Medical, Surgical, and Combination Therapies

Struggling with weight loss is a common frustration. If you are one of the millions of people living with obesity, you may feel stuck in what seems like a never-ending cycle of losing weight through diet and exercise, and then regaining it. Experts agree that for many people, losing weight is not as simple as diet and exercise. Obesity is a chronic, progressive disease that requires an experienced obesity medicine physician.

Obesity medicine is an evidence-based field of medicine. By combining the latest research with leading-edge medication and surgical options, our affiliated weight-management doctors work with your individual genetics, physiology and hormonal pathways to help you reach and maintain a healthy weight. When obesity is controlled, you can enjoy a longer, more active life with fewer health concerns. Working with a team of specialists can help you reach your health goals, with both physical and emotional benefits.

At Memorial Hermann’s NewStart™ Surgical and Medical Weight Loss Programs, we understand that each patient has different needs, and we offer a range of medical and surgical options to provide individualized care, so you can live a healthier life with sustainable weight loss.

Which Tools in the Toolbox are Right For You?

Choosing whether to start with medical, surgical or both interventions to achieve weight loss should be a shared decision between a patient and their health care team. While one patient may need more significant intervention early in the process, another may decide on a less-invasive approach.

As part of our weight management program, we will work with you to consider several factors, including treating related health conditions you may have. Many patients with obesity are also living with high blood pressure, diabetes, arthritis pain and more. An effective plan will address not only obesity but also any related health concerns.

Whether you begin your journey with surgical or medical weight loss, the foundation of our program is lifestyle intervention. For sustained success, it is essential to address the underlying causes of obesity which may include barriers related to physiology like insulin resistance, psychological and emotional concerns, sleep habits, physical activity and healthy meal planning.

Medical Weight Loss

Prescription anti-obesity medication can be an effective method of weight loss by addressing the physiological causes of obesity.

Who is a Candidate for Medical Weight Loss?

People with body-mass index (BMI) greater than 25 may consider medical weight loss options. Some medications are indicated for people with BMI greater than 25, while others are intended for people with BMI greater than 27 with at least one obesity-related medical condition, and some are indicated for those with BMI greater than 30. If your BMI indicates you are overweight or are suffering from obesity, early intervention can help control the condition or prevent it from advancing.

How do Weight-Loss Medications Work?

Each medication has a different way of supporting weight loss. The most common way prescription medications work is by sending signals to the appetite control center in the brain to promote the feeling of fullness and reduce feelings of hunger. Many patients who have been successful with medical weight loss report feeling like they finally have a normal appetite, are better able to manage portion control and experience fewer episodes of stress or emotional eating.

Some anti-obesity medications address both obesity and other related conditions, including diabetes or depression. By examining each patient’s individual health, doctors can help you choose the most appropriate medication for your health goals.

Long-term use of weight-loss medication can help patients lose up to 22% (or more) of their total body weight. For example, if you weigh 300 pounds, a 66-pound weight loss could have significant benefits, including improved cardiovascular health, stable blood-sugar levels and less joint pain.

Risks and Side Effects

All medications have benefits and risks, and your doctor can recommend the most appropriate option. Serious side effects are rare with weight-loss medications, but mild effects like nausea, diarrhea or constipation are fairly common.

Some people regain weight when they stop taking their prescription medication. That is why anti-obesity medications are intended for long-term use to give long-term support, just like diabetes or blood pressure medications. Lifestyle changes are essential to sustained success and are an important part of the overall weight-management plan.

Surgical Weight Loss

Bariatric (weight loss) surgery involves making physical changes to your digestive system to assist with weight loss.

Who is a Candidate for Surgical Weight Loss?

Bariatric surgery is usually appropriate for people who meet one of these qualifications:

  • BMI greater than 40
  • BME greater than 35 with one or more obesity-related medical conditions

In addition, weight-loss surgery evaluation includes a behavioral health screening and upper endoscopy to evaluate the stomach and esophagus.

Are You a Candidate?

How Does Surgical Weight Loss Work?

Surgical options fall into three main categories: restrictive procedures, malabsorptive procedures or combination procedures.

Restrictive procedures reduce the size of the stomach to limit food intake and promote the feeling of fullness.

Malabsorptive procedures re-route the small intestine, so food does not travel through the entire intestinal tract, which allows fewer calories to be absorbed.

Combination procedures include both restrictive and malabsorptive components.

After bariatric surgery, many patients lose 20% to 30% of their total body weight, and keep it off. Weight-loss surgery also has been shown to lower a person’s risk of death by more than 40%. It is important to understand that surgery is not the end of obesity treatment. Lifestyle changes are essential to sustained success and are an important part of the overall weight-management plan. Additionally, sometimes surgery needs to be combined with medication for successful, sustainable weight loss.

Risks and Side Effects

Bariatric surgery offers significant health benefits, but like all surgical procedures, there are risks involved. Discuss risks and side effects with your physician. Patients may experience:

  • Nausea
  • Vomiting
  • Abdominal pain
  • Ulcers in the stomach or small intestine
  • Blood clots
  • Gallstones
  • Rupture of staples or sutures
  • Abdominal hernia
  • Anemia
  • Osteoporosis
  • Need for a necessary follow-up procedure
  • Death

Medical, Surgical or Combination Treatment: Which is Right for You?

Both medical and surgical weight loss options can be effective at controlling obesity. The choice is often based on personal preference and the level of invasiveness that is acceptable to the patient. However, because obesity is a chronic, progressive disease, many patients will undergo both options at different points during their lifetimes.

The decision is not necessarily about choosing one option or the other. Together with the obesity-medicine physician, bariatric surgeon and the entire obesity care team, patients will make a decision about which option is best suited to begin treating the disease, knowing that other options may be needed later. Many surgical patients will also need medication at some point.

Medication is often the first approach. The currently available prescription medications have significantly more impact than older medications, and the gap between the effectiveness of medication and surgery is narrowing. This progress allows patients to have more flexibility in their treatment choices.

If a treatment option does not achieve the desired weight loss, or becomes less effective, it is important to speak with your physician about additional treatment options. Weight management is often most effective when patients are open to trying different therapies as well as combinations of therapies to address the long-term nature of the disease.

Let's Get Started

The weight loss specialists affiliated with Memorial Hermann’s NewStart Surgical and Medical Weight Loss Program are here to help people struggling to lose weight. When you are ready to start, let us guide you on a path to better health with a medical plan to control obesity. Specialists are located throughout Greater Houston, and most insurance plans are accepted.

NewStart Surgical Weight Loss Program

NewStart offers the full range of weight loss surgeries, including Gastric Banding (Lap Band), Gastric Sleeve, Gastric Bypass, Duodenal Switch and bariatric revisions and reversals.

NewStart Medical Weight Management Program

NewStart's comprehensive program provides an in-depth assessment to determine which factors are driving weight gain along with a personalized treatment plan.