Semaglutide for Bariatric Surgery Candidates: Enhancing Outcomes

semaglutide for bariatric surgery

About 42% of American adults suffer from obesity with a BMI of 30 or higher. According to a 2018 study, about 9% suffer from severe obesity, meaning they have a BMI of 40 or higher.

Once someone has reached obesity, weight loss becomes infinitely harder. Studies have shown that current methods of weight loss show limited results for those with BMIs higher than 30 with only 10% of women and 1 in 12 men losing 5% of their body weight.

And, the majority of those patients gained the weight back within 5 years.

Many obese Americans are turning to alternative methods like weight loss injections or bariatric surgery, also known as weight loss surgery, seeing it as the only option.

For those with severe obesity, bariatric surgery often becomes a necessary path to reclaim their lives.

Semaglutide, already recognized for its efficacy in aiding weight loss, is now gaining attention as a potential ally in the post-bariatric surgery phase. Semaglutide after bariatric surgery can be a valuable addition to the post-surgery regimen, promoting further weight loss and helping individuals achieve their target weight.

Bariatric Surgery and Its Limitations

Bariatric surgery is undoubtedly effective in promoting significant and often rapid weight loss, making it a valuable tool for individuals with severe obesity. With several weight loss surgeries to choose from, there are options for nearly everyone:

  • Laparoscopic Sleeve Gastrectomy (“the sleeve”)
  • Roux-en-Y Gastric Bypass (RYGB)
  • Adjustable Gastric Band (AGB)
  • Biliopancreatic Diversion with Duodenal Switch (BPD/DS)
  • Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S)

Most people who opt for a bariatric surgery will lose about 50% of their excess weight, manage to keep it off, and significantly reduce comorbidities, such as type 2 diabetes, hypertension, and sleep apnea.

There are some drawbacks, though, including:

  • Sustainability. Sustainability can be difficult and many do regain at least some of the weight several years post surgery. About 20-25% of patients will either regain the weight or deal with insufficient weight loss.
  • Nutritional deficiencies. Bariatric surgery alters the digestive tract, affecting nutrient absorption. Patients must carefully manage their diet, including the possibility of requiring supplements to prevent deficiencies, , particularly in vitamins and minerals like B12, iron, and calcium.
  • Lifestyle changes. Post-surgery, individuals must adhere to strict dietary guidelines, adopt healthier eating habits, and engage in regular physical activity.

Bariatric surgery is highly effective in promoting significant weight loss and improving health, especially in individuals with severe obesity and related comorbidities. But, it is not a standalone solution. 

Semaglutide After Bariatric Surgery: A Complementary Solution for Patients

While bariatric surgery alone can be life-changing, the journey toward lasting weight loss and metabolic improvements might benefit from an additional ally—semaglutide.

Originally developed for managing type 2 diabetes, semaglutide has shown significant results in reducing body weight for obese patients. Semaglutide belongs to a class of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists. Its mechanism of action is twofold:

  1. Appetite control: Semaglutide reduces appetite and slows down gastric emptying, enhancing the feeling of fullness.
  2. Blood sugar management: Semaglutide regulates blood sugar levels by increasing insulin secretion and inhibiting glucagon release.

For individuals considering or who have undergone bariatric surgery, semaglutide offers several potential benefits:

  • Enhanced weight loss: Semaglutide can further augment weight loss, helping individuals achieve their target weight more quickly.
  • Metabolic improvements: Beyond weight loss, semaglutide contributes to metabolic benefits, such as better insulin sensitivity, reduced inflammation, and improved glycemic control.
  • Fewer plateaus: Weight loss plateaus are a common challenge post-bariatric surgery. Semaglutide after bariatric surgery can help individuals break through these barriers and continue their progress.

With your doctor’s blessing, you could potentially use semaglutide and bariatric surgery together for optimal weight loss. Semaglutide can be used:

  • Before your surgery as part of a preoperative plan and after surgery to further promote weight loss.
  • After your surgery to further promote weight loss and support the required lifestyle changes.
  • Long after your surgery to help promote weight loss for those who have regained weight post-surgery.

Semaglutide vs Bariatric Surgery

There are many individuals who choose to use semaglutide or bariatric surgery alone. There are many benefits and drawbacks to both.

Benefits and Drawbacks of Bariatric Surgery


  • Rapid and substantial weight loss. Bariatric surgery typically results in rapid and substantial weight loss, making it an effective option for those with severe obesity.
  • Resolution of comorbidities. Many obesity-related comorbidities, such as type 2 diabetes and hypertension, often improve or resolve after surgery.
  • Long-Term effectiveness. In many cases, bariatric surgery leads to long-term weight loss and health improvements.


  • Invasiveness. Bariatric surgery is an invasive procedure with associated risks and potential complications, including infection, bleeding, and long recovery periods.
  • Nutritional concerns. Post-surgery, patients must be vigilant in monitoring nutrient intake and often require lifelong supplementation.

Individuals with severe obesity or urgent health risks may benefit more from the rapid weight loss achieved with surgery.

Benefits and Drawbacks of Semaglutide


  • Non-invasive. Semaglutide is a non-invasive option that does not require surgery, reducing the associated risks. It is, however, an injection, which many find to be a drawback.
  • Appetite control. Semaglutide is effective in reducing appetite and increasing the feeling of fullness, aiding in weight loss.
  • Reversible. Semaglutide usage can be adjusted, and the medication can be discontinued if needed, offering more flexibility.


  • Slower weight loss. While effective, Semaglutide may lead to slower weight loss and less significant results compared to bariatric surgery.
  • Gastrointestinal disturbances. Semaglutide’s common side effects include nausea, vomiting, diarrhea, constipation, and abdominal pain. 
  • Ongoing medication. Semaglutide requires ongoing medication adherence for sustained effects.

Patients who prefer non-surgical approaches and want to avoid the invasiveness of surgery may opt for semaglutide vs bariatric surgery.

It is always important to discuss options with a licensed physician to determine the most appropriate option based on your individual needs and weight loss goals.

Semaglutide Dosing and Guidelines for Bariatric Patients

The standard semaglutide dosing schedule for weight loss is as follows:

  • Weeks 1-4. 0.25 mg once a week
  • Weeks 5-8. 0.5 mg once a week
  • Weeks 9-12. 1 mg once a week
  • Weeks 13-16. 1.7 mg once a week
  • Weeks 17+. 2.4 mg once a week (maintenance dose)

Remember, this is the standard schedule and will need to be tailored to the individual needs of the patient. Those who have undergone bariatric surgery may not need the maximum dose.

Enhance Your Weight Loss with Semaglutide After Bariatric Surgery

Bariatric surgery is an excellent option for those who are dealing with severe obesity and obesity comorbidities. While it delivers rapid results, there is still significant potential for insufficient weight loss or weight regain after surgery.

Combining semaglutide and bariatric surgery can enhance your weight loss and help you maintain that weight loss for longer. Semaglutide is a viable option, either alongside or instead of surgery, to enhance weight loss and metabolic benefits.

Consult with healthcare professionals to receive personalized recommendations tailored to individual needs and preferences.


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