Archives: February 2026

GLP-1 RAs: Transitioning from Meds to Surgery

GLP-1 medications have changed the way we approach weight loss, but they may not be enough for some patients. Still, they have a place in improving health outcomes both before and after bariatric surgery.

What GLP-1 RAs Can Do

GLP-1 receptor agonists (GLP-1 RAs) are changing the way many clinicians approach medical weight management. These medications work by mimicking a naturally occurring hormone that helps regulate blood sugar, slow stomach emptying, and signal fullness to the brain.

For patients with excess weight to lose, GLP-1 RAs can produce meaningful weight loss when paired with lifestyle changes such as improved nutrition and increased physical activity. In some cases, these medications help people establish healthier eating patterns and build confidence in their ability to manage weight.

GLP-1 therapies can also reduce the risk of complications linked to metabolic disease, and many individuals also see improvements in related health conditions, including high blood sugar, high blood pressure, and abnormal cholesterol levels. Patients with type 2 diabetes often benefit from improved glucose control, and some medications in this class have demonstrated cardiovascular benefits in high-risk populations.

What GLP-1 RAs Can’t Do

Despite their effectiveness, GLP-1 medications are not a cure for obesity, and their benefits typically continue only while the medication is being used. When therapy stops, appetite signals and metabolic processes gradually return to their previous state, and weight regain is likely to occur.

There are also limits in the amount of weight loss GLP-1 drugs typically produce. Results vary widely from person to person, and some individuals may not achieve the level of weight reduction needed to improve certain obesity-related conditions. Genetics, metabolic adaptation, existing health conditions, weight at the start of therapy, and long-term weight history influence how the body responds. It is also well known that many patients regain the weight after stopping GLP-1 medications.

For individuals with severe obesity or longstanding metabolic disease, medical therapy alone may not be sufficient to produce durable weight loss or fully address related health risks. In these situations, other treatment strategies may be considered.

When It’s Time for a New Approach

Body mass index (BMI) and overall health status help determine which treatment approach may be most effective. Individuals with higher BMIs – particularly those with obesity-related conditions such as type 2 diabetes, sleep apnea, or hypertension – may require more substantial and sustained weight loss to improve their health.

GLP-1 therapy helps initiate progress. Patients who use or have used GLP-1 medications consistently but are unable to reach or maintain sufficient weight reduction may benefit from exploring surgical treatments. Bariatric surgery is not a replacement for medical therapy, but rather another tool in the continuum of obesity care. It has great potential as part of a personalized strategy to achieve long-term metabolic health.

Note: GLP-1 medications need to be discontinued 10-14 days prior to bariatric surgery. Because of the effect of slowed gastric emptying, continuing these medications into surgery can raise your risk of complications. If you are taking GLP-1 drugs, let your doctor know so you can both plan your surgery accordingly.

Benefits of GLP-1 Therapy Before and After Surgery

We are increasingly seeing the benefits of GLP-1 RA use prior to bariatric surgery. Though it seems counterintuitive, some weight loss before the procedure is beneficial. Weight loss achieved through GLP-1 therapy can help lower surgical risk by improving blood sugar control, reducing liver size, and decreasing inflammation. Even modest weight reduction before surgery can make the procedure technically easier and support a smoother recovery.

GLP-1 therapy prior to weight loss surgery can also help patients build habits that support long-term success. Learning to recognize fullness cues, reduce portion sizes, and make healthier food choices prepares individuals for the lifestyle adjustments that accompany bariatric surgery.

We’re also recognizing the benefits of GLP-1 medications after surgery. Patients typically experience the most substantial weight loss in the first 12 to 18 months after surgery, along with improvements in obesity-related conditions. After this initial rapid weight loss, the body can go through metabolic adaptation. This is when the body adjusts to the lower weight by slowing metabolism and increasing hunger signals to conserve energy, and patients may notice a plateau or even weight regain.

GLP-1 RAs can help patients get back on track when this occurs. They can be used to help support additional weight loss, prevent weight regain, or address persistent metabolic conditions. When used thoughtfully, medication and surgery together can form a powerful, complementary approach to long-term weight management.

If you’ve been using GLP-1 medications but feel your progress has stalled, it may be time to explore the full range of treatment options. The bariatric specialists at MASJax will evaluate your health history, treatment goals, and current therapy to determine whether surgical care is the appropriate next step in your weight management journey. With the right combination of medical support and personalized care, lasting health improvements are possible. Reach out to the team to schedule your consultation.

