M Health Fairview is redefining weight loss for the long term
In a cultural moment where GLP-1 medications like Wegovy and Zepbound dominate the conversation around weight loss, M Health Fairview experts are reminding patients that medications aren't the only path forward – and for many, they may not even be the most effective one. Recent studies are reinforcing what bariatric experts have long observed: Weight loss surgery can deliver greater and more long-lasting results.
This year, researchers presented an important study comparing surgery with the new GLP-1 medications in the real world at the American Society for Metabolic and Bariatric Surgery annual meeting. The study found people who underwent gastric bypass or sleeve gastrectomy surgery lost five times more weight after two years than those who used GLP-1 medications. What's more, surgical patients were far more likely to maintain their weight loss over time, while many individuals using GLP-1s discontinued treatment within the first year.
"Patients often want a quick fix, but sustainable weight loss is rarely that simple," said Daniel Leslie, MD, a bariatric surgeon and director of the M Health Fairview Comprehensive Weight Management program. Leslie is also a professor and chief of the division of gastrointestinal/bariatric surgery at the University of Minnesota Medical School. "It's about improving weight and overall health-blood vessel function, diabetes, sleep apnea, fatty liver control, improved mobility, and even enhanced quality of life. Bariatric surgery continues to be one of the most durable, long-term tools for achieving those goals."
Leslie points to a growing body of evidence that goes beyond the scale. Research shows that weight loss significantly reduces the risk of diabetes, heart disease, kidney impairment, and even major cardiovascular events – benefits that bariatric surgery is far more likely to achieve. A recent study showed that patients treated with GLP-1 medications lost 6.8% of their weight at 10 years compared to 21.6% with surgery. Surgery patients had a 32% lower death rate than those on GLP-1 medications.
"For the effort of one surgical intervention, patients gain a lifetime tool to manage their weight-something that lasts well beyond a course of medication," said James McGreevy, MD, a bariatric surgeon and surgical director of the bariatric program at M Health Fairview St. John's Hospital in Maplewood.
Still, both he and fellow bariatric surgeon Luis Laguna, MD, emphasized that no single solution fits every person. "The most important thing is to meet people where they are," said Laguna, who’s the surgical director for the bariatric program at M Health Fairview Southdale Hospital. Laguna has been with M Health Fairview for nearly two decades. "Some patients will do very well with GLP-ls, others will benefit from surgery, and many will use a combination of approaches over time. Our role is to provide all the tools and help everyone decide what's best for them."
That personalized, multi-disciplinary approach is central to the M Health Fairview philosophy. Each person entering the program begins with an in-depth evaluation that considers their health history, lifestyle, and goals. From there, the care team develops a plan that may include surgical options, medications, or both. Care plans are always anchored in education, nutrition counseling, lifestyle adjustments, and long-term follow-up.
"We remind patients that surgery isn't a shortcut or a failure. It's a powerful tool which happens to be much safer than it was 20 years ago," said Leslie. "Like cancer care, which focuses on prevention and treatment, we know that there isn't one weight loss treatment that works for everyone. Patients need to consider all the options."
Laguna agrees, adding that personal commitment remains key. "Surgery builds the foundation, but the patient builds the house," he said. "We give them the tool; they use it to create change. Seeing people come back a year later, playing with their kids, traveling, living without pain – those are the moments that remind us why we do this work."
With GLP-1 medications now widely available and increasingly popular, M Health Fairview experts hope more patients will understand that these treatments don't have to compete. Instead, they can complement each other.
"This is an exciting time in the field of weight management because our tools are getting better," McGreevy said. "GLP-1 medications give us a whole new medical avenue to help people manage their weight and diabetes. Weight loss surgeries have improved to a point where the complication rates are extremely low. They also offer a huge, long-lasting benefit. By combining surgery with medication, we have entered a whole new frontier of weight management. GLP-1 medications are not a replacement for weight loss surgery for patients who qualify for surgery, but they are another powerful tool to help manage weight."
"A lot of what we do is education – helping people understand what options exist and what each can realistically achieve," McGreevy said. "The goal isn't surgery versus medication. It's giving people hope by connecting them to the available tools."
Learn more about the M Health Fairview Comprehensive Weight Management program.
