Bariatric surgery: How surgery and medications work together to improve health and quality of life

Bariatric surgery is a transformative intervention for obesity that can support weight loss and improve overall health and quality of life. Together with the use of medications, bariatric surgery can aid in long-term weight maintenance, supporting your journey towards better health.

This article explains how bariatric surgery works, its effects on weight loss, and the complementary role of medications in enhancing health and quality of life.

How does bariatric surgery support weight loss?

Bariatric surgery promotes weight loss by altering the digestive system. Depending on the type of surgery, this may involve reducing the size of the stomach, rerouting parts of the digestive tract, or a combination of both, to:

• Restrict food intake: The smaller stomach size means patients will feel full after eating smaller portions, reducing overall calorie consumption.
• Limit calorie absorption: Some surgeries change how food is digested, reducing the absorption of calories and nutrients.
• Alter hormonal signals: Bariatric surgery impacts hormones like ghrelin, which regulates hunger, and insulin, which regulates blood sugar, helping patients experience fewer cravings.

This dual action - physical and hormonal - not only leads to significant weight loss but also helps in the management of obesity-related conditions such as type 2 diabetes, hypertension, and sleep apnoea.

Why are medications important after bariatric surgery?

Immediately following surgery, patients may be prescribed medications to prevent complications, such as infections or blood clots.

In the long-term, bariatric surgery alters the digestive system, which can affect how the body absorbs nutrients like iron, calcium, vitamin B12, and vitamin D. To prevent nutritional deficiencies that could lead to fatigue, bone weakness, or other complications, patients will need to take prescribed vitamin and mineral supplements for life.

Additionally, many patients undergoing bariatric surgery have chronic health issues such as diabetes or high blood pressure. Medications may still be required initially or adjusted as the body adapts.

The emotional impact of bariatric surgery can be challenging. For this reason, in some cases, medications may be prescribed to help manage anxiety or depression as patients adapt to their new lifestyle.

Are there medications that can aid weight loss after bariatric surgery?

Yes, medications can also be used alongside bariatric surgery to enhance and sustain weight loss, especially for patients who experience plateaus or begin to regain weight after their procedure.

Some of the most commonly used medications for weight loss include:

• GLP-1 receptor agonists: For example, Semaglutide or Liraglutide, which are highly effective in curbing appetite and improving glucose metabolism. These medications work by mimicking natural hormones that influence hunger and blood sugar levels.
• Orlistat: This medication reduces fat absorption in the digestive tract, supporting in weight management.

Above all, it’s important to remember that medications aren’t a replacement for surgery or lifestyle measures like a nutrient-rich diet and regular physical activity. Instead, weight loss medications should act as supportive tools to maximise and maintain the effects of bariatric surgery.

What are the typical results after bariatric surgery?

The results of bariatric surgery are often life-changing, with most patients losing 50-70% of their excess weight within the first 12-18 months after surgery. This rapid weight loss can also lead to substantial improvements in obesity-related health conditions, such as remission of type 2 diabetes, lower blood pressure and cholesterol levels, improved sleep apnoea, and joint pain relief.

Beyond physical health, many patients report improved quality of life, including better mobility, higher energy levels, and enhanced self-esteem.

Nonetheless, bariatric surgery and medications alone aren’t a guarantee for long-term weight loss. Lasting success requires a lifelong commitment to healthy eating, regular exercise, and consistent follow-up appointments. Without these necessary changes, patients may experience weight regain.