Do regular exercises help with long-term weight reduction?

Question

Hello doctor,

I have been struggling with obesity for years. I have tried every diet, ketogenic diet, intermittent fasting, and calorie counting, and I always gain the weight back. It is really affecting my confidence and my health.

My body mass index (BMI) is around 36, and my doctor mentioned medications like Semaglutide or Tirzepatide. I also wonder if I am a candidate for bariatric surgery, but I am scared of the risks. I exercise regularly now, but the scale does not move. It is frustrating because people assume I am lazy, but it is much more complicated than that.

Do they actually work long-term, or does the weight return when you stop them?
Are there any new treatments or metabolic options that can help reset my system?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I can truly understand how discouraging and emotionally exhausting it can be to keep trying different diets and lifestyle changes, yet still not see lasting results. Obesity is a complex medical condition influenced by genetics, hormones, metabolism, and environmental factors, not simply willpower or effort. You are absolutely right that it is not about being lazy, and it takes real strength to keep working on your health despite the frustration.

With a BMI of 36, both medications and surgery can be considered, especially if weight-related issues like high blood pressure, diabetes, or sleep apnea are present.

Medications such as Semaglutide and Tirzepatide have shown good results in helping people lose 15 to 25 percent of their body weight when combined with healthy eating and activity. They work by reducing appetite, improving fullness, and supporting blood sugar control. These medicines are generally safe under medical supervision, but weight can return if they are stopped.

Bariatric surgery is another option for those with a BMI over 35, particularly when medications and lifestyle changes are not enough. Procedures like sleeve gastrectomy or gastric bypass can lead to 50 to 70 percent excess weight loss and improve conditions like diabetes and high blood pressure. Surgery carries some risks, but modern techniques are safer, and most patients recover well.

The key is finding a sustainable approach that fits your life. Staying active and seeking medical guidance, as you are doing, is the right step. With the right combination of therapy, nutrition, and follow-up, meaningful and lasting progress is achievable.

I hope you are satisfied with my answer.

For further queries, you can consult me at iCliniq.

Thank you.