Bariatric surgery has been a top choice for tackling obesity. It offers substantial and lasting weight loss. For instance, procedures like sleeve gastrectomy and gastric bypass have shown impressive results. After a decade, these surgeries can lead to a total weight loss of 23. 4% and 26. 9%, respectively. Even more complex surgeries, like the duodenal switch, can achieve greater weight loss.

Recently, a new player has entered the field: GLP-1 receptor agonists. These medications, such as tirzepatide, have shown promise. They can help with weight loss, achieving up to 25. 3%. However, they come with their own set of challenges. Many people stop using them due to side effects, high costs, and limited insurance coverage. This makes them less effective in the long run compared to surgery.

Surgery, on the other hand, provides better long-term results and is more cost-effective. Yet, it is not as commonly used as it could be. Less than 1% of eligible patients opt for surgery each year. This is a missed opportunity for many who could benefit from it.

There is a place for GLP-1 receptor agonists, though. They can be a good option for those who are not suitable for surgery or are hesitant about it. They can also serve as a stepping stone to surgery or a supplement to postoperative weight management. However, they require consistent use, and weight regain is a common issue when people stop taking them.  It is important to note that weight regain is not a failure. It is a normal part of the weight loss journey.

A combined approach seems to be the best way forward. This would involve surgery, medication, and lifestyle changes working together. Future research should focus on the long-term effects of GLP-1 receptor agonists, combining different treatments, and making both surgical and medical options more accessible.  This is not just about losing weight. It is about improving overall health and quality of life.

Weighing Up: Surgery versus Medication for Long-Term Weight Loss

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