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We recommend surgery once your weight has been stable for ~36 months and your medication plan is steady

( GLP-1 RAs recently appearing on the market, in particular liraglutide, semaglutide and tirzepatide (a GIP/GLP-1 RA dual agonist) seek to overcome the problem of the short plasma half-life of native GLP-1 through (i) changing the amino acid sequence of the peptide so that it is no longer broken down by DPP-4, and/or (ii) attaching a long acyl chain to the peptide, thus allowing it to bind to albumin, and avoid rapid elimination via the kidney

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