Let’s Talk About Weight Loss Surgery
June 16, 2025Significant obesity was rare prior to the 1950s, but as the epidemic of obesity became evident, people weighing 400 or 500 pounds would not achieve their goal weight using exercise and dieting. Initial weight loss surgeries were performed using a large open incision. In 1994, a pioneering surgeon, Dr. Alan Wittgrove, performed bariatric surgery using minimally invasive techniques (1). The number of bariatric surgeries increased markedly; the most recent numbers indicate that more than 250,000 Weight Loss Surgery operations are done per year in the United States.
People Can Be Scared About Weight Loss Surgery
People are scared of undergoing a major surgery to help with weight loss, but today’s weight loss surgeries are more effective and much safer, almost as safe as removal of your gallbladder (2). The obvious question is, do I need weight loss surgery if there are strong medications that can accomplish the same goal? The answer is that you and your doctor have to look at the degree of obesity and the medical conditions that are made worse or are created by the obesity. In those who need to lose under 50 pounds or have a BMI < 35, today’s medication would likely accomplish the goal of getting healthy. Once the BMI increases past 40, 50, or 60, the likelihood that diet, exercise, and medication will get the person into a healthy BMI are pretty minimal (3).
Sure, there are people who lost more than 100 pounds, but this is a rare phenomenon, and unfortunately, many of them begin to regain most of the lost weight (4). For those requiring significant weight loss, the combination of medication and surgery can play a crucial role. One can take weight loss medication prior to having the weight loss surgery. By losing weight prior to surgery, the risk of surgical complications decreases. On the other hand, for those who have had weight loss surgery and stop losing weight or regain weight, medication can play a useful role.
None of the options that are mentioned represent the best choice. The ideal approach is to keep an open mind, do your homework, and concentrate on a long-term goal. As you can see, this is a complex process that should be taken seriously and discussed with a medical and surgical professional.
Sources:
- Laparoscopic Gastric Bypass, Roux-en-Y: Preliminary Report of Five Cases. Wittgrove et al. Obesity: 01, Volume 4, pages 353–357, (November 1994)
- Bariatric surgery is as safe as other common operations: an analysis of the ACS-NSQIP. Benjamin Clapp, MD, FACS et al. Surgery for Obesity and related diseases. Volume 20, Issue 6, June 2024, Pages 515-525
- Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records. Alison Fildes PhD et al. Am J Public Health. 2015; 105(9):e54-e59. https://bit.ly/4dSkWCC
- Maintenance of lost weight and long-term management of obesity. Kevin D. Hall, Ph.D.1 et al. Med Clin North Am. 2018 Jan; 102(1): 183–197. https://bit.ly/3yAY9fD
Stay Healthy, Stay Strong
Dr. Leon Katz
This material is for educational purposes and should be discussed with a medical professional.
Dr. Leon Katz MD, FACS, FASMBS, is a bariatrician specializing in non-surgical, medically supervised weight loss. Dr. Katz currently practices at Dr. Leon Katz Medical Weight Loss Center.
 | ABOUT THE AUTHOR Dr. Leon Katz MD, FACS, FASMBS, is a bariatrician specializing in non-surgical, medically supervised weight loss. He focuses on patients seeking alternatives to surgery and those needing care after bariatric procedures. Dr. Katz was recently the director of a major medical weight loss program. With extensive experience in establishing successful weight management programs, he now concentrates exclusively on non-surgical weight loss solutions. Dr. Katz is a Diplomate of the American Board of Obesity Medicine and Fellow of American College of Surgeons. Dr. Katz currently practices at Dr. Leon Katz Medical Weight Loss Center.Read more articles by Dr. Katz! |
