Local Chief Medical Officer removes barriers for those avoiding bariatric surgery

THE WOODLANDS, TX – While the airwaves and timelines are being bombarded with the latest information on GLP-1s as weight-loss options, one local surgeon wants to assure Woodlanders and visitors wanting to weigh less that the benefits of bariatric surgeries are without comparison.

Dr. Yong Choi, Chief Medical Officer at St. Luke’s Hospital, recently talked with Woodlands Online about the comparisons and contrasts between medicines and surgeries when talking about shedding pounds.

Bariatric surgery is a highly effective surgical intervention designed to treat severe obesity and its related metabolic conditions by modifying the digestive system. These procedures work by restricting the amount of food the stomach can hold, reducing the body’s calorie absorption, or altering the gut hormones that control hunger and metabolism.

Done primarily through minimally invasive laparoscopic or robotic methods, bariatric surgery has a success rate of an excess of 90% for maintaining significant long-term weight loss.

Types of bariatric surgeries include the sleeve gastrectomy (also known as the gastric sleeve) where the surgeon permanently removes roughly 80% of the stomach; gastric bypass, a procedure that creates a small pouch at the top of the stomach and connects it directly to the lower small intestine; and the duodenal switch and SADI-S, where both of these procedures combine a gastric sleeve with a significant intestinal bypass. The gastric sleeve and gastric bypass procedures are considered by Choi to be the two “mainstays” in his experience.

“These surgeries have withstood the test of time,” he told Woodlands Online. “Because of things like the pandemic lockdowns and the rise of GLPs, there has been a slight dip in the number of bariatric surgeries; however, that number is still high. In 2024, 177, 297 surgeries were performed in the United States.”

In the world of Dr. Choi, who has more than 30 years’ worth of medical experience, there is room enough for both surgery and medicine. “When considering GLP-1s or surgery, it doesn’t necessarily have to be one or the other. We don’t have to pit them against each other; being smart can help you discover the best options for you.”

GLP-1 – like medical treatments such as Rogaine, Viagra, Latisse, Wellbutrin, and Propecia – were originally intended for treatment of other medical issues but whose side effects branched them out. GLP-1s were originally intended solely for diabetic treatment, but the accompanying weight loss inspired its makers to enter them into the weight-loss market.

Primarily available in shot form and not covered by many insurance plans for weight-loss purposes, GLP-1s can include side effects such as nausea, abdominal, and increased bleeding. Not everyone can tolerate them, and those who do can most likely look forward to a lifetime of self-injections. Additionally, as is the case with most other medications, once you stop, the odds of undoing all the “good work” increase dramatically, and weight re-gain is probable.

“GLPs offer people around 10 to 15% weight loss, which means most people who take it can look forward to losing a maximum of 20 to 30 pounds,” said Choi. “With a gastric surgery, you can lose much, much more. And if for some reason your weight starts to come back after the surgery, you can always then be put on GLP-1.”

Bariatric surgery is often considered metabolic surgery because it directly rewires your body’s metabolic programming. Beyond weight reduction, it is clinically proven to improve or entirely resolve several serious health issues; it often puts diabetes into immediate remission, reducing or eliminating the need for daily medication. It also lowers blood pressure and cholesterol levels, sharply reducing the risk of stroke and heart attacks. Sleep apnea is dramatically reduced or entirely eliminated, and the surgery also relieves chronic mechanical strain on the lower back, hips, and knees.

“Surgery isn’t a magic pill,” warned Choi. “It’s a way to modify your behavior. It’s life-changing decision, but it isn’t high risk at all.”

To qualify for bariatric surgery, individuals generally must meet specific clinical criteria established by insurance providers and surgical groups, typically with the candidate having a body mass index of 35 - 40 existing with comorbidities.

Dr. Choi encourages people wishing to lose significant weight to – pardon the pun – weigh their options, and to reach out to medical experts such as himself to find the best treatment. St. Luke’s Hospital The Woodlands is more than capable of handling all of your bariatric – another surgical – needs.