Medication or Surgery?

Recent advent and increasing use of medical therapy for the treatment of obesity continues to be a hot topic in both the medical literature and social media. Which is best? There are many with strong views on this question and really, like with anything medical your particular circumstances will dictate what is best for you. Another article was published recently giving weight to the benefit of surgery for particular groups and for those interested it can be accessed https://doi.org/10.1016/j.amjsurg.2025.116242 or by searching for its title "Metabolic and bariatric surgery versus glucagon-like peptide-1 receptor agonist therapy: A comparison of cardiovascular outcomes in patients

with obesity" in the American Journal of Surgery.

Whilst there are a number of important considerations, the conclusion of the authors was bariatric/metabolic surgery (MBS) resulted in a lower risk of adverse cardiovascular outcomes than the medications studied. Was this due to a better weight loss in the surgical group or other factors not yet understood? No doubt further studies will clarify. Either way, the management of obesity is not a choice between medications OR surgery, it is a choice between what treatments may suit best at the time knowing that one does not necessarily exclude later use of another treatment.