or that fruits and vegetables are good for you. It’s figuring out how to apply these ideas that takes some practice. A good place to start is with myplate.gov, which will show you how to create a balanced plate to ensure you meet your nutritional needs.

Practicing mindful eating by paying attention to your hunger and fullness cues. Be intentional about what you are eating, and free from distractions like TV or work. Try to tune in to how meals taste, feel and smell, which will help you be more aware and thoughtful about your food.

People end up in larger bodies for a lot of reasons; overeating is only one of them. Undereating also can be a huge problem, and a concern for those on GLP-1 drugs. People at higher weights often fall victim to diet culture ideas about calorie restriction and ignore hunger cues so frequently that they stop recognizing them at all — you have to eat to switch that metabolism back on. For bariatric patients, you have to relearn what full feels like, or you risk undoing the benefits of the surgery.

The Bottom Line

Both bariatric surgery and GLP-1 drugs have risks and side effects. You need to understand what you are choosing. Each is a great complementary therapy, but they are only part of your weight-loss journey; neither is a magic bullet. You’ll still need to commit to a healthy diet and an exercise regime in order to achieve — and maintain — your goals.

This content is not AI generated.