MASJax is the longest-established bariatric program in the Jacksonville area, with a level of experience that sets the standard for care in the region. Our program holds a Center of Excellence designation through the American Society for Metabolic and Bariatric Surgery MBSAQIP program and is also recognized as a Blue Distinction Center for Bariatric Surgery, reflecting our commitment to the highest quality standards.

MASJax surgeons routinely perform advanced bariatric procedures, including sleeve gastrectomy, gastric bypass, duodenal switch, and complex revisional bariatric surgery. As specialists in minimally invasive techniques, we offer laparoscopic and robotically assisted procedures using the da Vinci Surgical System for appropriate patients.

What Do Younger Populations, Ultra-Processed Food, and Colon Cancer Have in Common?

The habits we build in our twenties and thirties may have consequences we don’t see for decades. From sugary drinks to sedentary routines, everyday lifestyle choices may be shaping colorectal cancer risk in younger generations.

The habits we build early on can influence disease risk later in life.

From the foods we eat to how active we are, researchers are seeing how daily choices made in young adulthood might be setting the stage for rising rates of colorectal cancer among younger age brackets than before. Once considered primarily a disease of older age, colorectal cancer is now appearing more often in people under 50. Not only is the incidence higher, but statistics are climbing in death rates.

Scientists and physicians are looking more closely at lifestyle factors that have changed over the past few decades – particularly diet, physical activity, and weight.

The Rising Rates Of Colorectal Cancer

In recent years, colorectal cancer has become the leading cause of cancer death in adults under 50 in the United States.¹ This change marks a significant shift from decades past.

Researchers have also found that many younger patients are diagnosed at later stages of the disease. In fact, about three out of four people under 50 with colorectal cancer are diagnosed after the cancer has already progressed.¹ The subtlety of symptoms or that they can be mistaken for less serious digestive issues is one speculative reason for later-stage diagnosis.

In response to these trends, screening guidelines have evolved – the U.S. Preventive Services Task Force (USPSTF) lowered the recommended starting age for colorectal cancer screening from 50 to 45 in average-risk adults. Earlier screening helps detect precancerous growths or early-stage cancer when treatment is most effective, but many eligible adults are still not getting screened. What’s more is that adults with a family history or otherwise considered high-risk should start screening before age 45 and/or at higher frequencies.²

Stool tests are recommended annually. Direct visualization tests have varying increments. A regular colonoscopy is recommended every 10 years for those with an average risk profile, but can be as soon as every three years for those with a higher risk. (Higher risk comes from a family history of colorectal cancers or discovery of pre-cancerous polyps at a younger-than-expected age.) Another imaging option is the CT colonography, which is recommended every five years.²

Talk to your physician about a screening schedule that works for your unique health circumstances and family medical history.

What Do Ultra-Processed Foods Have to Do With Any of This?

One of the biggest shifts in modern diets has been the rise of ultraprocessed foods (UPFs). They are full of ingredients not found in home kitchens, including industrial preservatives, emulsifiers, artificial flavors, and additives designed to enhance taste, texture, and shelf life. Frequently stocked UPFs at the grocery store include packaged snacks, sugary drinks, ready-to-eat meals, and many breakfast items.

Surprising fact: processed foods started showing up over a century ago, and the ultra-processed foods that began appearing in the 1980s have come to dominate about 70% of our grocery store shelves.³ Processed foods, like canned beans and cheese, are altered for safety, convenience, or preservation using few ingredients. Ultra-processed foods are industrial formulations like soda and fast food that are packed with additives, colors, and preservatives made of industrial ingredients not used in home cooking.

UPFs also account for a large portion of total calories consumed in many American diets. They are engineered to be hyper-palatable and easy to overconsume. Because UPFs are low in fiber and high in added sugars, unrecognizable ingredients, and unhealthy fats, they’re capable of exacerbating a range of chronic health conditions.

