Over the past few years, new medications known as GLP-1 receptor agonists have become big news for weight management. At the same time, bariatric surgery (weight loss surgery, or also known as Metabolic Bariatric Surgery MBS) has been around for decades and is still considered the most effective long-term treatment for obesity on available data.

So, which option is the “optimum” solution, for your situation? A few studies have come out recently that can help with making the decision; medication, surgery or both?

What the Research Says

Weight loss and cost

A recent U.S. study compared people who had bariatric surgery with people who started GLP-1 medications.

1. Weight loss was much greater with surgery in a real-world setting. On average, people lost about 28% of their body weight with surgery, compared to about 10% with GLP-1s.
2. Costs over time were lower with surgery. Surgery had a big upfront cost, but after the first year, ongoing medical costs (including the cost of medication) were much lower than for people staying on GLP-1 medication.

What this means for you: Surgery may provide more weight loss, longer-lasting results, and might cost less over a few years compared to paying for medication long term.

Heart and kidney health

Another study looked not just at weight loss, but at long-term health outcomes in people with obesity and type 2 diabetes.

1. People who had surgery had fewer heart problems (like heart attacks and strokes) and better kidney and eye health compared to those who stayed on GLP-1 medications.
2. Researchers think surgery (compared to medication) changes hormones and metabolism in ways that go beyond weight loss alone.

What this means for you: If you have diabetes or heart risks, surgery could offer stronger protection for your long-term health.

Medication challenges

A recent report found that more than half of people stop GLP-1 medications within one year.

1. The main reasons were side effects (like nausea) and cost.
2. Stopping the medication often means weight regain.

What this means for you: These medicines can be powerful, but they only work if you can stay on them long term.

Putting It All Together

Both options can be life-changing, but they work in different ways:

• 1. Surgery: Bigger and more reliable weight loss, one-time procedure (with some risks and recovery), long term health benefits, lower costs after the first year.
  2. GLP-1 medications: Non-surgical, easier to start, effective for many people, but require ongoing injections, can be expensive, and often lead to side effects or discontinuation.

How to Decide

When choosing between surgery and medication, think about:

1. Your medical history – Do you have diabetes, heart disease, or high BMI?
2. Your lifestyle and preferences – Are you open to surgery? Would you be comfortable with  long term injections on a regular basis?
3. Your budget – Can you afford long term medication, do you have private health cover for surgery or can you access your superannuation to pay out of pocket costs?

The Bottom Line

1. Bariatric surgery is still the most effective and durable option for significant weight loss and health improvement.
2. GLP-1 medications are an important tool, especially for those who aren’t ready or eligible for surgery.
3. There’s no “one-size-fits-all” answer. The best choice depends on your health, preferences, and circumstances.

If you’re considering your options, the next step is to talk with an obesity specialist. Together, you can look at your medical history, goals, and resources to make a decision that feels right for you. Call us on 9760 2777 to book an appointment with our team or click here to request an appointment.