Should I get gastric sleeve or wegovy? (Photo)

Question

Hi! I’m 5’9 about 300 lbs. my BMI is high enough so I don’t need the co-morbidities. but I also have prediabetes, PCOS, pseudotumor, metabolic syndrome, and fatty liver. Im only 21. I am stuck between surgery and wegovy. I hear wegovy isn’t long term as when you stop it you may gain the weight back. Surgery is expensive and id have to give up a lot of things for life. I’d prefer the meds. I’ve included pics and measurements. What’s a better option for me?

Jorge Maytorena, MD · Answer

You have a BMI of 44.3, I would definitely recommend a gastric sleeve as long as you do not suffer from gastroesophageal reflux because the sleeve would increase the reflux, and the other option would be a gastric bypass which has better metabolic control and a better long-term result. Compared to the gastric sleeve, I recommend the bypass for metabolic control

Walfre Edwin Guerrero Burgueno, MD · Answer

Hi! How are you? 
Given your BMI (44.3), comorbidities (prediabetes, PCOS, pseudotumor, metabolic syndrome, fatty liver), and your young age, both gastric sleeve surgery and Wegovy could help, but they have different long-term impacts.
Wegovy is effective while you're on it, but stopping may result in weight regain. Gastric sleeve is a more permanent solution, it involves lifelong changes. Given your health conditions, surgery may offer better long-term outcomes, but it's crucial to weigh the pros and cons to determine what's best for your situation.
Bariatric surgery is considered the most effective long-term treatment for obesity because it not only leads to significant and sustained weight loss, but it also addresses obesity-related comorbidities, such as type 2 diabetes, hypertension, and sleep apnea. The surgery alters the body's metabolism, reduces appetite, and improves the body's ability to process insulin, which makes it more successful at maintaining weight loss compared to diet, exercise, or medication alone. In contrast to temporary treatments, surgery provides a permanent change in the digestive system, leading to more durable outcomes over time.

Riza Ozdemir, MD · Answer

Your body mass index is 45, that is, at the stage of morbid obesity. Therefore, surgery is not one of the options for you, it is the only option. Weight gain after surgery is around 10% in the literature, but only 2 of our 4500 patients gained weight back. If surgery is not performed, diabetes and hypertension will become inevitable in a short time. This level of obesity both shortens life and reduces the quality of life due to additional diseases.

Should I get gastric sleeve or wegovy? (Photo)

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