Bariatric Surgery or GLP-1's: Which weight loss treatment is right for you?
January 9, 2025
By: Tallahassee Memorial HealthCare
Categories: Healthy Living, Bariatric Surgery, Bariatric Medicine
Evaluating your health and making long-lasting changes can lead to a stronger, healthier future. With advancements in weight-loss treatments, options like glucagon-like peptide-1 (GLP-1) receptor agonists and bariatric surgery are helping individuals achieve their goals. If you’re considering ways to lose weight, it’s essential to explore the full range of options to find the best fit for your needs.
It's difficult to discern which option may be the best for you. Before deciding, learn more about these two methods to determine which path may be right for you!
What are GLP-1 Agonists?
GLP-1 agonists stimulate your pancreas to produce more insulin, lowering your blood sugar levels and decreasing your appetite. Popular brand names you may have heard of include Ozempic, Mounjaro, Wegovy and Zepbound.
What is Bariatric Surgery?
Bariatric surgery is weight loss surgery where a procedure is used to restrict the stomach and reshape the gastrointestinal tract so it can hold less food and absorb fewer nutrients. There are a few different types of bariatric surgery, or weight loss surgery. At Tallahassee Memorial HealthCare (TMH), we offer gastric bypass, gastric sleeve, revision and conversion procedures, utilizing the latest technology, the Da Vinci Surgical Systems.
Gastric Sleeve
During the gastric sleeve procedure, a thin, vertical sleeve of the stomach is created, and the rest is removed. This procedure limits the amount of food you can eat and helps you feel full sooner. It allows for normal digestion and absorption. Food consumed passes through the digestive tract in the usual order, allowing it to be fully absorbed in the body.
Gastric Bypass
Gastric bypass is a restrictive surgery technique that also alters the digestive process. The surgery restricts food intake by creating a smaller stomach pouch. It alters the body's normal digestive process by decreasing the amount of calories and nutrients the body can absorb. After surgery, food bypasses a large part of the stomach and most of the small intestine.
Revisions and Conversions
At TMH, we offer revisions to previously performed procedures from other facilities. Sometimes, previous surgeries patients received were not the best fit for them or are no longer recommended, such as lap bands. When this happens, patients will see their surgeries become less effective. We work with patients to determine the best approach and procedure for your individual needs to help you get back to your weight loss journey.
How to Choose the Best Path for You
Deciding between GLP-1 agonists and bariatric surgery requires careful thought about your unique circumstances. Factors such as medical history, weight loss goals and lifestyle preferences play a key role in making the right choice. Consider the following points to help guide your decision:
1. Consider your medical history
BMI and Comorbidities:
- GLP-1 agonists: Weight loss medications are an approved treatment for people with a Body Mass Index (BMI) over 30, or a BMI over 27 with at least one comorbidity like type 2 diabetes, hypertension or sleep apnea.
- Bariatric surgery: You must meet the requirements of having a BMI over 40 or a BMI over 35 with serious comorbidities to be eligible for bariatric surgery. If your BMI is lower and you have diabetes, some insurers may approve surgery.
Insurance requirements vary by plan, so you should call your insurance provider to see if they cover these options and to find out any additional requirements.
Health Conditions:
- GLP-1 agonists: Medication may be better for those with type 2 diabetes or prediabetes, as they improve glycemic control and support weight loss.
- Bariatric surgery: Long-term remission of diabetes and other obesity-related conditions, like dyslipidemia, hypertension and obstructive sleep apnea, has been shown to happen in individuals who receive weight loss surgery.
2. Set Your Weight Loss Goals
Both options are effective to lose weight— however, the amount of weight you wish to lose and the longevity of that weight loss will determine which is best for you.
- GLP-1 agonists: Weight loss medication users average 5-15% of body weight loss over a year with consistent use and lifestyle changes.
- Bariatric Surgery: Patients may lose up to 60% of excess weight six months after surgery and 77% of excess weight as early as 12 months after surgery. On average, patients maintain 50% of their weight loss after five years. For severely obese people, the National Institutes of Health (NIH) recognizes bariatric surgery as the only effective treatment for maintaining long-term weight loss for individuals who had no success with diet, exercise and other common weight-loss strategies.
3. Evaluate the Time Commitment
- GLP-1 agonists: Ongoing use of medication is required for sustained results. Stopping the medication often leads to weight regain for patients if permanent lifestyle changes were not made.
- Bariatric Surgery: As a one-time procedure, permanent lifestyle changes and adjustments to diet will need to be made. The surgery takes less than two hours to perform, and patients typically stay in the hospital for one or two nights and are back to work within one to two weeks.
4. Consider the Risks and Side Effects
Benefits of weight loss include reducing or eliminating conditions like diabetes, cardiovascular disease, hypertension, obesity-associated cancer risk, stroke and more. These benefits may outweigh the risks and side effects of medication or surgery.
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GLP-1 agonists: With animal studies, there have been concerns of thyroid issues, including cancer, from using GLP-1 agonists. However, there haven’t been any conclusive studies using humans yet. While GLP-1 agonists have been on the market for a few years now, longitudinal studies are needed on large groups of individuals for any conclusive findings.
◦ The U.S. Federal Drug Administration have received reports of adverse events, some including hospitalizations on compounded GLP-1 drugs due to dosing errors or incorrect doses with self-administration.
◦ Common side effects from using the drugs may include dehydration and stomach issues, like nausea, diarrhea or constipation.
- Bariatric Surgery: All surgeries have risks involved; however, bariatric surgery is a safe procedure, especially with the use of robotic surgical systems. TMH’s most recent data, spanning August 2023 to August 2024, shows post-operative complication rates below the national average in several categories.
◦ Potential complications include acid reflux, hernias, nutritional deficiencies, dumping syndrome – a condition that can lead to symptoms like nausea and dizziness – and more.
5. Factor in the Cost
GLP-1 agonists: Medication can be expensive, especially if it is not covered by insurance and requires regular prescriptions until your desired weight is reached. List prices range from $700 to $1,400 per 30-day supply, without insurance. Your health insurance may cover the shots, but it depends on the medication, your insurance plan and if you meet eligibility requirements.
Bariatric surgery: There is a higher upfront cost, but health insurance companies will usually cover it if you meet the insurance requirements. If your insurance does not cover surgery, you may be able to use a self-pay option, averaging about $17,000 for the procedure.
6. Align with Your Preferences
- GLP-1 agonists: If you prefer a less invasive, gradual approach and can commit to regular injections or pills, GLP-1 agonists might be better.
- Bariatric Surgery: If you’re seeking a long-lasting solution and are prepared for the commitment, surgery could be the answer.
Next Steps
At TMH, we have a robust, multidisciplinary team to help you through your weight loss journey. We are committed to providing the most comprehensive bariatric care designed to help you make a lasting change.
While many different physicians can prescribe GLP-1’s, TMH houses the only surgical center in the region that has earned accreditation through the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®), a joint quality program of the American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgery (ASMBS). We’re also home to the regions only fellowship-trained bariatric surgeons, Joey Jarrard, MD and James Parker, MD.
If you want to learn more about bariatric surgery, fill out our form to have a member of our team contact you!
