When Heather Bade started taking weight loss medication, she hoped it would be the answer. Instead, the side effects nearly brought her to a standstill.
“When I was on the medications, I had a lot of side effects,” Bade said. “Those side effects made it really hard for me to do my job, to be a mom and a wife.”
She wasn’t alone in her struggle. Despite the widespread popularity of GLP-1 medications like Ozempic, Wegovy and Zepbound, many patients are finding the drugs don’t work for everyone - or come at too high a cost, financially and physically.
Dr. Carl Pesta, a board-certified bariatric surgeon and founder of Physique By Pesta, says that conversation is shifting.
“These medications have now allowed us as physicians to talk with patients that obesity is a disease that is really heavily rooted in hormones,” Pesta said during an appearance on Live in the D. But he is quick to add that surgery offers a more powerful and durable outcome. “Bariatric surgery has about 3 to 5 times better weight loss than the medications in general.”
Pesta wants to dispel the notion that surgery is a measure of last resort.
“I want people to know that it’s not a last resort to go to bariatric surgery,” he said, pointing to the durability of surgical outcomes. “The durability of bariatric surgery, the long-term success, the fact that often it’s just a one-time treatment, is going to give people that long-term results.”
He also says the surgery works on the body’s hormonal system in ways that parallel - and in some cases, surpass - what GLP-1 drugs do pharmacologically. “Bariatric surgery actually does what the GLP-1 medications do itself,” Pesta explained. “It’s not just about changing the anatomy.”
For Bade, the decision to pursue surgery came after her medications left her managing a long list of serious conditions. “The weight was causing me so many other health-related issues,” she said. “I had hypertension, I had diabetes, I had sleep apnea, cholesterol problems, the whole gamut.”
She says she felt out of options until she connected with Pesta. “I felt hopeless at the time until I was able to reach out to Dr. Pesta and he helped me find an alternative that really made a huge difference in my life.”
The results, she says, have been transformative - and emotional. “When I’m looking at the before,” Bade said, “it reminds me of the discomfort, not only physically, but mentally, emotionally.” But looking at her life now tells a different story. “I look at the after and I see how I’m living my life,” she said. “My quality of life has improved so greatly. To me it felt like a miracle, honestly.”
For those hesitant about the risks of surgery, Pesta offers reassurance. “Safety is the number one thing,” he said, noting that the procedure carries a risk profile comparable to routine operations. “This is on the same profile of like a gallbladder surgery.” He adds that cost is often less of a barrier than patients assume: “It’s covered by most insurances.”
Pesta acknowledges surgery is not a passive fix. Patients still need to commit to dietary changes, daily exercise and lifelong vitamin supplementation. But he says the surgical foundation makes that work sustainable in a way medications often cannot.
“Obesity is a disease requiring medical or often surgical treatment,” Pesta said. “Surgical treatment has 3 to 5 times as much weight loss, has a very good safety profile, and it really helps people live their lives again.”
More information is available at physiquebypesta.com.