I've personally been on both Saxenda and Wegovy. With Saxenda, I lost 20 pounds and my blood sugar and cholesterol improved, but high blood pressure was unchanged. I stopped because the insurance price went from $50 a month to over $200, and my weight loss plateaued so $2400 a year to keep off 20 lbs seemed a bit steep. As soon as I stopped, the weight came back, the A1Cs went up, and the cholesterol went higher than before I started. With Wegovy, I was only ever able to get the first two months of doses before shortages made it impossible. After that, I switched insurance and lost coverage of Wegovy completely, meaning over $1k per month out of pocket if I wanted to continue. I wasn't on it long enough to see how my labs would have been. From everything I've seen, surgery is the only durable option. In my case, the copay is less than a single month of Wegovy, with the possibility of it lasting a lifetime, and the ability to add the GLP-1 drugs down the road if needed. Only you can decide what is right for you, but I think for most people who are at the point of qualifying for surgery, the drugs alone will not be enough, and if you lose access to them, you will most likely go back to square one with weight. Or in my case, square one plus 10 pounds.