The world of obesity treatment is moving fast. New medicines like semaglutide (Wegovy) and tirzepatide (Mounjaro) — known as GLP-1 receptor agonists — have given millions of people a powerful new way to lose weight safely and effectively.
At the same time, experts remind us that weight-loss (bariatric) surgery remains the most proven and long-lasting solution, especially for people with severe obesity.
These two approaches aren’t rivals — they’re tools that can work together. The key is finding the right treatment for the right person.
GLP-1s: A Powerful, Non-Surgical Option
GLP-1 medicines copy natural gut hormones that help control appetite and blood sugar. They make people feel full sooner and less hungry between meals.
On average, users lose 15–20% of their body weight within a year and see better blood-sugar levels and heart-health markers. Because the treatment is non-invasive (no surgery) and reversible, many prefer to start here.
But there’s a catch — the effect only lasts while you keep taking it. As Professor Ildiko Lingvay from the University of Texas explained at the 2025 IFSO World Congress, “Once treatment stops, weight tends to come back.”
Cost is another major issue. In the UK, GLP-1 medicines cost about £250–£350 a month — that’s around £9,000–£12,600 over three years. That’s roughly the same as the one-off cost of bariatric surgery.
Even if prices dropped by two-thirds, studies show that after three years, surgery still becomes the cheaper option. So, while GLP-1s are convenient, they may not offer the best long-term value.
Surgery: Still the Gold Standard for Lasting Weight Loss
Despite all the buzz about new drugs, bariatric surgery remains the most effective and durable treatment for obesity.
Operations like the gastric sleeve or gastric bypass typically help patients lose 70–80% of their excess body weight, while also improving type 2 diabetes, high blood pressure, and cholesterol.
Professor David Cummings from the University of Washington notes that less than two years of GLP-1 medication costs about the same as one gastric bypass — a procedure that, for many, “solves the problem for life.”
Read also : How Effective Is Bariatric Surgery Compared to Weight Loss Medications?
Finding the Right Balance
Most specialists now see the future of obesity care as combined treatment — using medicines and surgery together, depending on the person’s needs.
GLP-1s can help patients who aren’t ready for surgery or can be used before or after weight los surgery to support results. Surgery, on the other hand, provides a metabolic “reset” for people who need more dramatic or permanent weight loss.
As Dr Monali Misra from Cedars-Sinai says, “These drugs are powerful, but for some patients they may not be enough. Surgery gives a more complete reset.”
Helping Patients Make Informed Choices
Obesity treatment isn’t one-size-fits-all. The best plan is personalised, sustainable, and guided by good medical advice.
GLP-1 medicines offer flexibility and ease of use. Bariatric surgery provides stronger, longer-lasting results and better value over time.
Understanding the benefits, risks, and costs of each approach helps patients make realistic, confident decisions about their health.
Medically Reviewed by Mr. Qutayba Almerie, MD, MSc, FRCS
Consultant Upper GI & Bariatric Surgeon, Medical Director at Phoenix Health.
