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Needle or Knife? Truth About Long-Term Weight Loss | LOC Blog

25/07/2025 No Comments

Author- By Dr Shashank Shah
The modern obesity pandemic has brought two groundbreaking interventions to the forefront: bariatric surgery and GLP-1 receptor agonists, such as Ozempic (semaglutide) and Mounjaro (tirzepatide). Both offer promising results in weight loss and metabolic improvement.

But are they equal? When evaluated through the lenses of long-term outcomes, hormonal impact, cost-effectiveness, and real-world utility, the answer becomes nuanced.

Bariatric surgery, once seen as a last resort, is now widely recognized as a scientifically validated, long-term solution for metabolic disease. In contrast, GLP-1-based injections have captured the imagination of patients and physicians alike, presenting themselves as an appealing, non-invasive alternative.

Yet, the critical question remains: are these injectables truly comparable in effectiveness, durability, and value? The answer lies not just in clinical studies, but also in the lived experiences of patients, and in the hard economics of healthcare systems.

Recent studies from the United States indicate that while GLP-1 medications can deliver impressive short-term weight loss, only about 30% of patients continue these treatments beyond one to two years. The majority discontinue use due to high cost, waning effectiveness, or unpleasant side effects.

In contrast, a new paper comparing real-world outcomes (not industry-sponsored trials) found that bariatric surgery led to five times more weight loss than either Ozempic or Mounjaro after two years. This is not a marginal difference; it is a striking one.

The Hormonal Advantage of Surgery

The true power of bariatric surgery lies in its ability to trigger a comprehensive hormonal reset. It’s not simply about reducing the size of the stomach. Surgery reprograms the hormonal signals that travel from the gastrointestinal tract to the brain and pancreas.

Hormones such as ghrelin, GLP-1, PYY, oxyntomodulin, and several others are naturally and rhythmically modulated after surgery. This physiological resetting drives genuine changes in appetite control, satiety, insulin sensitivity, and long-term compliance, without relying solely on a patient’s willpower.

By comparison, GLP-1 medications deliver a synthetic, sustained dose of hormone for 24 hours, often injected into adipose tissue where receptor density is low. The resulting impact is narrower, less coordinated, and ultimately less sustainable.

This difference in mechanism is critical. While bariatric surgery patients often experience reversal of diabetes, hypertension, and high cholesterol within weeks, GLP-1 users may still require statins, uric acid medications, protein supplements, and diabetic drugs, even while on the injectable therapy.

A Financial Reality Check

There is a pressing financial dimension to this discussion that neither patients nor policymakers can afford to ignore.

In India, a patient on semaglutide or tirzepatide can expect to spend between ₹15,000 and ₹20,000 per month. Adding in the cost of supportive medications and supplements, the monthly outlay often climbs to ₹30,000–₹40,000.

Over a year, this totals close to ₹4 to ₹5 lakhs—a figure that matches, or exceeds, the one-time cost of bariatric surgery, which typically ranges between ₹3 to ₹4 lakhs. Crucially, while GLP-1 therapy is open-ended, bariatric surgery offers a decade or more of benefits with minimal ongoing medical expenses.

Equally important is what happens after stopping the medication. Clinical studies show that more than 50% of lost weight is regained within six to eight months of discontinuing GLP-1 therapy. This is not due to patient failure—it is simply the body reverting to its original hormonal pathways once external hormone support is withdrawn.

Why GLP-1s Fall Short for Severe Obesity

Consider a patient weighing 180 kilograms. Even if this person loses an impressive 20% of body weight on Mounjaro—mirroring clinical trial outcomes—they would still weigh 150 kilograms. For such individuals, joint pain, diabetes, and mobility issues persist even after maximum injectable therapy.

In these scenarios, bariatric surgery is not just more effective—it is essential. Later, medications may be reintroduced for fine-tuning weight maintenance, but they cannot be the primary modality in severely obese individuals.

GLP-1 Use in Women Planning Pregnancy: A Hidden Concern

Another important limitation of GLP-1 medications concerns young women planning to conceive. Current guidelines require that GLP-1 therapy be discontinued at least two months before conception. However, since conception doesn’t occur immediately, women may be off the drug for six to eight months, leading to substantial weight regain and a possible resurgence of metabolic risk.

