“Why the ‘rebound effect’ has become the surgeon’s best ally against Ozempic

In the last two years, the GLP-1 receptor agonists like for example Ozempic either wegovy have gone from being drugs for diabetes to becoming the cultural and medical phenomenon of the decade for fight obesity. And such was its impact, that it was thought that surgery for obesity had come to an end, but the reality has been very different. The premise. The idea is quite clear: if I can take medication twice a month to lose weight… Why would I go into an operating room? A logical idea, especially given the risks that one always has when entering surgery, no matter how well controlled they are. But this enthusiasm of abandon the scalpel It is slowly being diluted, since according to the latest research, bariatric surgery is still superior to GLP-1 agonists and achieves much better results. The devastating fact. The study that has shaken the board comes from NYU Langone where researchers compared patients undergoing interventions such as gastric bypass with those who had taken Ozempic. The result was quite clear. Those who had undergone surgery managed to lose between 24 and 26% of their body weight, while patients on drugs lost an average between 5 and 6%. A result that does not agree with what was expected by pharmaceutical companies with their clinical trials in hand. But the problem is that the variable adherence to treatment It is once again a big problem in medicine. More data. The University Clinic of Navarra He also wanted to investigate in this field, doing a large study with 20,000 patients, concluding exactly the same thing: bariatric surgery surpasses GLP-1 agonists in total weight loss, reduction in BMI and body composition. The human factor. The great failure of a pharmacological treatment is undoubtedly the humans who are going to take it. And it is quite common in medicine for patients to forget to take a dose of their medication or even abandon treatment halfway through without any type of control. But luckily, the big difference between a pill (or injection) and surgery is that the second cannot be “forgotten.” The studies are clear in this sense: between 60% and 70% of patients They abandon GLP-1 treatment before the first year. Something that causes a great rebound effect which makes a patient return to their original weight, especially if they return to the same eating habits as before starting treatment with Ozempic or others. The difference. The reasons for reaching this point in treatment are varied: from persistent gastrointestinal side effects to the high monthly cost of treatment or the shortage. But the thing is that while stopping pricking yourself causes a rebound effect, bariatric surgery, although invasive, offers much more stable long-term results. Although logically he has many other problems behind him. Beyond the scale. The superiority of surgery is not measured only in waist centimeters. Science points through a systematic review published in JAMA Network Open This 2025 suggests that surgery is associated with lower overall mortality and a more drastic reduction in major cardiovascular events compared to drugs. And although GLP-1 has shown great benefits, the truth is that science indicates that surgery is still better in remission of type 2 diabetes with a minimal risk of mortality. Furthermore, despite the initial cost of the operation, in the long term surgery is cheaper for health systems than chronic drug treatment that costs hundreds of euros per month for life. A combined therapy. Despite all this, we are not in a war of one against the other, but the future points to an integration of both elements. In this way, strategies are already being explored where GLP-1 is used before surgery to reduce surgical risk in patients with extreme obesity, or after surgery as a rescue tool if the patient begins to regain weight years later. Even the WHO has begun to include these drugs in its comprehensive treatment guidelines, but emphasizing that they are one more piece of the puzzle, not a universal substitute. Images | David Trinks In Xataka | We have more and more research on the effects of Ozempic. And the problem is that we have more and more doubts

