Can GLP-1 Drugs Like Ozempic Replace Bariatric Surgery?

Think of it like Formula One racing — an F1 driver put on a city road will crash everywhere, and a city driver put on an F1 track won't know how to handle it. Every surgical approach needs specific training, and with the right training complications are very few. The key criterion is size: if the thyroid nodule or lobe is under 6 centimetres, I do it robotically or laparoscopically; above that, I advise open surgery regardless of cosmetic preference. In every case I identify the recurrent laryngeal nerve on both sides and all four parathyroid glands before removing the thyroid — the rule is, don't touch what you haven't seen.

The two have a complementary role, not a replacement one. Weekly injectable GLP-1 drugs aren't a permanent cure, and if a patient's BMI is above 45 or 50, injections alone won't take them from 150 kg to 75 kg — that needs a definitive, more durable intervention. But if someone just wants to go from 100 kg to 85 kg, injections are the right option and no surgery is needed. I sometimes even use GLP-1 injections for two to three months before surgery, to bring a patient's BMI down to a level the anaesthesiologist is comfortable with — so the two approaches often work together.

In females the urethra is only about 4 centimetres long, and incontinence happens when the internal urethral meatus — where the urethra meets the bladder — sags downward and loses muscular control. My job is to lift that junction back into its correct anatomical position, using a procedure called Burch colposuspension: three sutures on each side of the urethra along the anterior vaginal wall, lifted and fixed to Cooper's ligament. Doing this robotically lets me suture in that very narrow retropubic space with far more precision than laparoscopically. The surgery takes about an hour and the patient goes home happily the next day.

No. If the lifestyle is maintained correctly — diet, exercise, behaviour — there is no chance of weight regain. It's entirely lifestyle-related.

I can teach laparoscopic surgery in one to two months to any doctor or surgeon who wants to travel to India — I can generate good surgeons, and at least my students say I'm a good teacher. For the financial and logistical side of a patient's journey, that's where Jivo's team comes in: share the case with us, and even before a patient decides to travel, the hospital can give a tentative cost estimate to work from.

Above 45 or 50: injections alone will not take a patient from 150 kg to 75 kg, which calls for a definitive, anatomical, durable intervention instead.

Real comorbidities such as obstructive sleep apnoea, joint disease, back pain and stress incontinence, where the weight itself is compromising quality of life.

Yes. GLP-1 injections are sometimes prescribed for two to three months before surgery, purely to bring a patient's BMI down to a level the anaesthesiology team is comfortable operating on.

Someone who simply wants to go from 100 kg to 85 kg is often better served by injections, with no surgery needed at all.