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Weight Loss Pathways

What is the best pathway for weight loss. With so many options, it can be confusing. Let me try to help. Firstly, an appropriate diet to avoid energy dense food is part of any weight loss program. We have a very experienced dietitian Joanne Dembo to assist. Regular exercise also is part of the back bone of weight loss. Alone, diet and exercise are unlikely to produce significant long term weight loss.

Group 1
Group 1

MEDICATIONS

Common prescription medications include: Duromine, Contrave, Saxenda, Ozempic, Wegovy and Mounjaro

Pros:

  • No surgery
  • Modest weight loss in most patients (10 to 15%)

Cons:

  • On going yearly cost (over $5000) is greater than surgery with insurance
  • Weight regain when medications are ceased
  • Uncommon but serious. (blindness, pancreatitis)

ALLURION BALLOON PROGRAM

Pros :

  • No surgery nor endoscopy
  • Outpatient procedure 10 to 15% weight loss

Cons:

  • Expensive (over $7000)
  • More than surgery in patients with insurance
  • Weight regain after balloon passes at 4 months
  • A week off work

WEIGHT LOSS SURGERY

Pros:

  • The most effective treatment long term
  • 30% Weight loss
  • Less costly than medications and balloon with private insurance
  • Safety profile about equivalent to gallbladder surgery

Cons

  • Hospital stay 2 day
  • Two weeks off work
  • Uncommon but serious side effects from surgery

Patient Pathway

 

  • BMI between 27 and 35 with weight related issues and wanting to lose 10 to 15 kg consider medications.
  • Failure to lose weight on medications, consider Allurion.
  • Balloon BMI over 35 consider weight loss surgery.
  • Patients with a BMI from 30 to 35 can be considered for weight loss surgery on an individual basis taking into account presence of weight related issues, previous attempts at weight loss and to avoid higher costs with medications or Allurion balloon.

Weight loss surgery is an excellent tool for management of:

  • Diabetes
  • Asthma
  • Hypertension
  • Sleep apnoea
  • High triglycerides
  • Infertility
  • Musculoskeletal pain due to weight (back, hip, knee, ankle, foot)
  • Benign intracranial hypertension
  • Work Place weight restrictions