GLP-1 medications such as semaglutide (Wegovy) and tirzepatide (Zepbound) have changed how obesity is treated. Many people now ask whether they still need surgery. Houston Surgical Weight Loss offers both physician-supervised medical weight loss and bariatric surgery, so we can help you compare them without steering you toward one.
How much weight do people lose?
- Semaglutide (Wegovy): in its main clinical trial, people lost about 15% of their body weight on average over 68 weeks.
- Tirzepatide (Zepbound): in its main trial, people on the highest dose lost about 21% of their body weight on average over 72 weeks.
- Bariatric surgery: people typically lose about 25–30% of their total body weight, and studies following patients for many years show most of that loss is maintained.
Results vary from person to person with any of these options.
What happens if you stop?
GLP-1 medications work while you take them. In a study of people who stopped semaglutide after a year, they regained about two-thirds of the weight they had lost within the following year. For most people, these medications are a long-term treatment. Surgery is a one-time procedure, followed by lifelong vitamins and follow-up care.
Cost and coverage
Without insurance coverage, GLP-1 medications can cost hundreds of dollars or more each month, for as long as you take them. Coverage varies widely by plan. Bariatric surgery is a one-time cost. Many insurance plans cover it for patients who meet their criteria, and our self-pay gastric sleeve starts at $6,999.
Which is right for me?
- Medication may suit you if your BMI is 30 or more (or 27 or more with a weight-related condition), you would prefer to avoid surgery, or you want to see how you respond first.
- Surgery may suit you if your BMI is 35 or more, or 30 or more with a weight-related condition, you want the largest and most durable weight loss, or you would rather not take medication indefinitely.
- Some people use both. Medication can help with weight loss before surgery, or with weight regain years after it.
Dr. Wadiwala will go through your options at your consultation, including the benefits and risks of each.
Related reading
Sources
- Wilding JPH, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). N Engl J Med. 2021;384:989-1002.
- Jastreboff AM, et al. Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1). N Engl J Med. 2022;387:205-216.
- Wilding JPH, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes Obes Metab. 2022;24(8):1553-1564.
- American Society for Metabolic and Bariatric Surgery (ASMBS), Metabolic and Bariatric Surgery fact sheet, asmbs.org.
This article is general information, not medical advice. Talk with your doctor about what is right for you.