28: Does saying yes to bariatric surgery mean saying no to GLP-1s?

Aug 28, 2023

“Are GLP-1s even an option after bariatric surgery?” This is such an important discussion that unfortunately is surrounded by a world of misinformation and improper care. 

I was chatting with one of my friends about bariatric surgery and whether or not it’s advised to consider GLP-1s as an option after having surgery, and this discussion made me think about all the misinformation I have come across surrounding the topic. I have seen a lot of confusion, even in medical circles, where physicians are unsure when it is appropriate or not to prescribe these newer weight loss medications. So when I heard this story from my friend, I didn’t want to delay covering this important topic on my podcast.

My friend saw a physician regarding weight management and was not able to get weight loss medication prescribed, even though their situation warranted the prescription. It was a sad circumstance, because this person may now experience a delay in care for a life-affecting chronic medical condition.

More than half of my patients that are on weight loss medications have had bariatric surgeries in the past, and I am a huge advocate of keeping options open and considering all possible paths of care in the process of ongoing metabolic health care. 

There are many reasons why someone might benefit from going on weight loss medication after bariatric surgery. 


  • The surgery may not have been as effective as desired


Sometimes it happens where a patient will have bariatric surgery, and they don’t ever see the desired health benefits completely. In this case, it is appropriate to get on medication to work towards reaching those health and wellness goals. Often, the amount of weight surprise what the surgery can provide, and medications allow the patient to continue to reach further goals. 


  • The surgery has the desired effect, but through time and life circumstances, we see weight gain and a regression in health


This is the type of situation I see most often, and this is completely normal. There are a lot of factors that play into the weight gain some people experience, and in this case, it is also still very reasonable to consider GLP-1s as an option. 

There are many reasons why metabolic health will fluctuate, even after having bariatric surgery, and the reality of weight management is that it is a chronic medical condition and typically not something that is going to be forever solved after one change in routine or medical procedure. 


American Board of Obesity Medicine