For years, weight loss was reduced to a simple formula, eat less, move more. But for millions struggling with obesity, it’s never been that straightforward.
Today, with the rise of GLP-1 drugs like Ozempic
and Mounjaro and increasing acceptance of bariatric surgery, the conversation around weight loss is shifting from willpower to medical science. “As a bariatric surgeon with over 20 years of experience, I’ve seen a major change in how people think about weight loss,” says Dr Neha Shah, Bariatric Surgeon and co-founder, The Good Weight.
Earlier, fear of surgery often delayed treatment. “Patients would come to us only when their weight had made them nearly immobile or when they had developed severe complications like uncontrolled diabetes, sleep apnea, or heart disease,” she explains. “Surgery was seen as a last resort, something to consider only after everything else had failed.”
A Shift Towards Early Intervention
The introduction of GLP-1 medications has changed this landscape.
“With the advent of GLP-1 injections like Ozempic and Mounjaro, people are now more open to seeking medical help for weight loss,” says Dr Shah.
This has encouraged patients to seek help earlier in their journey.
“Many patients now come in wanting to understand all their options instead of waiting for their health to deteriorate,” she notes. “This is a very positive shift, because early intervention leads to better outcomes and fewer long-term complications.”
GLP-1 Medications vs Bariatric Surgery
It is important to understand that GLP-1 medications and bariatric surgery are not competing treatments.
“They are complementary approaches, not alternatives,” explains Dr Shah. GLP-1 injections can be effective for individuals who are overweight or have Grade 1 obesity.
“These medications mimic natural gut hormones, suppress appetite, slow gastric emptying, and help patients feel full with smaller portions,” she says. “For the right candidate, they can be a complete treatment when combined with lifestyle changes.”
However, for individuals with severe obesity, surgery remains the most effective option.
“Bariatric surgery is the gold standard for patients with a BMI of 40 or higher, or 35 and above with comorbidities,” says Dr. Shah. “In such cases, medications alone are unlikely to provide sufficient or sustained weight loss.”
Why Surgery Still Matters
Bariatric surgery works by physically altering the digestive system. “It restricts food intake and, in some procedures, reduces nutrient absorption,” explains Dr Shah. “This leads to more predictable, long-term weight loss.”
The benefits extend beyond weight reduction. “We often see significant improvement or even remission of conditions like type 2 diabetes, hypertension, and fatty liver disease,” she adds. “There are also improvements in mobility, mental health, sleep, and overall quality of life.”
Cost and Practical Considerations in India
In India, financial factors also influence treatment decisions. “Many insurance providers cover bariatric surgery if clinical criteria are met, which makes it more accessible for middle-class families,” says Dr Shah.
In contrast, GLP-1 medications can become expensive over time. “These injections are a recurring monthly expense, and the cost can add up significantly,” she explains. “Additionally, weight regain is common if the medication is stopped without a long-term plan.”
A Personalised Approach to Weight Loss
Dr. Shah emphasises that treatment should always be tailored to the individual.
“If you are at the beginning of your weight loss journey and your BMI is not very high, GLP-1 injections under proper medical supervision can be a good starting point, along with diet, physical activity, and behavioural changes,” she advises.
However, delaying the right treatment can be harmful for those with severe obesity.
“If you are morbidly obese or already facing serious health complications, do not let the fear of surgery hold you back,” she says.
The Takeaway
“With proper patient selection, evaluation, and follow-up, bariatric surgery remains the most effective and durable treatment we have for severe obesity,” concludes Dr Shah.
