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How desperate to lose weight would you have to be before you’d let a surgeon slice a hole in your abdomen and remove three-quarters of your stomach? This is “sleeve gastrectomy,” a common bariatric surgery that reduces stomach size and decreases appetite by blunting the release of ghrelin—a hormone that stimulates hunger. More than 1.5 million Americans have elected for bariatric surgery in the last 10 years, having repeatedly tried and failed to lose weight via conventional means. All bariatric surgeries carry significant risk, including bleeding, infection, gastrointestinal leaks, and even death. They’re also expensive and met with varying degrees of success. Even so, the benefits are often deemed to outweigh the risks, and for years surgery has been the last bastion of hope for sections of an obese population that are otherwise hopeless. What’s more, the number of bariatric surgeries performed is rising year on year. Now, promising new drugs Ozempic and Wegovy, therapies for type II diabetes and obesity, respectively, are showing documented success in clinical trials. Lauded by some as “breakthrough weight loss treatments” that will reduce dependence on surgery, yet vilified by others for promoting drug dependency, Ozempic and Wegovy are now making the predictable transition from clinical therapy to commercial shortcut. The implications could be disastrous for population health.
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