GLP-1s vs. surgery: Which is right for you?

More than half of Americans say they want to lose weight, but losing weight is easier said than done. When diet, exercise and lifestyle changes aren’t enough, there are other options to consider.

Popular weight loss medications, such as GLP-1 receptor agonists (glucagon-like peptide-1), have revolutionized weight loss. In 2025, they contributed to a 37% drop in the adult obesity rate in the U.S. — down from a record high of nearly 40% in 2022.

GLP-1 medications help you feel fuller, so you don’t eat as much food. They also lower your blood sugar. About 1 in 8 adults in the U.S. have tried a GLP-1 drug.

“I use GLP-1s as another tool in the toolbox along with emphasizing diet and exercise first,” says Dr. Eric Luedke, a surgeon affiliated with Sharp Rees-Stealy Medical Group and the medical director of the Bariatric Surgery Program at Sharp Memorial Hospital. “I use surgery as a last resort.”

Common weight loss procedures

The most common types of bariatric or weight loss procedures are gastric bypass and gastric sleeve. Gastric bypass alters the stomach and small intestine, limiting how much food the stomach can hold. Gastric sleeve reduces the stomach’s size by removing about 80% of it.

Dr. Luedke says one of the main differences between GLP-1 medications and weight loss procedures is the lasting results.

“Surgery is more effective long-term,” he says. “With gastric sleeve or gastric bypass, patients lose about 60% to 70% or even more of excess weight. With GLP-1s, it’s usually 20% or less. The problem with GLP-1s is that as soon as patients are off the medication, many gain the weight back.”

According to Dr. Luedke, some people don’t like GLP-1s because of the side effects, and they stop taking the medication on their own. The most common side effects of GLP-1s include nausea and bloating.

“On the other hand,” he adds, “with any surgery, there is always a risk.”

Combining GLP-1s and surgery

For some people, GLP-1s can help before and after weight loss surgery. They can be used before surgery to help patients lose extra weight to become better candidates for surgery. GLP-1s can also be used after surgery if patients start to regain weight.

Dr. Luedke notes that he always emphasizes the importance of diet and exercise first when discussing weight loss options with patients. “At Sharp, we offer a variety of options for weight loss strategies to help people live healthier lives,” he says.

Some of those options include weight loss counseling, working with a dietitian, and health education programs.

Deciding whether to use a weight loss medication or undergo a weight loss procedure depends on a patient’s circumstances and starting weight. “Some patients are just not interested in GLP-1s, but they may still be interested in surgery. If so, we’ll proceed with surgery, if that’s still a good option for them,” says Dr. Luedke.

If you’re interested in weight loss, talk with your primary care provider. Together, you can decide which weight loss option is right for you.

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