While it’s true there are pills for weight loss, they aren’t “magic pills.”

You don’t just fill the prescription, swallow the dose, and watch the weight melt off, says Danielle Friedman, MD, a bariatric and minimally invasive surgeon at Hartford HealthCare’s Medical & Surgical Weight Loss Program.

But what is medical weight loss, and how does it work? Dr. Friedman has the answers.

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Medical weight loss is more than just a prescription.

Overseen by a physician or advanced provider, medical weight loss offers patients a way to lose weight without surgery. It can include medication, but there’s a lot more to it.

“Medical weight loss involves nutritional and medical evaluation as well as discussion of lifestyle factors,” she says. “It requires nutritional changes and lifestyle changes along with any medication. A multi-modal approach is critical.”

This includes:

  • Nutritional education
  • Lifestyle guidance
  • Exercise plans
  • Eating techniques
  • Trigger analysis

But when medications are necessary, there are plenty of options.

Many of the drugs on the market have been around for some time, and have been shown to offer many benefits. But newer drugs are showing promise too, says Dr. Friedman.

“Some of these medications can be long-term,” she notes, “and others will have side effects that need to be monitored. And with the newer medications, the studies only go out about four years so far, so the research needs to be followed.”

Anyone whose body mass index (BMI) is in the obese range might benefit from medical weight loss. Those who are overweight and have an associated medical condition like sleep apnea or diabetes are also eligible.

> Related: How Medical Weight Loss Can Help You Reach Your Goals

And when that’s not enough, surgical weight loss is an option.

If your BMI is over 35, or over 30 with a weight-associated condition, surgical weight loss might be right for you.

The “gold standard” of surgical weight loss is gastric bypass surgery, which limits the amount of food the stomach is able to hold and helps patients feel full faster. Another option is the gastric sleeve surgery, which removes about two-thirds of the stomach and leaves behind a narrow “sleeve.”

And if you have more than 100 pounds to lose, medical weight loss can always supplement the surgery.

“Patients can often benefit from an initial weight loss with medical treatment, before their surgery,” says Dr. Friedman. And since there is a long term risk for weight regain after surgery, medical weight loss is an option post-operatively as well.

“Obesity is a chronic disease, and the risk of recurrence remains even with the best efforts,” she says. “So it’s critical that we have multiple tools to tap into.”