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GLP-1 agonists may: Optimize high-risk patients before surgery Improve metabolic control Potentially reduce surgical risk But durable long-term outcomes in severe obesity still rely heavily on: Surgical intervention Lifelong follow-up Nutritional monitoring Multidisciplinary care The future may not be medicine vs surgery. It may be the intelligent integration of both

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This review will outline the physiology and pharmacological potential of amylin and GLP-1, respectively, and focus on innovative peptide drug development leading to drugs acting on two or more distinct receptors, such as an amylin and GLP-1 peptide hybrid, potentially producing a more effective treatment strategy to combat the rapidly increasing global obesity.