For individuals seeking to manage their weight and improve their health, non-surgical weight loss programs offer a range of options. These programs can be a beneficial alternative for those who do not want or do not qualify for bariatric surgery. They provide various methods to facilitate weight loss, from lifestyle modifications to endoscopic procedures, all under the guidance of medical professionals.
Understanding Non-Surgical Weight Loss
Non-surgical weight loss procedures can help people with obesity lose a significant amount of weight. Unlike surgical weight loss procedures, nonsurgical procedures can be performed without needing to cut open your body, which can significantly reduce your risk of complications and the length of your recovery.
These programs often involve a combination of approaches tailored to the individual's needs, overall health, and weight loss goals. It’s important to find a weight loss treatment that is focused on safely losing pounds while supporting balanced lifestyle changes. Mercy takes an integrated approach to weight loss by providing behavioral counseling, dietary counseling, disease management, exercise counseling, pharmacotherapy, psychological counseling and weight loss surgery. Those who struggle with losing weight and don’t qualify for weight loss surgery may benefit from our alternatives to weight loss surgery which include nutritional education, personal fitness, intragastric balloon, behavioral therapy and more.
Medical Weight Loss Programs
Medical weight management is for patients with a Body Mass Index 30+ or 27-29.9 with an obesity related condition such as diabetes, hypertension, high cholesterol, or sleep apnea. Some services may not be safe if currently on dialysis, pregnant, or undergoing cancer treatment. This program incorporates long-term engagement and proven strategies for sustainable weight loss. A commitment of at least 12 weeks is required. Weekly group sessions are available virtually, with in person appointments with a Dietitian and Physician. The first appointment is a detailed assessment with the physician that includes an EKG, Body Composition, and Metabolic Labs.
Key Components of Medical Weight Loss
Medical weight loss programs typically include several key components, such as:
Read also: Weight Loss Without Surgery
- Medical Evaluation: A thorough assessment of your health, including weight-related conditions.
- Dietary Guidance: Creating a personalized diet plan with a registered dietitian/nutritionist.
- Behavioral Counseling: Addressing unhealthy eating habits and emotional barriers to weight loss.
- Exercise Guidance: Setting achievable exercise goals and incorporating physical activity into your lifestyle.
- Medications: Utilizing weight loss medications to control hunger and reduce fat absorption, when appropriate.
Benefits of Medical Weight Loss
The benefits of medical weight loss extend beyond just losing weight. It can also lead to:
- Lower blood sugar levels
- Reduced blood pressure
- Improved cholesterol levels
- Decreased pain in weight-bearing joints
Endoscopic Weight Loss Procedures
Endoscopic weight loss procedures are minimally invasive options for people who want help losing weight but don't want -- or may not qualify for -- bariatric surgery. Endoscopic weight loss procedures can achieve better weight loss than medication but not as much as bariatric surgery. Because they are newer procedures, more data is needed on how they perform over the long term. Endoscopy is a thin, flexible tube with a light and camera at its tip that allows your doctor to view your internal organs. The endoscope is inserted through a small opening in your body, such as your mouth, to reach your stomach and small bowel. These procedures require specialists with advanced training in GI endoscopy. Our surgeons and gastroenterologist have completed this advanced training and have years of experience performing these procedures with positive outcomes. Like other weight loss procedures, nonsurgical weight loss options require lifestyle changes for you to achieve success. Our bariatric team evaluates your condition as well as your commitment to making these lifestyle changes.
Gastric Balloon
The gastric balloon may be an option for adults whose BMI is between 30 and 40. First, the doctor gives you a mild sedative. Then, using an endoscope passed through your mouth, the doctor will insert a soft, durable balloon in your stomach and fill the balloon with a saline solution. Gastric balloon is a temporary procedure; the balloon is removed after six months. Rapid weight loss is typically experienced during the first four months following placement of the balloon. In the first few days after it is placed, the gastric balloon can cause abdominal pain, nausea, and vomiting.
Intragastric Balloons: Intragastric balloons are balloon-like devices that are inserted into your stomach and expanded with liquid or air to reduce the available space inside your stomach. There are two primary types of intragastric balloons on the market:
- Liquid-filled: Once liquid-filled intragastric balloons are inserted into your stomach, they can be expanded with liquid. Orbera, which was first approved by the Food and Drug Administration (FDA) in 2015, is the most commonly used liquid-filled intragastric balloon.
- Air-filled: Air-filled intragastric balloons are inserted into your stomach and then expanded with air instead of liquid. Obalon, which was approved by the FDA in 2016, a year after Orbera, is the most common air-filled intragastric balloon.
