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While there is no universal answer on if or when to choose bariatric surgery after GLP-1s, there are clear clinical signals that a conversation about surgery is worth having

Lets first talk about carbohydrates and blood sugar

However, among the common gastrointestinal side effectsincluding nausea, vomiting, diarrhea, and constipationnausea consistently appears as the most frequently reported symptom

And Alzheimers definitely has a connection with insulin resistance so much so that a 2005 paper proposed it be called type 3 diabetes, with actual insulin resistance in the brain demonstrated nearly a decade later

But the animal data is consistent enough that anyone with a personal history of MTC, or a family history of it, should not take retatrutide