In such cases, the patient might gain a partner, but not the healthy pregnancy she hoped for. This is an under-discussed but real issue, especially in countries like India, where fertility planning is a critical concern.

Clinical Trials vs. Real Life: The Compliance Gap

The impressive weight loss numbers in GLP-1 clinical trials occurred under strict conditions—150 minutes of exercise per week, dietary monitoring, behavioral support. Real-life patients, however, often treat these injections as a “quick fix,” hoping for results without lifestyle changes.

This is where bariatric surgery shines. Its hormonal changes automatically induce compliance, reducing appetite, improving insulin response, and changing taste preferences. Unlike medications that require continuous effort, surgery biologically aligns the body with the goal of weight loss.

That’s also why results from bariatric surgery are more durable, often lasting 7 to 10 years or longer. Even when some weight is regained, the foundational benefits of surgery—altered gut hormones, better metabolic control, improved quality of life—remain intact.

The Future: A Smarter Combination

Looking ahead, the best outcomes in obesity care may come from a combination of tools. Bariatric surgery can act as the metabolic reset, while medications like Mounjaro can help maintain weight loss in the longer term, especially when small gains begin to creep back.

However, the sequence and strategy matter. Surgery, for the right candidate, should come first, not last. Medications can play a supporting role, not a central one.

The Final Word

It is time for both patients and clinicians to look beyond the hype. This is no longer just a matter of losing weight—it’s about reclaiming health, reducing chronic disease, and breaking free from lifelong medical expenses and pharmaceutical dependence.

While GLP-1 drugs have their place, bariatric surgery remains the most comprehensive, cost-effective, and durable solution available today. Backed by science, economics, and real-world success stories, it continues to offer a level of transformation that no injection—however promising—can yet match.

Why Choose LOC for Weight Loss

We at Laparo Obeso Centre (LOC) offer all types of treatments including Wegovy, Ozempic, Mounjaro, bariatric surgery, balloon, and related diet & nutrition care.
LOC is one of the pioneer hospitals in bariatric surgery and ranked as the best hospital in Western India by TOI.

LOC is also certified as a Centre of Excellence for metabolic and bariatric surgery.

Cashless insurance facility is available.

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Hernia

Umbilical Hernia: Symptoms, Treatment & Surgery | Advanced Keyhole Repair

10/07/2025 No Comments

What Is an Umbilical Hernia?

An umbilical hernia is a condition where part of the intestine or abdominal tissue bulges through a weak spot in the abdominal muscles near the belly button (umbilicus). This causes a visible lump or swelling, especially when you cough, lift something heavy, or strain your abdomen.

Umbilical hernias are not just found in infants — many adults also develop them, especially those who are overweight, have had multiple pregnancies, suffer from chronic coughing, or perform heavy lifting regularly.

What Is an Umbilical Hernia?

Normally the naval or umbilicus is deep and called inverted
If your naval is flat or does not have the depth or if it protruding outside or if the shape of naval changes, you may be having an umbilical hernia.

What Causes Umbilical Hernias in Adults?

In adults, an umbilical hernia typically develops due to increased pressure in the abdomen combined with a weak spot in the abdominal wall. Common causes include:

  • Obesity
  • Multiple pregnancies
  • Chronic constipation or straining
  • Persistent coughing
  • Previous abdominal surgery
  • Heavy weight lifting
  • Fluid in the abdomen (ascites)

Common Symptoms of Umbilical Hernia

Not all hernias are painful at first, but symptoms may worsen over time. You might notice:

  • A soft or firm bulge near the navel
  • Pain or discomfort during activities like lifting, bending, coughing, or standing for long periods
  • Swelling that becomes more obvious when standing or straining and disappears when lying down
  • A sense of pressure or fullness in the abdomen

If the hernia becomes hard, painful, or discolored, or if you’re experiencing nausea and vomiting — this may signal a strangulated hernia, which is a medical emergency. Seek immediate medical attention.

Is Umbilical Hernia Dangerous?

