Does having had bariatric surgery 30 years ago affect the use of GLP 1

@msdimples25

Welcome to Mayo Connect.
You might be interested in this publication from John Hopkins:
"One in Seven Bariatric Surgery Patients Turn to New Weight Loss Drugs"
https://publichealth.jhu.edu/2025/one-in-seven-bariatric-surgery-patients-turn-to-new-weight-loss-drugs
If I had to summarize the article, it is a quote in the article:
“We think in the future, obesity treatment will follow that paradigm for some patients, people won’t just use surgery or GLP-1s—they’ll often use both.”

I had bariatric surgery about 15 years ago. I am on some medications that have a side effect to reduce cravings. Not a GLP-1. I am using the medications for another condition, but they contain some of the same active ingredients that are used in weight loss drugs.

It is always best to talk to your provider about options.

I would speak to my physician about a Glp1 addition and start low dose. It really helps me with my blood pressure and A1C even when I do not lose weight. It works well with some exercise like walking or whatever you like. Keep at it and stay positive for the long run. All my best.

@max2
Thanks for this! I had lap-band surgery in 2006 and lost about 100 lbs, but have bounced around between 150-195 in the last 10 yrs. I got back in the gym 4 months ago and am very active 3x a week with a personal trainer, then burning 300 cals doing cardio. I am also post menopausal and eat about 1500 cals per day and I cannot seem to lose at all.
My sis started a glp-1 around July, does not work out and has lost about 30 lbs, closing in on her goal. She has a revision from lapband to the sleeve a few years back. So I have been thinking about adding a glp-1 but didn't know how it would work w a lapband, since my diet is already pretty restricted. I would like to lose 40-50 lbs.

Thanks for your thoughts. Much to consider. All my best.

I had roux-en-y surgery 15 years ago, lost 75 pounds, put back on 30 pounds, started on zepbound last June with the goal of losing that 30 pounds, never got higher than the third dosage level, began ramping back down once I had lost about 25 pounds, ultimately lost 45 pounds in total by the time I got back to the starting dose level. Clearly, it worked great!

There is now considerable medical literature supporting the use of GLP-1 RAs to deal with weight gain after bariatric surgery, and it's pretty much all positive in the sense that it works, and the side effects are no different from those of people who have not previously had surgery.

Having said that, I was the poster child for side effects: nausea, constipation, migraines, even peripheral neuropathy (which is very rare). By December, I had switched over from tirzepatide to semaglutide (ozempic) in hopes that the side effects would be less. They are now tolerable, but only because I've been knocking them down one at a time with a suite of drugs. Because I'm now on ozempic, which is a multipen, I can fine-tune the dosage (unlike with zepbound and monjaro), which also helps. This also means I can cut the cost of the drug in half, since I refill the prescription every two months instead of every month.

It seems very unlikely that the bariatric surgery made the side effects better or worse -- they are just a manifestation of my personal wiring.

In my personal case, I went into this knowing that it's like a statin -- dropping off the drug would cause the weight to return, so I'm figuring I'm on it for life. I might explore other drugs in the class, but I'll be on some version of this drug forever. That's something you'll want to think about.

It's also currently expensive if your insurance won't cover it, and I really wouldn't recommend solving that problem by turning to a compounding pharmacy or some sort of (possibly dubious) internet source. If you have some other problem for which your insurance will pay for a GLP-1 RA (like diabetes, sleep apnea, or kidney disease), you might be able to get it prescribed and covered for that purpose, and get the weight loss as a side effect.

Had surgery in 1987. Lost 100 lbs and then held at 190 for years. Started Monjaro and had significant result in health stats. Lower blood pressure, great A1C, from, 8.2 to 6.2 in a couple of months. I did not change my eating habits as after 35 years there was not much left to give up. I feel better, lost another 15 lbs and holding. Monjaro is good for me. I need to walk more and get off my duff now. All my best.

I had bariatric surgery 20 years ago. Last year I began to use zepbound and have had incredible results. I am on lower doses of medicine and am within 3 % of being in the BMI for normal weight. I have to say I would think hard about taking any drug if I had to only lose 20 lbs.. If it is just to get to a weight you feel is more healthy and you really need to lose 50 I would consider it. I had to lose quite a bit more. I think having had the surgery you know you don’t need a ton of food. The divorce from bad food habits was memory muscle for me