Minimally invasive surgery, medications revolutionizing weight loss

CHICAGO - Are one of the new weight loss drugs right for you? Or is it something else?

In a FOX 32 special report, Sylvia Perez weighs some of your options.

"I weighed 310 pounds and I wanted to lose 150 pounds," said weight loss patient Hillary Miller.  

Miller said she was looking to lose half of herself when she began working with Dr. Neha Shah, a triple board-certified physician with Endeavor Health, in 2019.

"I’ve talked to doctors before about weight loss and the answer was always diet and exercise. Diet and exercise just don’t work for me," Miller said.

"I really wanted to have surgery because I felt like the point that I was at in my life, being hard to go up stairs, being very hard to really do anything. That my only option was surgery," she added.

But Dr. Shah had another plan in mind.

"Obesity medicine as a practice has changed dramatically over the last 10 years," Shah said.

She says the number of weight loss options for patients has grown and there is no one size fits all approach.

"Through my weight loss career, I will say the patients who are most successful in the long term have some form of hybrid approach," Shah said.

For Miller, that meant not only diet and exercise but also going to therapy and taking the medication phentermine. And it worked.

"I was taking pictures every month in the same clothes for my before picture. It was kind of fun to watch it all sort of fall away," Miller said.

She lost the 150 pounds she wanted to without any surgery.

"We have procedures now that are less invasive," said Dr. Michael Ujiki, a gastrointestinal surgeon with Endeavor Health. "Even our most invasive surgeries are minimally invasive surgeries."

He says some of those minimally invasive weight loss procedures provide more weight loss for patients than medication. They also have the added bonus of a quick recovery time.

"The endoscopic sleeve gastroplasty is one of those non-surgical procedures that I was mentioning," Ujiki said. "It’s completely through the mouth - incisionless. We started doing it in 2016. We were the first in Illinois to do it. We were one of the first in the country to do it."

When it comes to deciding between a weight loss procedure and a medication, you might not have to choose.

Ujiki said a lot of patients qualify for both and that it’s not uncommon to take a multistep approach to losing weight.

"We treat other diseases. Some cancers we treat with multi-modal therapies, meaning that it’s not just surgery, but it’s surgery and chemotherapy. And I see treating obesity very similarly. Multimodal therapy tends to be better than just one or the other," Ujiki said.

The bottom line is to decide what is right for you.

"There’s some people that don’t need both," Ujiki said. "But there’s some people that would benefit from both. Let’s remember that it’s not just about weight. It’s also about the conditions that come with being overweight. Things like diabetes, hypertension, high cholesterol, sleep apnea and others."

Because of the embarrassment or shame that can be associated with being overweight, Ujiki said some patients don’t take advantage of the weight loss options available to them.

"There are plenty of studies that have shown that if you look at the patients who are eligible for a weight loss procedure that don’t get it, their mortality or their duration or lifespan is less than someone eligible for a procedure that gets it done," Ujiki said.  

Once you carry out your weight loss plan, doctors say the battle of the bulge is not over.

"I think the thing that’s gotten a lot of attention that’s important to note is that there’s a whole second leg of our journey in maintenance and how hard it is for patients to sustainably maintain weight loss above 5 to 10 percent," Shah said.

Shah said patients who have had bariatric surgery tend to be successful in keeping off the weight if they have a team support system.

She also noted that even though you've had surgery, your hunger can come back two to three years later.

"I tell patients how you lose the first 30 pounds in your weight loss journey may be completely different in medication or surgical approach to how you’re going to maintain that weight loss or continue to lose," Shah said.

For Miller, the maintenance part of her weight loss journey has been a bit bumpy. Following a few life-changing events, she did gain back some of the weight she had lost.

Some of those pounds are now gone and Miller said she is committed to losing the rest with her multistep approach.

"The stigma around weight is changing, but there’s no reason to be afraid, embarrassed or ashamed if diet and exercise just isn’t doing it for you," Miller said.

She also said following a hybrid weight loss plan did feel like a lot in the beginning, but she knew it was something she had to do.

When it comes to whether or not your health insurance covers weight loss procedures, Dr. Ujiki said they are starting to see some of the big companies doing so.