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A growing number of Americans are turning to a new class of medications known as GLP-1s for help with weight management, fueling what many experts describe as a meaningful shift in how obesity is treated.
About one in eight U.S. adults report having tried a GLP-1 medication, according to a recent KFF survey. At the same time, roughly 250,000 bariatric surgeries are performed each year, based on data from the American Society for Metabolic and Bariatric Surgery.
Taken together, those numbers point to something larger: more options, more personalization and a growing understanding that obesity is a complex medical condition, not simply a matter of willpower.
Originally developed to treat diabetes, GLP-1 medications are now being used more widely to support weight loss and metabolic health along with reducing the risk of cardiovascular events and treating sleep apnea and fatty liver disease. They work by targeting the connection between the gut and brain, helping regulate hunger, reduce cravings and slow digestion, so people feel full sooner.
As interest grows, so do the questions.
Should patients choose a weekly injection or a daily pill? How do those options compare to surgery? And what matters most when deciding between them?
For many patients, the answer isn’t straightforward.
“It’s not just about what works on paper, it’s about what works for your life,” said Dr. Allison Steele, a bariatric medicine physician at the HonorHealth Bariatric Center. “By the time people come in, they’ve already read the headlines. They’re hopeful, but also unsure. They want something effective, but also something they can stick with.”
GLP-1 medications currently come in two primary forms: weekly injections and daily oral pills, each with their own advantages and challenges.
Injectable options are often preferred for their simplicity. Taken once a week, they eliminate the need for daily reminders. Because they bypass the digestive system, they may also be absorbed more consistently, which can lead to greater weight loss for some patients.
“For patients who don’t want to think about or may have issues with taking a daily medication, the weekly shot can feel like a relief,” Dr. Steele said.
Oral medications offer a needle-free alternative, which can make them feel more approachable. But they require consistent daily use, something that can be difficult to maintain over time.
“A pill sounds easy,” Steele said, “but real life can get in the way, making sticking with taking a daily medication a struggle.”
Side effects for both forms are similar, most commonly including nausea, constipation or mild stomach discomfort, particularly early in treatment. Starting at a lower dose, increasing your dose slowly and making thoughtful nutrition choices can help ease those symptoms.
Still, medications are only one part of a broader and evolving treatment landscape.
“There’s been a major shift in how we think about obesity,” said Dr. Mohan Ramalingam, a bariatric surgeon at HonorHealth General Surgery – Tempe. “It’s a chronic disease, and we now have multiple ways to treat it, not just one path.”
Bariatric surgery, which includes procedures that alter the stomach or digestive system, remains the most effective option for significant and sustained weight loss. Advances in minimally invasive techniques have improved safety and reduced recovery times, making surgery more accessible than in the past.
“Surgery still delivers the most durable results, especially for patients with more severe obesity,” Dr. Ramalingam said. “But it’s no longer the only tool we rely on.”
He noted that while GLP-1 medications can produce meaningful weight loss, they often require ongoing use to maintain results. While both surgery and GLP-1 medications require long-term lifestyle changes, surgery often entails a more involved procedure and recovery.
Each option carries trade-offs. For many patients, the decision isn’t about choosing one over another, it’s about finding an approach that fits their health needs, their goals and their daily lives. Many times, this may not mean GLP-1 medication or surgery alone. It can often mean using both tools to successfully achieve your treatment goals.
