Obesity is a complex environmental condition that affects millions of people around the world. Traditional methods of weight loss, such as diet and exercise, fall entirely short in providing long-term, sustainable results. They simply don’t work. In recent decades, metabolic surgery has emerged as the only proven avenue for people with severe obesity. Not only does it lead to significant weight loss, but it also induces hormonal changes that can mimic the effects of medications like Ozempic (semaglutide). With these new drugs becoming more popular, I thought it helpful to explore the mechanisms by which metabolic surgery causes hormonal alterations and how these changes can contribute to sustained weight loss, in some ways mimicking—and in other ways going far beyond—the effects of taking Ozempic.
Metabolic Surgery and Hormonal Changes
Metabolic surgery encompasses several procedures, including gastric bypass, biliopancreatic diversion, and the most widely performed, sleeve gastrectomy. All of these involve anatomical modifications to the gastrointestinal tract. While a minor mechanism of weight loss after metabolic surgery is the reduction in stomach capacity and altered nutrient absorption, overwhelming evidence demonstrates that hormonal changes play the crucial role in its success.
One of the key hormonal changes observed after metabolic surgery is the alteration in gut hormone secretion. The gut produces several hormones, including glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and ghrelin, which regulate appetite, satiety, and glucose metabolism. Metabolic surgery promotes an increase in GLP-1 and PYY levels while reducing ghrelin secretion.
Ozempic, a medication used in the treatment of type 2 diabetes and obesity, belongs to a class of drugs called glucagon-like peptide-1 receptor agonists (GLP-1 RAs). It acts by mimicking the effects of GLP-1, leading to increased insulin secretion, decreased glucagon release, delayed gastric emptying, and increased satiety. In short, GLP-1 causes lower blood sugar and lower body weight. Similarly, metabolic surgery-induced changes in gut hormones, particularly the rise in GLP-1 levels, replicate the effects of GLP-1 RAs such as Ozempic. Having a sleeve gastrectomy is like taking Ozempic forever.
Metabolic surgery has another benefit. It also improves insulin sensitivity, a critical factor in managing obesity and diabetes. Insulin resistance is a hallmark of these conditions, contributing to excessive fat storage and metabolic dysregulation. By altering the hormonal milieu, metabolic surgery enhances insulin sensitivity, allowing for improved glucose control and reduced fat accumulation, similar to the effects seen with Ozempic therapy.
The sustained weight loss observed after metabolic surgery can be attributed, in large part, to the hormonal changes it induces. By reducing appetite, enhancing satiety, decreasing storage of fat, lowering blood sugar, and improving insulin sensitivity, these hormonal alterations create an environment that supports long-term lowered weight set point. Similarly, treatment with Ozempic has been associated with significant, although less profound, weight loss, but only as long as the person continues taking the medication.
Additional Benefits of Metabolic Surgery
Apart from weight loss and hormonal changes, metabolic surgery offers additional benefits that make it a favorable option for individuals with obesity. Metabolic surgery reduces the chronic inflammation in the body, measurable by several key blood markers, resulting on lowered inflammatory risk factors for conditions such as atherosclerosis and heart disease. It has been shown to improve or resolve obesity-related comorbidities such as type 2 diabetes, hypertension, and obstructive sleep apnea. These positive outcomes can further enhance the effectiveness of metabolic surgery and contribute to long-term weight management.
The Bottom Line
Metabolic surgery represents a transformative approach to obesity management, offering not only substantial weight loss but also inducing hormonal changes that mimic the effects of medications like Ozempic. But it goes several steps further, too. By modulating gut hormone secretion, enhancing insulin sensitivity, and reducing inflammation, fat storage and appetite, metabolic surgery provides a sustainable solution for individuals struggling with severe obesity.
Ready to learn more about weight-loss surgery and whether you might be a candidate? Contact the Nevada Surgical team today to get started.
