Surgery or a GLP-1?

NYU Langone Hospital-Suffolk recently appointed a new chief of surgery, Dr. Alexander Barkan. Barkan is a bariatric surgeon by trade who has offered his expertise deciding between surgical interventions and/or the GLP-1 drugs on the market for weight loss. NYU Langone Hospital-Suffolk was just designated as a comprehensive bariatric center by The American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. This designation allows them to perform all types of bariatric surgeries at the hospital.

Q: As the new chief of surgery, what excites you most about serving this community and improving care for local patients?

A: What excites me most is that the hospital is in a real growth phase. There is a strong opportunity to bring the NYU Langone brand to this community, along with its culture of excellence and high-quality patient care. It is an exciting time to be here because we are building something that will have a lasting impact on local patients and families.

Q: How does your experience as a bariatric surgeon influence the way you think about overall community health and prevention?

A: My background as a bariatric surgeon has given me a close view of how prevalent obesity is in every community. It affects so many aspects of health, and treatment continues to evolve. We now have more tools than ever before, including medication and surgery, but the need for care is still very much there. There are still many patients who can benefit from bariatric services.

Q: What is your future vision for the Department of Surgery at the hospital?

A: Surgery at the Suffolk hospital is evolving, and there is tremendous opportunity to continue developing specialized programs. Some of the areas we are focused on include vascular surgery, surgical oncology, orthopedics, and advanced general surgery, including minimally invasive and robotic surgery. The goal is to continue expanding services so patients in this community can receive more advanced care close to home.

Q: Many people are hearing about GLP-1 medications. What should the community understand about how these fit alongside surgical options?

A: GLP-1 medications have become very popular over the last several years, and many patients have benefited from them. At the same time, some patients plateau on the medication and still qualify for surgery based on their BMI and overall health history. Too often, people feel that if the medication did not fully work for them, they somehow failed, and that should not be the case. These medications are one important tool, but surgery remains a very strong and effective treatment option as well.

Q: How are you helping patients navigate their choices when it comes to weight loss and overall health, whether through medication, lifestyle changes, or surgery?

A: In some cases, medication may help a patient lose enough weight to make surgery safer. In other cases, surgery may come first, followed by medication later as part of long-term management. It is very similar to how other areas of medicine work. For example, in cancer treatment, some patients receive chemotherapy first and then surgery, while others have surgery first and then chemotherapy.

Traditionally, many people waited years before coming in for surgery because there is such a psychological battle around it. Patients often feel they need to try everything else first. Now, with medication available, some people start there.

Some people do well, but others become tired of 52 [weekly] injections. They lose weight, but they also feel dull, less interested in food, and sometimes even emotionally flat. Surgery, on the other hand, can allow patients to remain themselves while still achieving significant weight loss.