Dietary patterns have a direct correlation to digestive health, and researchers have been examining how unhealthy patterns contribute to colorectal cancer incidence. In a large, long-term study of more than 29,000 women, those with the highest intake of ultra-processed foods had a 45% higher likelihood of developing early precancerous colon polyps compared to those with the lowest intake. While this type of research does not prove cause and effect, it does point to a meaningful association between long-term dietary habits and early changes in the colon.⁴

Researchers are still hot on the trail, but several biological mechanisms might explain the connection. Diets high in UPFs can disrupt the gut microbiome, reduce protective nutrients (like fiber), and promote chronic inflammation. Some evidence also suggests these foods can affect the gut lining or produce harmful byproducts during digestion. Over time, these changes will likely create an environment that allows abnormal cell growth to develop.

Taken together, this research reinforces a broader point: eating patterns established early in life may also influence disease risk years or even decades down the line.

How Obesity Factors Into This Picture

Obesity is a well-established risk factor for developing colorectal cancer. Excess body weight is associated with chronic inflammation, hormone fluctuations, and metabolic disruptions; add a diet full of ultra-processed goods, and the equation doesn’t lead to an optimal outcome.

Because UPFs are calorie-dense, low in fiber, and designed to be appetizing, they can lead to overeating without providing lasting satiety. Over time, this pattern of eating contributes to weight gain and makes it more difficult to maintain a healthy metabolic balance.

Poor lifestyle habits will compound these effects. Consuming high amounts of ultra-processed foods, combined with low physical activity, smoking, alcohol overconsumption, or unmanaged health conditions like type 2 diabetes, can reinforce an unhealthy spiral into increased risk for a myriad of chronic illnesses and early mortality.

Diet, weight, and metabolic health are closely intertwined, and over time, that combination can increase the risk of colorectal cancer.

What To Do About It

Lifelong habits start in early life. But that doesn’t mean you can’t make improvements at any age. Small adjustments in diet, activity, and screening routines are simple acts that can make a big difference.

One of the most effective steps is to reduce the amount of ultraprocessed foods that you eat. Focus on building meals with whole, minimally processed ingredients – vegetables, fruits, whole grains, legumes, nuts, and seeds provide fiber, nutrients, and compounds that support gut and metabolic health. Over time, these foods can help stabilize weight, reduce inflammation, and promote better digestive function.

Colorectal screening is a preventative tool that, as of the time of this publication, is covered by insurance. Start with a conversation with your physician, at least by the time you are 45. Start that conversation earlier if you have a family history of colorectal cancer. Blood in the stool, persistent abdominal pain, unexplained anemia, or sudden changes in bowel habits should also prompt a conversation with your healthcare provider. Early evaluation with a knowledgeable provider can catch issues before they progress.

Prevention is one of the best defenses you have against disease, and next to that is screening. Let us help support your journey toward better digestive health and long-term disease prevention. Talk to the team at MASJax.

1. McKay, B. (2026). Colorectal Cancer Is Now the Top Cause of Cancer Death in Younger People. Wall Street Journal. https://www.wsj.com/health/healthcare/colorectal-cancer-is-now-the-top-cause-of-cancer-death-in-younger-people-02f08587?gaa_at=eafs&gaa_n=AWEtsqcEwBsyxYnRPuIaA0BgkgA9KirJGjZI_K1gAadxQOtg323VHFRSjSvZIdKqIZ0%3D&gaa_ts=69979a12&gaa_sig=jxTT6VEs8KZaGeg90WM95BJ_lNhQrBghZKXauUwIdDHsIC3zxom4I3KtbJKLZG64BvQ1e9_9_fyoPqpS6Yty6A%3D%3D.
2. U.S. Preventive Services Task Force. (2021, May 18). Colorectal Cancer: Screening. U.S. Preventive Services Task Force. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening.
3. Callahan, A. (2025, October 16). How America Got Hooked on Ultraprocessed Food. The New York Times. https://www.nytimes.com/interactive/2025/10/16/well/eat/ultraprocessed-food-junk-history.html.
4. Wang, C., Du, M., Kim, H., Nguyen, L. H., Wang, Q.-L., Drew, D. A., Leeming, E. R., Khandpur, N., Sun, Q., Zong, X., Gweon, T.-G., Ogino, S., Ng, K., Berry, S., Giovannucci, E. L., Song, M., Cao, Y., & Chan, A. T. (2025). Ultraprocessed Food Consumption and Risk of Early-Onset Colorectal Cancer Precursors Among Women. JAMA Oncology, 12(1). https://doi.org/10.1001/jamaoncol.2025.4777.