Weight Loss Medications
GLP-1 medications changed what non-surgical weight loss can achieve. They also come with a question most pages skip: what happens after. This is the practice’s full picture — how the medications work, who they suit, and where surgery does something a prescription cannot.
Book a complimentary consultationWhat GLP-1 medications actually are
GLP-1 receptor agonists imitate a hormone the small intestine already releases after a meal. That hormone slows how quickly the stomach empties, prompts insulin release when blood sugar rises, and acts on the parts of the brain that register fullness. The practical effect for most people is that meals feel finished sooner and food occupies less mental space between them.
Semaglutide is sold as Ozempic for type 2 diabetes and as Wegovy for weight management. Tirzepatide — which acts on a second gut hormone receptor as well — is sold as Mounjaro for type 2 diabetes and as Zepbound for weight management. The distinction matters when you are checking coverage, because insurers treat the diabetes label and the weight-management label as different products even though the molecule is the same.
The medications, one page each
Who these medications suit
Medication is a reasonable first move for a great many people, and this practice says so plainly even though it performs surgery. If your weight has been stable-but-high rather than climbing for years, if you have not yet tried a structured medical program, or if surgery is something you would only consider after everything else — a GLP-1 is a sound place to start.
The picture changes when the amount of weight to lose is large, when weight-related disease is already established, or when a medication has been tried and could not be sustained. Those are the situations where the durability question below stops being academic.
The part most pages leave out: what happens when you stop
GLP-1 medications treat obesity the way blood-pressure medication treats hypertension — while the drug is present, and not after. This is not a criticism of the drugs. It is how they were designed, and it is what the trial evidence shows.
In the extension of the STEP 1 trial, participants who had taken semaglutide 2.4 mg alongside lifestyle support for 68 weeks lost a mean of 17.3% of body weight. Treatment and lifestyle support were then withdrawn, and a year later the group had regained roughly two-thirds of what they had lost, with cardiometabolic markers moving back in step. The trial authors read this as confirmation that obesity behaves as a chronic condition requiring ongoing treatment.
That is a finding from a randomized trial population, not a prediction about you and not a claim about this practice’s patients. What it establishes is the shape of the decision: a GLP-1 asks for indefinite continuation, and the plan for year five matters as much as the plan for month three. Cost, supply and tolerability all have to survive that timeline.
Medication and surgery are not opponents
The framing of drugs-versus-surgery suits headlines more than patients. In practice the two are used together often enough that the American Society for Metabolic and Bariatric Surgery has published on exactly that. Its 2026 statement on non-response and weight recurrence after bariatric surgery treats surgical, endoscopic and pharmacologic options as complementary roles rather than rivals, and describes the newer obesity-management medications as a major advance. Notably, it declines to frame weight recurrence as surgical failure.
That has a direct consequence for anyone who had a procedure years ago and has seen the weight move back. A stalled result is a treatable situation with more than one route out of it, and a medication may be part of that route.
When surgery is the more honest recommendation
Eligibility for metabolic and bariatric surgery follows the 2022 ASMBS/IFSO indications: a BMI of 35 or above regardless of whether weight-related disease is present, and a BMI of 30 to 34.9 where metabolic disease is. Lower thresholds apply for patients of Asian descent. These superseded the 1991 NIH criteria that a great deal of older material online still repeats.
Surgery earns its place when the durability problem is the problem — when the weight to lose is substantial, when the goal is to hold a result across decades rather than across a prescription, or when a medication has already been tried in good faith and could not be kept up. It is a larger decision with a recovery attached, and it is not the right answer for everyone who reads this page.
If you are on a GLP-1 and have a procedure booked
Advice on this changed, and much of what is online is out of date. Guidance issued in 2023 told patients to hold GLP-1 medications before a procedure. That was superseded in October 2024 by multi-society guidance — written with the American Society for Metabolic and Bariatric Surgery among its authoring societies — under which most patients continue their medication before elective surgery.
The current approach stratifies risk instead: whether you are still escalating the dose or holding a maintenance dose, how high that dose is, weekly versus daily dosing, whether you have gastrointestinal symptoms such as nausea or vomiting, and whether anything else is slowing gastric emptying. Where that assessment raises concern, a liquid diet for at least 24 hours beforehand is one of the measures available, and the anaesthetic plan can be adjusted rather than the procedure cancelled.
None of that is a decision to make from a web page. Tell your surgeon and your anesthesiologist exactly what you take and when you last took it, and let them make the call.
A word on compounded and telehealth-sourced versions
The FDA has set out its concerns with unapproved GLP-1 products used for weight loss: dosing errors, unapproved salt forms of the active ingredient, and adverse events including some requiring hospitalization. The agency also notes those events are likely under-reported, because state-licensed compounding pharmacies are not required to report them.
If you are considering a compounded product, that FDA page is worth reading in full before you buy — and worth preferring over the marketing material of the service selling it.
Source: U.S. Food and Drug Administration. FDA’s concerns with unapproved GLP-1 drugs used for weight loss
En español
Esta práctica atiende a pacientes en español. Estas páginas cubren los medicamentos para bajar de peso y las opciones sin cirugía en Los Ángeles.
Side effects, in detail
Gastrointestinal effects are the common ones and the usual reason people stop. Each medication has its own profile, and these pages go through them individually.
Comparisons
Where a medication sits against each of the procedures this practice performs.
Medically reviewed by David G. Davtyan, MD, FACS, FASMBS. Last reviewed August 24, 2026. This page is general information about treatment options and is not medical advice, a dosing instruction, or a substitute for consultation.