Intragastric balloons are typically inserted through your esophagus in a noninvasive, nonsurgical procedure called an endoscopy. The intragastric balloon procedure can help you shed pounds without the need for surgery. This minimally invasive outpatient procedure typically takes about 30 minutes. It can help jump-start weight loss by taking up space in your stomach - limiting how much you can eat and keeping you feeling full longer after meals. Long-term weight loss requires a commitment to major lifestyle changes, such as eating healthy and being active.
Read also: Comprehensive Diet Guidelines
In one small study from 2017, researchers investigated the effectiveness of the intragastric balloon Orbera for weight loss in 35 study participants. Results of the study found that almost 55% of participants experienced at least a 10% reduction in their baseline weight after the surgery. In addition, 34% of those participants maintained their weight loss 6-12 months after the procedure.
Endoscopic Sleeve Gastroplasty
People with a BMI greater than 30 may be candidates for endoscopic sleeve gastroplasty. Folds are stitched into your stomach to reduce its size by about 70%. This restricts how much food and drink you can consume and makes you feel fuller faster. No part of your stomach is cut or removed. Only stitches hold the folds in place. The procedure can be undone, but scar tissue may remain. Studies report that 60% of people lost about 20% of their total body weight during the first year after surgery.
In a recent study from 2022, researchers studied the effectiveness of endoscopic sleeve gastroplasty for weight management in 91 people with obesity. Results of the multicenter study showed that the procedure was able to produce significant weight loss in study participants both after surgery and at 6 months.
AspireAssist
AspireAssist is another nonsurgical weight loss device that was first approved by the FDA in 2016 to help assist with weight loss in people with obesity. With this device, a tube running from the inside of your stomach to the outside of your stomach allows you to drain a portion of your stomach’s contents after a meal. This reduces your calorie intake by roughly 30%. Like many other nonsurgical weight loss procedures, AspireAssist is inserted directly into your stomach with the help of an endoscope.
Another study from 2016 explored the effectiveness of the AspireAssist with lifestyle counseling for weight loss in people with obesity. According to the study results, when used alongside lifestyle counseling, AspireAssist was effective at reducing at least 25% of baseline weight in more than 58% of study participants.
Read also: Weight Loss Options: Riverside Guide
Endoscopic Gastric Bypass Revision
There are times when people have trouble reaching their weight loss goals -- or even gain weight -- after gastric bypass, because of stretching that may occur at the connection between the stomach and small intestine, also known as gastrojejunostomy. In this case, we may recommend an endoscopic gastric bypass revision, which is performed by inserting a tube into your mouth to reach your stomach.
Nonmedical Weight Loss Programs
Nonmedical weight loss programs include meal replacement programs and exercise guidance.
Meal Replacement Programs
Meal replacements can be an effective tool choosing nutritionally balanced, low-calorie foods. They offer a convenient and controlled way to manage calorie intake while ensuring nutritional needs are met. These products are designed to replace one or more meals per day and are often formulated with balanced macronutrients, vitamins, and minerals to support overall health. When used as part of a structured program, under the supervision of one of our weight management providers, meal replacements can help to achieve and maintain weight loss goals.
A new GLP-1 Weight Loss Program is designed to complement the use of GLP-1 medications typically prescribed for the management of diabetes, sleep apnea, cardiovascular disease, and obesity. The program integrates the use of meal replacement products, which contain prebiotic fiber and probiotics to help manage medication side effects such as nausea and gastrointestinal discomfort, along with ingredients to help maintain and build muscle. Low-calorie meal replacements are available at some UPMC bariatric locations.
Exercise Guidance
Our providers help you set exercise goals that are aligned with your current fitness level and that can be used at your local gym, at home, or in the community. We understand how difficult it can be to add regular physical activity into your busy lifestyle, so we also provide guidance that makes physical activity more enjoyable, and therefore easier to maintain as a healthy habit. Our recommendations are based on professional guidelines such as those from the American College of Sports Medicine.
Lifestyle Modifications
Many people who struggle with their weight find that lifestyle changes - such as following a healthy eating plan and getting regular exercise - can help them lose weight and keep it off. They’ll help you to recognize unhealthy eating habits, emotional eating, and other personal barriers to weight loss.
Individual Meal Planning
Planning out meals in advance, awareness of the nutritional value of the foods you choose, and being accountable to your goals can be crucial for weight loss success. We teach you how to create a healthy eating plan and maintain a food diary.
