Continuing Lifestyle Intervention, Part 6

The large question under consideration here is whether the seemingly miraculous new weight-loss drugs are enough, in and of themselves, to permanently and meaningfully change people’s lives. In this context, it was interesting to draw comparisons between committing to one of those drugs and submitting to bariatric surgery.

A brief digression

When surgery is the topic, Childhood Obesity News is not a big fan. Here is an excerpt concerning Dr. Pretlow’s attendance at the European Childhood Obesity Group Congress in 2014:

He was disappointed to learn that, rather than being viewed as an extreme measure and a last resort, especially for the young, bariatric surgery had become a treatment of choice. Nevertheless, the chair of the bariatric surgery session said, “Even gastric bypass surgery produces only a temporary remission” and noted that 25% of the adolescents who undergo gastric bypass surgery fail to lose weight and of those who do, 43% gain the lost weight back.

As this post has pointed out before,

[E]ven those who carefully follow all the rules can expect 20% to 25% of the lost weight to have returned, after 10 years. For someone who undergoes this kind of surgery at, say, age 20, this sounds rather grim. By age 30, they can expect to plump up again, only this time, there is no last-resort surgery to save them, because the most extreme measure has already been taken.

It looks like users of the new meds are finding themselves in the same position. Discussion brings up phrases like “the chronicity of obesity” — i.e. its tendency never to go away. In relation to the new meds, researchers from the University of Liverpool addressed the matter characterizing the rebound after withdrawal from semaglutide as “relatively rapid.” They also reported that…

[…] people who lost the most weight while taking semaglutide tended to then regain the most after stopping it…

In the self-improvement department, the person who went through bariatric surgery is not done. They still have to carefully manage their nutrition, even more so than other people. The post-bariatric surgery diet is a lot of work, and then when the “new normal” condition stabilizes, the surgery has still caused anomalies that the body will need to compensate for somehow. And the patient still requires the other five components of lifestyle medicine: physical activity, stress management, restorative sleep, social connections, and avoidance of risky substances.

Why would people on the hot new meds be any different? Each and every one, if granted the chance and blessed with the desire, can still reap massive additional benefits by not “leaving well enough alone.” Whatever the medication is doing for a person, they can always wring more out of the experience. All it takes is to engage the body in an appropriate amount of activity; steer clear of the bad drugs, manage the stress, get enough sleep, and maintain healthy and nourishing social connections.

Your responses and feedback are welcome!

Source: “Bodyweight rebounds after semaglutide withdrawal,”, 05/09/22
Image by Rune Mathisen/CC BY-SA 2.0 DEED

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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