While many umbilical hernias may appear small and harmless initially, they do not heal on their own and can lead to severe complications if left untreated:

  • Incarceration – when the hernia gets stuck and can’t be pushed back in
  • Strangulation – when blood supply to the trapped intestine is cut off, leading to tissue death

Surgery is the only definitive and permanent treatment to repair an umbilical hernia and prevent such risks.

Modern Umbilical Hernia Treatment: Keyhole (Laparoscopic) Surgery

At our center, we specialize in Advanced Laparoscopic Umbilical Hernia Repair — also known as Keyhole Surgery — a minimally invasive technique offering excellent outcomes and faster recovery.

What Makes Laparoscopic Surgery Better?

  • Small Incisions (1–2 cm) – Reduced pain and faster healing
  • No Big Cuts or Stitches – Better cosmetic results
  • Faster Recovery – Most patients return home the same day
  • Lower Infection Risk – Thanks to minimal tissue handling
  • Scientifically Proven Mesh Reinforcement – Strong and long-lasting repair
  • Extremely Low Recurrence Rate – When performed correctly

Why Choose Us? How We’re Different

Laparo Obeso Centre (LOC), led by internationally acclaimed surgeon Dr. Shashank Shah, is not only equipped with the latest technology but also stands out for setting unmatched standards in hernia care. With a focus on innovation, safety, and patient-centered outcomes, LOC has become a trusted name in advanced laparoscopic hernia treatment.

Limca Book of Records Holder

We proudly hold the Limca Book of Records for:

  • 44 Hernia Surgeries in 10 Hours by a Single Surgeon
  • A Record Still Unbeaten in India

This reflects our team’s efficiency, skill, and dedication to high-volume, high-quality care — without compromising safety.

Our Commitment to Excellence Includes:

  • Advanced Laparoscopic Techniques – Performed by experts trained in high-precision surgery
  • Day Care Surgery – Most patients can walk in and walk out the same day
  • Highest Safety Standards – Even high-risk patients (with obesity, diabetes, cardiac issues) are managed with extreme care
  • Experienced Surgical Team – Led by a record-holding, internationally recognized bariatric and hernia surgeon
  • Minimum Recurrence – With modern mesh techniques and patient education
  • Comprehensive Care – From pre-surgical fitness to post-operative support

Real Results. Real Lives Transformed.

We don’t just repair hernias — we help restore confidence, comfort, and quality of life. Our approach combines cutting-edge science with human care, ensuring you receive treatment that is safe, effective, and life-enhancing.

When Should You Consider Umbilical Hernia Surgery?

If you notice a bulge around your belly button, experience pain or discomfort, or have a hernia that’s growing — it’s time to consult a specialist.

Early intervention means:

  • Simpler surgery
  • Faster recovery
  • Avoidance of emergency complications

Ready to Take the First Step?

Whether you need advice, a second opinion, or are ready for surgery, our team is here to help.

Contact Us Today

Phone: +917411804876

Website: https://obesityasia.com/

Location: 2143, Sadashiv peth, Vijayanagar Colony, N. C. Phadke Chowk, Near Neelayam Theater, Next to Hotel Kaveri, Pune 411030, Maharashtra, India

Advanced Hernia Care, Trusted by Thousands. Record-Holding Expertise You Can Rely On.

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About me

Dr Shashank Shah is an expert laparoscopic bariatric i.e. obesity surgeon in India. He is a director of Laparo Obeso Centre which is a centre for treatment for weight loss and weight-related metabolic diseases.

Recent Posts

  • लठ्ठपणा म्हणजे काय? कारणे, धोके आणि उपचार – डॉ. शशांक शाह, लॅपरो ओबेसो सेंटर (LOC)
  • Best Laparoscopic Surgeon in Pune | Minimally Invasive Surgery at LOC
  • Needle or Knife? Truth About Long-Term Weight Loss | LOC Blog
  • Umbilical Hernia: Symptoms, Treatment & Surgery | Advanced Keyhole Repair
  • 20 Years of LOC | Limca Record: 45 Hernia Surgeries in 10 Hours – Dr. Shashank Shah

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