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Following bariatric surgery, particularly procedures that alter gastric anatomy and intestinal transit, the normal physiological regulation of glucose homeostasis becomes disrupted

For example, tirzepatide may reduce the effectiveness of oral contraceptives, and patients taking warfarin with any GLP-1 receptor agonist should consider more frequent INR monitoring when starting or stopping therapy

One promising avenue of treatment is the use of GLP-1 medications after VSG to help control and maintain weight loss over the long term

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This article reviews the evolving evidence, current guidelines, and practical considerations to help clinicians navigate smarter treatment choices

Black or tarry stool, visible blood in the stool, vomiting blood, severe abdominal pain, unexplained weight loss, persistent fever, anemia, or progressive swallowing difficulty should be evaluated appropriately