Bariatric Surgery and Other Medical Treatments for Obesity

Learn about medical options for treating severe obesity: types of bariatric surgery, weight-loss medications, and the importance of long-term professional follow-up.

Severe obesity is a complex and chronic medical condition which can significantly increase the risk of diseases such as Type 2 diabetes, hypertension, sleep apnea, cardiovascular disease and some types of cancer. As this condition affects an increasing number of people around the world, a range of effective medical treatments, beyond lifestyle changes. The bariatric surgery It is one of the most effective tools in the most serious cases, but there are other alternatives such as pharmacological medication and specialized clinical monitoringIn this article, we explore the main therapeutic options, their benefits, risks, and long-term considerations.

📌 Types of bariatric surgery: options, benefits, and risks

Bariatric surgery is recommended for people with severe obesity (BMI ≥ 40) or in patients with BMI ≥ 35 that present comorbidities such as diabetes or sleep apnea. This type of intervention modifies the digestive system to restrict the amount of food eaten either limit the absorption of nutrients.

The main types of bariatric surgery are:

• Gastric bypass: It redirects the small intestine to bypass some caloric absorption. It is very effective for weight loss and rapid improvement of metabolic diseases, but it has risks such as nutritional deficiencies and greater surgical complexity.
• Gastric sleeve (sleeve gastrectomy): The stomach is reduced in size by forming a tube. It is a less invasive technique than bypass, but also has the potential to reflux or vitamin deficiency if there is no adequate follow-up.
• Adjustable gastric band: A band is placed on the upper part of the stomach to limit the amount of food. It has a lower surgical risk, but also a higher rate of failure or need for revision.

Benefits:

• Significant reduction in body weight (up to 50–70% of excess weight).
• Remission or improvement of chronic diseases such as type 2 diabetes, hypertension and sleep apnea.
• Increase in quality of life, mobility and self-esteem.

Risks:

• Surgical complications such as bleeding, infections, or intestinal leaks.
• Adverse reactions to general anesthesia.
• Nutritional deficiencies of iron, calcium, vitamin B12 and folate if there is no supplementation.
• Psychological adaptation: It is common to experience intense emotions after surgery, so psychological support is crucial.

📌 Use of medications for weight management

When surgery is not feasible or as an adjunct to lifestyle changes, some patients may benefit from the use of approved weight loss medicationsThese drugs are indicated for people with BMI ≥ 30, either BMI ≥ 27 with diseases related to excess weight.

Commonly used medications include:

• Orlistat: Partially blocks the absorption of fats in the intestine. It is useful, but can cause gastrointestinal side effects (such as flatulence or diarrhea).
• Liraglutide and semaglutide: They are GLP-1 analogues that reduce appetite and promote satietyThey are also used in the treatment of type 2 diabetes.
• Combinations such as phentermine/topiramate or bupropion/naltrexone: They act on the central nervous system to control hunger and improve impulse control.

Key considerations:

• They must be prescribed and supervised by a specialized health professional.
• Its effectiveness increases when combined with a balanced diet, regular exercise and psychological support.
• They have possible side effects and contraindications which should be evaluated according to the patient's clinical profile.

These medications are not a magic solution, but they can be a valuable tool for people facing metabolic or psychological barriers that make sustained weight loss difficult with lifestyle changes alone.

📌 Importance of continuous medical follow-up

In the case of both surgery and drug treatment, long-term success depends on a multidisciplinary clinical follow-upIt's not just about losing weight, it's about maintain the loss and comprehensively improve physical and emotional health.

Monitoring should include:

• Periodic medical evaluations to monitor parameters such as glucose, cholesterol, blood pressure and liver function.
• Constant nutritional control to avoid deficiencies, ensure a varied diet and adapt supplements according to needs.
• Psychological support, which helps to work on the relationship with food, avoid compulsive behaviors and cope with bodily change.
• Recommendations for progressive and safe physical activity, adjusted to the level of condition and preferences of each person.

In addition, tracking helps to detect possible relapses, prevent postoperative complications and strengthen long-term commitmentObesity is a chronic condition, and as such, requires sustained management over time, similar to other diseases such as hypertension or diabetes.

💡 Final Reflection: Treatments that transform from within

Severe obesity should not be addressed with willpower alone. It requires Effective medical tools, a compassionate approach, and consistent professional supportBariatric surgery and drug treatments can be catalysts for change, but their true value lies in being accompanied by Continuing education, medical follow-up, and patient engagement.

Addressing obesity as a health condition—and not a personal failing—is critical to building A path to lasting well-being, beyond body weightMedical treatments not only transform the body: they also restore hope, function, and self-esteem.