GLP-1 Medications & Bariatric Surgery: Myth vs. Fact
What’s true, what’s not, and how to decide what works best for you.
At Long Island Laparoscopic Doctors, led by board-certified surgeon Dr. Hesham Atwa, we specialize in both surgical weight loss and medically supported treatment plans. As medications like Ozempic®, Wegovy®, and Mounjaro® rise in popularity, many patients are deciding between surgery, medication, or combining the two.
Below is the most comprehensive, research-based breakdown of the myths and facts surrounding GLP-1 therapies, with links guiding you to additional resources.
MYTH #1: “If I’m taking a GLP-1 medication, I don’t need bariatric surgery.”
FACT
GLP-1 medications reduce appetite and support weight loss — but not at the same degree or sustainability as bariatric surgery.
Average Weight Loss Outcomes
| Treatment | Average Weight Loss |
|---|---|
| GLP-1 Medications | 10–17% of total body weight |
| Gastric Sleeve Surgery | 25–30%+ of total body weight |
| Gastric Bypass Surgery | 30–35%+ of total body weight |
GLP-1 medications work only while you are taking them. When stopped, most patients regain much or most of the weight. Bariatric surgery permanently alters hunger hormones, insulin sensitivity, and metabolism.
Additionally, ongoing costs are less with bariatric surgery.1
Additional resources:
GLP-1 medications work as long as someone continues taking them. Studies show that when patients discontinue therapy, a majority regain much or most of the weight.
Surgery, however, alters:
- Gut hormone signaling
- Feelings of hunger
- Insulin sensitivity
in a way medication alone cannot.
MYTH #2: “GLP-1 medications cannot be combined with bariatric surgery.”
FACT
Not only can they be used together, but for certain patients, combining both is ideal.
When GLP-1s are helpful prior to surgery:
- When BMI is very high
- To improve diabetes
- To reduce liver volume
After Surgery, GLP-1s may help with:
- Stalled weight loss
- Weight regain
- Persistent hunger
This combination is becoming the clinical standard for patients diagnosed with chronic obesity.
Additional Resources:
- Weight Regain After Bariatric Surgery
- Support Programs and Long-Term Success
- Preparing for Weight Loss Surgery
MYTH #3: “GLP-1s work faster than bariatric surgery.”
FACT
Both begin working quickly, but surgery produces faster and more profound changes.
GLP-1 Timeline:
- Appetite reduction within weeks
- Noticeable weight loss within 3-4 months
Surgical Timeline:
- Weight loss begins within weeks
- Highest loss occurs within first 12 months post-surgery
Surgery also triggers metabolic improvements independent of weight loss, especially for type 2 diabetes remission.
Additional Resources:
MYTH #4: “If you regain weight after surgery, the surgery didn’t work.”
FACT
Obesity is a chronic medical disease, not a one-time problem.
Patients may experience regain due to:
- Hormonal rebound
- Loss of structured habits
- Emotional eating behaviors
- Reduction of muscle tissue
This is where GLP-1 support is often beneficial.
At Long Island Laparoscopic Doctors, Dr. Hesham Atwa and his team, including Dr. Eileen Barr (medical weight loss specialist within the practice), frequently uses GLP-1 therapy as part of a medical maintenance plan after surgery.
Additional Resources:
MYTH #5: “GLP-1 medications replace nutrition and lifestyle changes.”
FACT
Medication changes biology. Changed behavior creates long-term success.
Even while taking GLP-1s, patients may still struggle with:
- Grazing
- Emotional eating
- Nighttime snacking
- Inadequate protein intake
This is why structured support matters.
At Long Island Laparoscopic Doctors, our follow-up plans include nutritional counseling, ongoing weigh-ins (including body composition), behavior modification guidance, and extensive educational programs.
Additional Resources:
MYTH #6: “You can stop GLP-1 medication after reaching your goal weight.”
FACT
For most patients, stopping GLP-1s leads to:
- Increased hunger
- Elevated cravings
- Regained body fat
- Worsening insulin resistance
Data suggests that on average, patients regained two-thirds of the weight lost after discontinuation (JAMA Network Open analysis of GLP-1 discontinuation).
Long-term obesity management often means long-term therapy, whether medication, surgery, or both.
Who Benefits Most From GLP-1s Along?
Patients most likely to benefit from medication alone are those with:
- BMI below bariatric surgery criteria
- Limited weight regain risks
- Early metabolic risk
- Strong desire for non-surgical treatment
Pediatric patients may also qualify in select situations.
Who Benefits Most from Weight Loss Surgery?
Ideal candidates:
- BMI ≥ 35
- BMI ≥ 30 with metabolic conditions
- History of multiple failed weight-loss attempts
- Insulin-resistant weight patterns
This describes many adults located in the Long Island region who are referred to our office each month.
Additional Resources:
When a Hybrid Approach Works Best
Combining GLP-1 medications with weight loss surgery can offer a powerful, complementary approach for patients seeking durable, long-term weight management. Bariatric surgery addresses the physical and hormonal drivers of obesity by reducing stomach capacity and altering gut hormones, leading to significant initial weight loss and metabolic improvement. GLP-1 medications, when used appropriately, can enhance these effects by improving appetite regulation, reducing food cravings, and supporting portion control. Together, they help reinforce behavior change and create a more supportive biological environment for sustained weight loss.
This combined strategy may be especially beneficial for patients who experience slower-than-expected weight loss, weight plateaus, or weight regain after surgery. GLP-1 medications can serve as a targeted tool to re-engage weight loss momentum while preserving lean body mass and supporting metabolic health. When guided by an experienced bariatric and obesity medicine team, the combination allows for individualized care (matching the right therapy at the right time) to optimize outcomes, improve confidence, and support long-term success beyond the scale.
Why Long Island Laparoscopic Doctors?
Our practice is recognized across Long Island and New York, because:
- We treat obesity as a lifelong chronic medical disease
- Dr. Hesham Atwa and his colleagues offer advanced robotic and laparoscopic surgical expertise
- We combine medical management, surgery, and behavioral support
- We follow patients long-term, not just during treatment
Whether you’re currently taking a GLP-1 medication, considering bariatric surgery, or questioning the next step, you don’t need to decide alone. You can reach out to us with any questions or schedule a consultation.
Additional References:
- Skutt J. et al. Semaglutide Withdrawal and Weight Outcomes
https://pmc.ncbi.nlm.nih.gov/articles/PMC9542252/
- JAMA Network Open Analysis of GLP-1 Discontinuation
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2829779
- Harvard Primary Care Discussion on GLP-1 Prescribing Trends
https://info.primarycare.hms.harvard.edu/perspectives/articles/glp-1-pharmacy-perspective