GLP-1 therapy and bariatric surgery are both established treatments for obesity but with different mechanisms, durability, and risk profiles. GLP-1 produces 14–22% mean weight loss with continuous therapy; bariatric surgery produces 25–35% with permanent anatomic change. Surgery requires a recovery period and carries surgical risks. Both are effective; selection depends on BMI, comorbidities, prior treatment history, and patient preference.
Side-by-side
| Dimension | GLP-1 therapy | Bariatric surgery |
|---|---|---|
| Editorial score | 0/100 | 0/100 |
| Semaglutide | Compounded $145–$215/mo · branded $25–$1,349/mo | $15,000–$35,000 (one-time, often insurance) |
| Tirzepatide | — | — |
Who should pick GLP-1 therapy
Patients who want pharmacologic therapy without surgical intervention; patients who haven't reached the bariatric BMI threshold; patients who want to start a treatment trial.
Who should pick Bariatric surgery
Patients with BMI ≥40 or ≥35 with serious comorbidity who haven't responded to medical therapy; patients seeking durable weight loss without ongoing medication.
Frequently asked
Can you do both?
Yes. GLP-1 is increasingly used post-bariatric for additional weight loss or weight regain. See our post-bariatric page.
Which is more durable?
Bariatric surgery produces more durable weight loss without ongoing medication. GLP-1 weight loss reverses if discontinued (STEP-4).