New Medications, But Bariatric Surgery Continues to Grow: Why?

Obesity is a global epidemic, and Brazil is no exception. As the prevalence of the disease increases, the search for effective solutions intensifies. In recent years, we have seen the emergence of new promising medications for the treatment of obesity, which could lead one to believe that bariatric surgery would lose ground. However, what we are seeing is exactly the opposite: the demand for surgery continues to rise. But why does this happen?

The Proven Effectiveness of Bariatric Surgery and Access via Health Insurance

One of the main reasons for the popularity of bariatric surgery is its proven long-term effectiveness. Several studies show that bariatric surgery promotes significant and lasting weight loss, in addition to considerably improving diseases associated with obesity, such as type 2 diabetes, hypertension and sleep apnea.

Furthermore, the bariatric surgery is covered by health insurance in Brazil, which increases its accessibility compared to high-cost medicines. Although there are specific criteria to be met in order to undergo surgery under the health plan, such as the duration of obesity and previous attempts at clinical treatment, this coverage ensures that many patients have access to this effective treatment option.

New Drugs: Promises, Limitations, and the Impact of High Cost

New obesity medications, while promising, still have some limitations. First, their long-term effectiveness has yet to be proven on a large scale. In addition, many of these medications can cause undesirable side effects, and continued use may be necessary to maintain results. The high cost of these medications is also a crucial factor that limits access to them, especially for patients with financial difficulties.

The favorites: Ozempic and Monjaro, how much does this treatment cost?

Ozempic, initially created to treat type 2 diabetes, gained popularity as a weight loss tool and has now been approved by the ANS. This situation raises questions about its long-term safety and effectiveness. In addition, the drug can cause side effects such as nausea and vomiting, and its monthly cost ranges from R$800 to R$1,600, and its annual cost can reach R$20,000.

Mounjaro, which is not yet available in Brazil, combines two hormones that control appetite and metabolism, and studies indicate that it can lead to weight loss of up to 20%. In the United States, its monthly cost is around US$1,000 (approximately R$50,000 per year), an amount that makes it inaccessible to many.

These examples illustrate how the high cost of new obesity medications can be a barrier for many patients, especially when compared to the cost of bariatric surgery, which is often covered by health insurance plans.

A crucial factor impacting accessibility to these medicines is their high cost.. Many of the most effective medicines are not yet available in the Unified Health System (SUS) and, in the private market, their prices can be prohibitive for the majority of the population.

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Factors that Influence the Choice of Which Treatment to Follow

The decision between drug treatment and bariatric surgery is complex and involves several factors, such as:

• ● Degree of obesity: Bariatric surgery is generally indicated for patients with severe obesity (BMI over 40) or moderate obesity (BMI between 35 and 40) associated with comorbidities.
• ● Response to drug treatment: Patients who do not respond adequately to drug treatment or who experience significant side effects may consider bariatric surgery.
• ● Lifestyle: Bariatric surgery requires significant lifestyle changes, including diet and exercise. Patients who are unwilling to make these changes may prefer medication.
• ● Cost of treatment: The high cost of the most effective medications can be a determining factor in choosing bariatric surgery, especially for patients with financial difficulties, which is a major reality in Brazil.
• ● The existence of Type 2 Diabetes: The presence of type 2 diabetes can be a crucial factor in the decision to treat. Although new medications can help control the disease, metabolic surgery has proven highly effective in remitting diabetes in many patients, providing a life free of medications and their complications.

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Curious Facts About Bariatric Surgery That They Don't Tell You

In addition to weight loss and improving comorbidities, bariatric surgery can bring surprising benefits that often go unmentioned.

• ● Increased Survival: Studies indicate that bariatric surgery can increase life expectancy in patients with severe obesity, reducing the risk of premature death from weight-related diseases.
• ● Drug Free Life: Bariatric surgery can lead to complete or partial remission of diseases such as type 2 diabetes and hypertension, allowing many patients to stop or significantly reduce their use of medications.
• ● Improved Fertility: Weight loss after bariatric surgery may improve fertility in women who have difficulty getting pregnant due to obesity.
• ● Reduced Cancer Risk: Research suggests that bariatric surgery may lower the risk of developing certain types of cancer, such as breast and colorectal cancer, in patients with obesity.

These additional benefits of bariatric surgery demonstrate its transformative potential, going beyond simple weight loss and providing a significant improvement in patients' health and quality of life.

Bariatric Surgery in times of new drugs: A balanced analysis

Obesity is a global epidemic and the search for effective solutions is ongoing. With the emergence of new medications such as Ozempic and Mounjaro, the question arises: is bariatric surgery still the best option?

Despite the promises of medications, bariatric surgery stands out for its proven long-term effectiveness, promoting significant weight loss and improving comorbidities such as diabetes and hypertension. In addition, it offers benefits such as increased survival and reduced risk of cancer, positively impacting patients' quality of life.

However, new medications also have advantages, with promising results in weight loss. The high cost of these medications, however, is a limiting factor, making bariatric surgery, often covered by health insurance plans, a more affordable option for part of the population.

We consulted specialist Dr. Rodrigo Barbosa, founder of Instituto Medicina em Foco and AdmDoctor, and he emphasizes the importance of an individualized assessment, considering factors such as degree of obesity, comorbidities, lifestyle and financial resources.

The choice between medication and surgery should be made in conjunction with a healthcare professional, seeking the best option for each patient. Obesity is a complex and multifactorial problem, and there is no single solution. Bariatric surgery and new medications represent important advances in the treatment of the disease, and the choice of the best approach should be based on clear and unbiased information.

“In short, bariatric surgery and new medications coexist as powerful tools in the fight against obesity. The key to success lies in a careful and personalized medical evaluation that takes into account the needs and particularities of each patient, thus ensuring the most appropriate and effective treatment.” Dr. Rodrigo Barbosa

Featured Photo: obesity (reproduction/disclosure)