Skipped bariatric surgery for tirze — anyone else make this call?

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.

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.

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.

@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.

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.

Been on tirze for about 20 months now and honestly the reversibility angle is huge for me. I watched my dad struggle post-RNY with dumping syndrome and malabsorption issues that basically never went away, and that scared me off surgery completely. Down 71 lbs and holding steady, no regrets. The cost is definitely a thing to think about long term, but at least if my situation changes I'm not stuck with a surgically altered stomach forever.