Mindful Eating and Nutrition Planning
Mindful eating is a cornerstone of our care. We discuss your eating habits, what triggers eating, and how to distinguish “head hunger,” which is wanting to eat even though you are not truly hungry, from your body’s true metabolic needs. We also discuss ways to manage stress that do not include food.
Knowing how to read food labels and menus to find the best choices, as well as understanding food composition, plays a part in mindful eating. Our registered dietitians teach you how to incorporate nutritional knowledge into your busy life while also balancing your family’s food preferences.
Self-Monitoring Tools
The bathroom scale, food diaries, and label reading can all help you reach your weight loss goals and maintain a healthy weight. We help you figure out which self-monitoring tools are best for you, and how often you should use them.
The Importance of a Comprehensive Approach
At UC Health Weight Loss Center demonstrates a comprehensive weight management approach by employing all specialties to help patients lose weight including nutrition, behavioral health, obesity medication, lifestyle intervention, physical activity, metabolic treatment, and bariatric surgery.
At UPMC, we know that weight loss is a very personal journey: what works for another person may not be the right path for you. Medical weight loss looks at the big picture, taking into consideration your individual needs, overall health and medical conditions, and weight loss goals.
At Mercy, we know medical risks like diabetes and high blood pressure are linked to obesity and a high body mass index (BMI). We also know different weight loss treatments work for different people, so we work to find the one best suited to you and your goals.
Additional Considerations
- Extreme Weight Loss: When it comes to losing weight, a weight loss of 1-2 pounds per week is usually recommended for most people. But there may be some situations in which a person with obesity needs to lose weight at a more rapid pace, such as to prepare for weight loss surgery. Extreme weight loss without surgery can be safe and effective when done under the supervision of medical professionals. But extreme weight loss that happens outside of the recommendation and supervision of a doctor or healthcare professional is generally not considered safe for most people. If you’re planning to lose weight through dietary or lifestyle changes, it’s always best to discuss your plans with a doctor so that you can get the support you need to lose weight safely.
- Review of Medications: Many medications used to manage conditions such as diabetes, depression, seizure disorders, arthritis, and high blood pressure contribute to weight gain. There may be alternative medications or ways to manage these conditions that allow you to take less medicine. Our clinicians work with your primary care physician to suggest helpful strategies.
- Metabolic Rate Testing: Metabolism analysis helps to determine your metabolic rate, which is a calculation based on body fat, muscle mass, age, gender, and fluid retention. Your metabolic rate helps to determine how many calories your body burns while at rest. This information is used by our experts to come up with a diet strategy focused on consuming fewer calories than you burn in a day. The testing, which uses a body composition analyzer, is quick, painless, and does not require a blood test or fasting.
- Medical Evaluations of Weight-Related Conditions: Many medical conditions can worsen as a person gains weight. Weight loss is often the best way to manage these conditions, which include metabolic diseases, such as type 2 diabetes, and movement issues, such as osteoarthritis of the knee and osteoarthritis of the hip. We help you manage these conditions while you lose weight and optimize your overall health. Women who have polycystic ovary syndrome or a history of gestational diabetes have unique vulnerabilities related to insulin resistance. Our providers work intensively with you to develop safe, effective meal plans that can jump-start and accelerate weight loss. We have several options for those who need to lose weight prior to a medical procedure. We can even help people who have tried traditional diet plans but have been dissatisfied with the results.
- Insurance Coverage: Insurance coverage for medical weight loss varies by plan and patient medical needs.
Finding the Right Program for You
If you and a doctor don’t feel that surgery is right for you, many other options exist for weight loss. For people with obesity who want to lose weight, there are a variety of surgical and nonsurgical procedures that can help people experience significant weight loss. But weight loss surgery isn’t for everyone - and for some people, nonsurgical weight loss procedures are a better option. From balloon systems to endoscopic surgeries, there are several weight loss procedures for people with obesity who don’t want to undergo surgical procedures. Ahead, we’ll explore some of those nonsurgical weight loss procedures, as well as cover more information about newer procedures and different weight loss approaches.
People who are affected by obesity and have had limited success losing weight on their own may benefit from medically supervised weight loss through the Weight Management Program at NYU Langone. Our nonsurgical medical weight loss methods focus on proper nutrition, physical activity, and making healthier lifestyle choices. We work with you and your primary care physician, exercise experts, nutritionists, psychologists, and other specialty providers as necessary. The program welcomes anyone who has a weight concern and hopes to gain a sense of control over their weight.