star surgeons, 100,000 euros and rebuild your face without noticing

The premiere of the new film Put in my place again Not only has the nostalgia of those who grew up with the original comedy aroused. He has also brought with him a radical change in its protagonist: Lindsay Lohanwhich surprised with a bright, defined and rejuvenated appearance. In parallel, the matriarch of the Kardashian, Kris Jenner, revolutionized social networks By showing a smooth and tuned face that made it look for several decades younger, despite being about to turn 70. In the case of Jenner, the answer is surgical and has its own name: Steven Levine, one of the most prestigious surgeons in New York, specialized in deep flat lifting. Lohan, on the other hand, attributes his Glow up to a healthy diet, laser treatments and skin care routines. Two different paths to the same promise: eternal youth. The “Invisible Effect” surgery What in the eighties meant tense faces and artificial features, today is synonymous with undetectable results. The star technique is deep -plane lifting, which works in the superficial musculosurotic musculosurotic system layer (SMAs) and repositions block muscles and ligaments. Thus, the dreaded “wind tunnel effect” is avoided and a more natural and durable rejuvenation is achieved. In an extensive report for the Financial Times They have explained That the procedure can last between 10 and 15 years, and is usually combined with blepharoplasties, fat transfers, eyebrow and laser lifting such as fractional CO2 or Morpheus8. The trend is clear: that the scalpel is not noticed. The designer Marc Jacobs Publicly documented his surgery on Instagrambreaking with the secretism of the past. Today, the real luxury is that no one can guess what you have done. The eternal surgical youth is priced, and is not available to everyone. In Cosmopolitan magazine They have specified That a classic stretch can cost between 4,000 and 10,000 euros in Europe, while a deep lifting in New York starts at $ 45,000. Nevertheless, According to Financial Timesamong the most renowned celebrities, prices exceed six figures. So more than aesthetics, we are facing a status paradigm. As the psychotherapist Paul Hokemeyer has pointed out in The British environment: “Impeccable surgery is a status symbol that exceeds any birkin bag.” Having access to Levine or other star doctors implies belonging to the elite circle that “knows” and can pay. In fact, Wendy Lewis, consultant to the beauty industry, has warned that many patients assume that the more expensive, the better, although the reality is that it also works as a social brand: paying more means exhibiting it as a gesture of distinction. In this same line, New York Post has detailed The rise of “quiet luxury” procedures: discreet buttocks (“Midwest Bbl”), natural dental veneers or sinuses. It is the countercara of what the Kardashian did at the time: the aspirational is no longer the exaggerated volume, but the undetectable, which seems “natural” but costs six figures. Although surgery is not available to everyone, aspiration filters down. The same thing happened with Ozempic and other GLP-1 drugs: at first restricted to Hollywood, expensive and difficult to get, turned into a luxury symbol rather than in medical treatment. Over time they popularized, but maintain their aspirational aura: extreme thinness as a class trophy. Those who cannot afford Liftings then resort to more affordable, although harmful alternatives. In Tiktok, hashtags like #skinnytok They accumulate thousands of videos in which adolescents share extreme diets, excessive exercise routines and phrases of “thinspiration”. As We have detailed in Xatakajust eight minutes of exposure to this type of content are enough to increase anxiety and body dissatisfaction. The supposed “average complexion” – nor fat or skinny – also circulates as a new restrictive ideal, disguised as inclusiveness. The digital culture acts as well as the mirror of the surgical elite: while some are subjected to liftings of $ 100,000, the rest absorbs impossible standards and searches for drugs or viral challenges the promise of an unattainable luxury. As The Week has summarizedthe postitive body that proclaimed bodily diversity has become a distant memory: red carpets full of ultradelgated actresses, fashion campaigns denounced for showing “dangerously skinny” models, and the resurrection of Y2K aesthetics as the return of Victoria’s Secret parades. To all this equation could not miss the technology. Digital filters and artificial intelligence not only embellish, they also mold impossible standards. As the aesthetic Jonny Betteridge has pointed out In Financial Timesmany patients reach the operating room with an unusual reference: their own face, but filtered. The AI ​​multiplies this dynamic: offers oneself versions With perfect skin, defined jaw or sharp cheekbones. And those images circulate as new identity promises. The result is that surgeons face an emerging market: patients who want to translate the digital avatars they see on Instagram or Tiktok into flesh and blood. The double edge: always under trial The aesthetic pressure does not admit escape. According to has detailed The journalist Noemí López Trujillo in Newtral, aesthetics such as the “Clean Girl” or the “Make Up-No Make Up” function as impositions of female discretion: they celebrate a deeply artificial naturalness, which demands hours of cosmetic work and invisible surgeries. Thus is punished in double route: both women who “operate too much” and those who decide not to operate anything. Examples are left over. Pamela Anderson, Remember the sociologist Rhea Ashley Hushin in Newtralwas punished for making visible its implants and refusing to become “invisible” with age, a case of femmephobia. At the opposite end, Sarah Jessica Parker It has been insulted For showing wrinkles, as if “neglecting” it was also a sin. For directors such as Bonnie Hammer, the facial homogeneity of the young women operated and the rigidity of the greatest hinders even the casting of common papers. And Jamie Lee Curtis has denounced the horror of seeing women disfigured by The “cosmecéutic complex”. But what happens to men? The scrutiny is deeply unequal. In recent years, names such as Brad Pitt, Tom Cruise or Bradley Cooper have starred speculations about liftings and … Read more

