Injections work on appetite signalling and are reversible. The balloon occupies stomach volume for about 16 weeks. Surgery permanently changes anatomy and is the most durable option at higher BMI.
GLP-1 injections
Best suited to people who describe constant hunger and food preoccupation as the main obstacle. It addresses that directly, without any procedure.
The trade-off is that it works while you take it. Stopping without changed habits usually means regain, and cost continues for as long as treatment does.
The Allurion gastric balloon
A capsule swallowed with water, filled with sterile fluid, occupying part of the stomach for around sixteen weeks before passing naturally. No surgery, endoscopy or anaesthesia.
It suits people wanting a defined, time-limited reset with a clear start and end, particularly those not ready to commit to surgery.
Side by side
| How it works | Injection: appetite hormones · Balloon: stomach volume · Surgery: anatomy |
| Anaesthesia | Injection: none · Balloon: none · Surgery: general |
| Duration | Injection: ongoing · Balloon: ~16 weeks · Surgery: permanent |
| Reversible | Injection: yes · Balloon: yes · Surgery: no |
| Typical BMI | Injection: 27+ · Balloon: 27+ · Surgery: 35+ or 30+ with conditions |
| Recovery | Injection: none · Balloon: days · Surgery: 2 to 4 weeks |
Bariatric surgery
Sleeve gastrectomy or gastric bypass permanently changes stomach size or the route food takes. It produces the largest and most durable weight loss, and frequently improves type 2 diabetes, sleep apnoea and blood pressure.
It carries surgical risk, requires lifelong vitamin monitoring, and is not reversible. For higher BMI or where weight is driving serious disease, it is often the most appropriate option.
How the decision is made
BMI is the starting point, but not the whole answer. Your medical history, whether diabetes or reflux is present, previous attempts, your tolerance for a procedure and what you want from the next year all shape it.
Sometimes the routes combine. Some patients use a GLP-1 medicine before surgery, or nutrition support after a balloon.
Our honest position
We recommend the least invasive option that will realistically work. If injections will get you there, we will not suggest surgery. If your BMI and health mean injections are unlikely to be enough, we will say that too.
If none is appropriate yet, we will tell you that rather than sell you something.
Cost over time
Injections carry a recurring monthly cost that continues as long as treatment does. Surgery carries a larger one-off cost with lower ongoing expense beyond supplements and follow-up.
Over several years the arithmetic often shifts. This is worth calculating honestly at consultation rather than comparing only the initial figure.
Combining approaches
These routes are not mutually exclusive. A GLP-1 medicine is sometimes used before surgery to reduce operative risk, or afterwards where weight regain occurs.
The balloon is sometimes used as a trial of tolerance for restriction before committing to surgery. Your doctor will discuss whether sequencing makes sense for you.
Questions to bring to consultation
What is my actual BMI and what does it mean for my options. Which conditions do I have that weight loss would improve. What does each route realistically achieve for someone with my profile.
What happens if the first approach does not work. What does follow-up look like in each case, and for how long.
Frequently asked questions
Which produces the most weight loss?
Can I use injections instead of surgery?
Can I use a GLP-1 before surgery?
Is the balloon better than injections?
What if I choose wrong?
Medical disclaimer. This article is general information, not medical advice, and does not replace consultation with a qualified doctor. The medicines discussed are prescription-only and must be prescribed and monitored by a physician. Outcomes vary between individuals. Never start, stop or change a prescribed medicine without medical advice.