Jennifer from Houston sent us this question: “I’ve been on GLP1… but I don’t lose a pound unless I do Keto. Is my Mounjaro dosage not enough? I’m 5’ 5” tall and 215 pounds. Are my satiety hormones that bad that the leading weight loss drug can’t even help me? You’re a bariatric surgeon, so you’re going to probably tell me to have a gastric sleeve surgery. But what about GLP1 and the keto? I’m hoping when I lose my excess weight, I no longer must do keto. And I can lower my dosage of GLP1 when I am at maintenance for life. Is this an actual possibility?

Dear Jennifer,

Mounjaro, a GLP-1 agonist, is an effective medication for weight loss. GLP-1agonists control appetite and increase satiety. They also increase insulin sensitivity. Consequently, your daily caloric intake decreases, and your carbohydrate metabolism improves. This results in significant weight loss in most patients. However, up to 15% of patients do not respond to GLP-1 therapy despite increasing the dosage.

If you are not losing weight on GLP-1agonist therapy, bariatric surgery remains the most effective weight loss solution. Sleeve gastrectomy is both safe and reliable. Sleeve gastrectomy mechanism of action relies on increasing your own intestine secretion of GLP-1 and numerous other neuro-hormones that increase satiety and decrease appetite. Sleeve gastrectomy is indeed more effective than GLP-1 agonist injections.

Please remember that healthy eating is always recommended whether you are on GLP-1 treatment, or you have undergone sleeve gastrectomy. A healthy eating regimen is not necessarily a keto regimen. At Houston Weight Loss Surgery Center, we recommend a nutritious diet regimen based on lean protein, legumes, nuts and fresh vegetables and fruits.