"GLP1's vs. Scalpels: What You Need to Know About Modern Obesity Treatment"
Imagine standing at a fork in the road. One path leads to surgery. The other to a weekly injection. Both promise weight loss. Both offer hope. But which one is right for you?
If you’ve been struggling with obesity, you’ve probably heard of GLP-1 medications like semaglutide and tirzepatide—or maybe you’ve considered bariatric surgery. What you may not know is how these options compare, and why the decision isn’t as simple as “just lose weight.”
I was recently asked to write an article based on a lecture I gave about this very question. My original article, "Injections vs. Scalpels: Where Do Surgery and GLP-1’s Align in Modern Obesity treatment?" was recently published in Missouri Medicine. If you're a nerd like me and want to deep dive, here's the link to the full article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331298
🧠 Let’s Make It Stick: 3 Things to Remember
- Obesity is a chronic disease—not a character flaw. Your body defends fat like it defends temperature or hydration. It’s not about willpower. It’s biology.
- Medications are catching up to surgery—but not replacing it. New drugs like semaglutide and tirzepatide can help patients lose 15–21% of their body weight. That’s close to what some surgeries offer—but not quite equal.
- Surgery still wins for severe cases and long-term health. For patients with type 2 diabetes or heart disease, bariatric surgery remains the gold standard. It’s not just about weight—it’s about survival.
💉 GLP1's: The New-ish Kids on the Block
GLP-1 medications have been around for a few decades but the new generation, once weekly injections like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound; also a GLP1 AND GIP agonist) have changed the game and the lives of many. They help regulate hunger hormones and improve blood sugar, among many other effects. They’re not magic—but, well, almost.
- Semaglutide: ~15% average weight loss
- Tirzepatide: ~21% average weight loss
- Retatrutide (coming soon): ~24% average weight loss
These medications also help with diabetes, fatty liver disease, and even alcohol use disorder. However, they’re not for everyone and cost/access have been a tremendous challenge.
🔪 Surgery: Still the Heavyweight Champion of Obesity Treatment
Procedures like gastric bypass and sleeve gastrectomy offer even greater weight loss—up to 31%—and better outcomes for people with serious health conditions. The way I explain this to patients and other physicians is the sicker (chronic illnesses, that is) someone is, the more benefit they will get from surgery over meds.
- Better diabetes control
- Lower risk of heart attack and stroke
- Longer life expectancy
But here’s the catch: only 1% of eligible patients ever get surgery. Why? Insurance barriers, fear, stigma, and lack of awareness.
⚖️ So, What Should You Do?
If you’re exploring weight loss options, here’s a simple guide:
- Mild to moderate obesity without major medical complications (BMI 30-40, for example)? Start with lifestyle changes and consider medications guided by an experienced obesity physician.
- Severe obesity or moderate obesity PLUS diabetes or heart disease or sleep apnea? Talk to a specialist about surgery.
- Not sure? Get a comprehensive metabolic health evaluation. We’ll help you decide. Careful who you ask, though, as many physicians that don't specialize in obesity have dated and/or incorrect ideas about bariatric surgery. Again, if you're considering this, you should be seeing an obesity specialist.
🩺 Our Clinic Can Help
At MoKan Weight Loss and Metabolic Health, we specialize in personalized obesity care. Whether you’re curious about injections, surgery, or just want to understand your options—we’re here for you.
- Insurance-covered treatments
- Affordable generic medications
- Family-centered care
- No judgment—just science and support
Ready to take the next step?Schedule your consultation today. Because your health isn’t just about weight—it’s about living well.
In health,
Dr. Matt Lindquist, DO