Patients lead to the operating room photos of their “improved” with AI. Surgeons are in charge of making them come true

A year ago, an unpublished contest copied The covers of different media: Miss Ia. As one can intuit, the models were created with artificial intelligence and presented impossible bodies: without wrinkles, without pores, without history … the event, promoted by the platform Fanvue World AI Creator AwardsNo only generated a flood of comments, but opened a deep debate: are we willing to accept something of beauty as an ideal that does not even exist? And something further, does the real body begin to be seen as a defective version of the digital render? Unreal expectations. According to The Columbus Dispatchplastic surgeons such as Dr. Jaclyn Tomsic and Dr. Craig Lehrman are observing a worrying phenomenon in their consultations: patients who come with images generated by AI, asking for impossible interventions. “With AI you can make your body as you want,” explained Tomsic, maxillofacial surgeon in Cleveland. For his part, Lehrman, a plastic surgeon at the Wexner Medical Center of the Ohio State University, has reported cases of older patients who carry photos of edited celebrities. “They tell me: ‘Why don’t I look like this?’ Both doctors have recognized that they have had to dedicate more and more time to explain why they cannot replicate what IA promises: biology, bone structure or age cannot be erased with scalpel. Beyond. The expectations created by filters, apps and image generators They are generating Frustration and danger: some people insist on operating again and again, chasing a non -existent ideal. In addition, they have warned of a psychological risk: people who fail to resemble these artificial images can become obsessed, resort to multiple surgeries and face constant frustration. Lehrman has summarized it as follows: “That will take many unhappy people and pursue this imaginary dream.” In fact, this phenomenon goes beyond the surgical: it affects the way we interact with our own image. It is increasingly common for people to ask AI that value their physical appearance Or tell them what to improve on your face. The point is not what the AI ​​can respond, but the fact that your judgment has so much weight on how we can perceive. Fiction made leather. Before, manipulating an image required technical knowledge or tricks of light and makeup. Today, with a free app, anyone can be seen as a supermodel in seconds. The AI ​​not only retouches, but has led it to another level: it can generate faces from scratch. According to Lehrmanthis makes it “increasingly difficult to distinguish the real from the invented.” Given this threat, the American Society of Plastic Surgeons has created a gallery with real photos before and after procedures to combat misinformation. But the battle is unequal: millions of false, stylized and standardized images are generated every day. The Aitana case. This logic is reflected in phenomena such as Aitana LópezSpanish influencer with more than 350 thousand followers on Instagram that does not really exist. In other words, it is a 100% model generated with AI. Its creators They have admitted They sought to create an influencer that “never gets tired, never ages, always smile.” With his success, he has not only obtained real advertising contracts; It has also imposed a new quite problematic aesthetic standard because there are no human limitations. Advances and dilemmas. The “artificial intelligence in plastic surgery: where do we stand?” has reviewed 96 Studies on the use of AI in plastic surgery. Although it has proven useful in diagnoses of dermatological diseases, surgical planning and even prediction of postoperative complications. However, the conclusions have also warned about ethical risks, lack of regulation and algorithmic biases. One of the key problems is that AI models are trained with limited populations data, which can generate racist, class or capacitist results. The bias behind the AI. The algorithms are trained with millions of images that reinforce Eurocentric, thin, cis and young people. As has warned Kenig et al. Quoted in the study, AI can exacerbate inequalities by replicating stereotypes invisible other bodies. This concern has also been pointed out by critical voices within the technological field. For example, author Ruha Benjamin holds that “Algorithmic discrimination does not need hate to function; You only need data from the past ”, in his book Race AFter Technology. For his part, Safiya Noble, in Algorithms of Oppression, has detailed How commercial and racist logic are embedded in search engines and recommendation systems. Technology, far from democratizing beauty, seems to strengthen it even more. The definition of beauty is not so much. As Bell Hooks said: “Representation matters.” However, if now the AI, trained with exclusion patterns, decides what faces we see, what bodies are shown, and which do not, then we are not only attending an aesthetic change, but to a deep reconfiguration of what we consider desirable, possible and human. The issue is not asking: “What is beautiful?”, But what are we willing to obey? Image | Freepik, Xataka Xataka | The cosmetics industry has found a new market: the problem is that they are girls under 10 years

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