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Bariatric surgery (sleeve gastrectomy, gastric bypass) typically produces larger and more durable weight loss than medication, but it is an operation with surgical risks and lifelong nutrition follow-up. GLP-1 medications avoid surgery but are usually needed long-term. Many programs now offer both and some patients use medication before or after surgery. Talk with a bariatric program and an obesity-medicine clinician about which fits you. Either way, a DEXA scan before and after shows how much of the weight lost is fat versus muscle.
Start with the programs above. Each lists procedures, a phone number and a website; most require an information session and an insurance check before your first consult.
The 2022 ASMBS/IFSO guidelines recommend considering metabolic and bariatric surgery for adults with a BMI of 35 or more regardless of other conditions, and for those with a BMI of 30–34.9 who have metabolic disease. Insurance plans often have stricter rules.
The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (run by the American College of Surgeons and ASMBS) accredits centers that meet standards for safety, staffing and outcome tracking. We note it only where a program states it on its own website.
Some programs use GLP-1 medications to help with weight regain after surgery. This is a decision for your surgical team.
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