What’s the Right Weight Loss Option for You—Medication, Surgery or Both?

Leading experts in bariatric surgery and obesity management convened at a news conference on Monday, October 6, to discuss the usage of weight loss medications, known as GLP-1s, and weight loss surgery. Nearly 40 percent of American adults are classified as overweight, while another 40 percent are classified as obese, with half of those experiencing severe obesity. The recent surge in popularity of GLP-1 medications has led to many questions regarding treatment choices. While these weight loss drugs are increasingly seen as the primary solution for obesity, experts frequently suggest a combined strategy, utilizing both approaches as complementary treatments. During the news conference at the American College of Surgeons (ACS) Clinical Congress 2025 in Chicago, Illinois, experts discussed the benefits and barriers of medication and surgical treatment of obesity, the importance of viewing obesity as a disease, and common questions patients have when considering what treatment is right for them. Moderator

• Matthew Hutter, MD, MPH, MBA, FACS, FASMBS, DABS-FPMBS, Chair of the Department of Surgery in the John Sealy School of Medicine, University of Texas Medical Branch

Panelists

• Thomas C. Tsai, MD, MPH, FACS, Medical Director for Health Policy Research at the American College of Surgeons, associate professor of surgery, Brigham and Women’s Hospital and Harvard Medical School
• Richard M. Peterson, MD, MPH, FACS, FASMBS, DABS-FPMBS, President, American Society for Metabolic and Bariatric Surgery (ASMBS), professor and chief bariatric and metabolic surgery director, University of Texas Health Science Center at San Antonio
• Monali Misra, MD, FACS, FRCSC, FASMBS, DABS-FPMBS, associate director of the Cedars-Sinai Marina Weight Management Center and director of the bariatric program, Beverly Hills Physicians

RELATED: 6 Things You Should Know Before Considering Bariatric Surgery

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Key Takeaways from the Panel Discussion

The panel of experts emphasized that the best approach is an individualized plan that uses all tools—diet, exercise, medication, and surgery—together. They stressed that bariatric surgery and weight loss medications are often used as complementary treatments, not one or the other.

1. The Stigma is Wrong

• It’s a Disease, Not Your Fault: The most important message is that you are struggling with a metabolic disease. It is unfair to blame yourself. Seeking treatment is a responsible step toward better health.
• Like Cancer Treatment: The doctors compared under-treating obesity to under-treating cancer. If a solution exists, patients should have access to it.

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2. Compare Your Options

The panel spent significant time addressing the crisis of access, noting that an effective treatment is useless if patients can’t get it.

• The Cost-Effectiveness Advantage: While surgery has a higher upfront cost, it is overwhelmingly more cost-effective in the long term. By curing or dramatically improving costly diseases like diabetes and eliminating the need for expensive, lifelong GLP-1 medication, surgery ultimately saves the healthcare system (and the patient) money over a decade.
• Insurance Coverage: The good news is that most major insurance providers and Medicare do cover bariatric surgery, although you may not realize it. However, coverage for GLP-1 medications specifically for weight loss is often denied, leaving patients with monthly costs that can exceed $1,000.
• The Unacceptable Gap: Despite bariatric surgery being a safe and effective treatment, the panelists revealed a staggering fact: Only about one percent of eligible patients currently receive it. The experts urged patients to learn about their options and demand access to the care they deserve.

3. Bariatric Surgery: The Most Powerful, Durable Solution

Despite the new attention on weight loss medications, the experts confirmed that metabolic and bariatric surgery (such as gastric bypass or sleeve gastrectomy) remains the safest, most effective, and most durable treatment for severe obesity. If you meet the criteria for surgery, it is a highly safe and effective treatment that gives you the best chance at a long, healthy life. RELATED: 6 Reasons to Talk to Your Doctor About GLP-1

Next Steps: Find Your Comprehensive Care Team

If you are considering your treatment options, don’t face this disease alone. The experts emphasized that the best results come from a multidisciplinary team of specialists. When you consult a bariatric surgeon, you aren’t just discussing surgery; you are accessing a team that includes:

• Obesity medicine specialists
• Registered dietitians
• Psychologists and behavioral health experts

This team will work with you to determine the right path, whether that involves starting with medication, moving straight to surgery, or a combination of both.