The scale may go down, but it doesn’t always stay there.
About 1 in 8 American adults now says they’ve used GLP-1 drugs such as Ozempic and Wegovy to lose weight or manage a chronic condition. But many also stop using them — and often regain the weight.
“It came back with taxes,” said Pamela Melgarejo, a former GLP-1 user. “I gained twice as much weight as I lost.”
For Pamela, that cycle led her to a different option: bariatric surgery at the NYU Langone Health Weight Management Program.
The results, she said, were dramatic — more than 100 pounds lost in six months — and the weight has stayed off for over a year.
“I no longer crave the same things, and I can no longer consume the same amount of food,” she said. “It offers a big change in a small period of time, and then that change is sustained.”
Her surgeon, Dr. Loic Tchokouani, said her case reflects a broader shift as patients who stop GLP-1s and regain weight increasingly turn to surgery.
“This is a scenario that is familiar and a major driver of patients seeking surgical treatment,” he said. “A majority of my patients have now tried a GLP-1, be it a sample or prescribed course, before seeing me. I do think many patients are missing out on, or at least foregoing, a more effective solution to their obesity.”
Searching for a solution
Pamela spent years working to lose weight, trying diets, juicing, fasting pills, acupuncture — even patches promising to melt belly fat.
“I did metformin before metformin was fashionable,” she quipped. “Everything I did was successful. But nothing got me near my goal, and nothing was sustainable.”
Weight impacted her health, causing sleep apnea, back pain and menstrual issues. It was no picnic mentally, either, especially when it took the fun out of shopping for clothes.
So, in 2021, Pamela came to NYU Langone. At first, she explored lifestyle changes. When those proved insufficient, she turned to GLP-1s.
They worked — in the beginning. Pamela lost 30 pounds, and her blood sugar returned to normal levels.
“I wasn’t hungry all the time, like I was before the injection,” she said. “I saw a lot of improvement.”
But side effects followed, including nausea, extreme appetite suppression and, most concerningly, suicidal thoughts that “came out of the blue.”
Her care team tried four different GLP-1s in an effort to balance benefits and side effects, but she eventually stopped taking the medication altogether.
“I have a lot to lose, and putting that in jeopardy to shed a few pounds wasn’t something I wanted to do,” said Pamela, a full-time caregiver for her husband, who suffers from Type 2 diabetes complications.
She hoped lifestyle changes would hold the weight off, but as is the case for so many people, that wasn’t enough. When her weight climbed to 267 pounds, doctors raised another option: bariatric surgery.
Long-term results
Bariatric procedures surged in the 1990s with the rise of minimally invasive techniques, but they have declined by as much as 25% amid the growth of GLP-1s. Yet surgery outcomes tend to be more durable than medication alone.
“Studies show patients can regain 60% of their lost weight within a year of stopping GLP-1s,” Tchokouani said. “In contrast, bariatric surgery, most commonly sleeve gastrectomy and gastric bypass, may see a 5% to 15% regain from their lowest weight over several years.”
In March 2025, Pamela underwent a gastric sleeve procedure, in which surgeons removed a large portion of her stomach to limit intake and reduce hunger signals.
“Everything has improved by a lot. My body now functions the way it’s supposed to — that is a big plus.”
Pamela Melgarejo
“I was incredibly scared, but it was so much easier than I expected,” she said.
A month later, she’d lost 30 pounds. In September of that year, she reached her goal weight of 160 pounds and has maintained it since.
“The GLP-1 tricks your mind more than anything, but the surgery is something that changes how your body functions,” she said. “Even if I wanted something that is very high in carbs, or that is not so good for my health, I couldn’t eat enough that would harm me.”
Tchokouani called bariatric surgery the “most effective and durable tool” against obesity, a chronic disease that affects more than 2 in 5 US adults.
“The hormonal effect produced by bariatric surgery is magnitudes higher than what GLP-1s can produce and thus helps patients lose weight more effectively,” he said. “GLP-1s require consistent administration and escalating doses to maintain their effect.”
More than a year later, Pamela says the operation has reshaped her life.
Today, she can run and play softball, breathe more easily and wake up without pain. She’s reversed several weight-related conditions, including high blood pressure and an irregular heartbeat. Her fatty liver disease “disappeared completely.”
“Everything has improved by a lot,” she said. “My body now functions the way it’s supposed to — that is a big plus.”
“Now, my life expectancy is as long as I want to make it.”
One of the greatest feelings in the world that she discovered? “Waking up and not feeling anything.”
“Your stomach is not supposed to hurt, you’re supposed to feel good — like it did when I was 15,” she said. “It’s like going back in time.”
She wants more people to know solutions aren’t one-size-fits-all and that they have options to explore.
“I think the NYU program is the best place to do that,” she said. “They provided support in so many aspects that I felt comfortable risking a surgery, which I was most afraid of. I think that can ultimately help people.”
Dr. Loic Tchokouani is a bariatric and general surgeon at NYU Langone Health. Experts at NYU Langone’s Weight Management Program offer a full array of medical and surgical weight loss options at locations across New York City and Long Island, supporting patients throughout their weight loss journey.
