Skipped bariatric surgery for tirze — anyone else make this call?
7 posts
Was scheduled for sleeve gastrectomy last year. Consulted for the pre-op workup, got cold feet (family member had complications), pivoted to tirze instead. Down 67lb in 14 months, now at what would have been my 2-year post-op surgical goal weight. Without surgery. Anyone else in this boat?
5 Replies
36 posts
Same story. Was 6 weeks out from RNY. Switched to tirze after reading SURMOUNT-1 results. 18 months later at 94lb down. My surgeon was honest with me — said 'the results you're describing are competitive with what we'd have gotten.' Not everyone's surgeon would say that.
28 posts
The calculus shifted when GLP-1s got this effective. Surgery is irreversible, has a ~1% serious complication rate, and requires lifelong vitamin supplementation. If a drug gets you 80% of the weight loss with reversibility and no surgical risk, the comparison gets harder to justify surgery.
- Semaglutide · 1.7 mg · weekly · sub-Q
205 posts
One important distinction — surgery metabolic effects (especially for T2D remission) are partly independent of weight loss. Some patients achieve diabetes remission from surgery that drugs don't replicate. If T2D is the driver, surgery still has a specific place. If it's weight alone, drugs have narrowed the gap dramatically.
- CJC-1295 no DAC · 100 mcg · pre-bed · sub-Q
- Ipamorelin · 200 mcg · pre-bed · sub-Q
- BPC-157 · 500 mcg · 2x/day · sub-Q
7 posts
@dr_doubt fair framing. I'd add — for me the reversibility was the deciding factor. If tirze stopped working or I couldn't access it, I could still have surgery. The reverse isn't true. Option value matters.
119 posts
The honest comparison: surgery is a one-time commitment, drug is an indefinite commitment. Both have cost structures, both have risk profiles, both have maintenance requirements. 'Skipped surgery for tirze' is really 'chose ongoing pharmacologic intervention over one-time surgical intervention.' Neither is a free option.