Sustaining healthy weight loss is about much more than cutting calories or injecting drugs, as many glucagon-like peptide-1 (GLP-1) receptor agonist users are discovering. Widely seen as miracle drugs, semaglutide, tirzepatide and related medications have transformed the treatment of obesity and diabetes and apparently lessened the need for medical device intervention in many instances. However, many patients will still need surgical intervention to achieve their weight loss goals.