Randomized trials demonstrate that liraglutide and semaglutide provide additional weight loss and improved blood sugar control in patients experiencing weight regain or insufficient results after bariatric surgery. These GLP-1 receptor agonists also show promise for pre-surgical metabolic optimization, potentially reducing operative risks through short-term weight loss. However, their appetite-suppressing effects create concerning nutritional vulnerabilities, particularly inadequate protein intake and micronutrient deficiencies that could accelerate sarcopenia, anemia, and bone disease in this already at-risk population. This finding represents a significant clinical development for the estimated 200,000 Americans who undergo bariatric surgery annually, as weight regain affects 20-30% of patients long-term. The data suggest GLP-1 drugs could reduce the need for costly revisional surgeries while extending the metabolic benefits of the initial procedure. Yet the nutritional surveillance requirements highlight a critical gap in current practice patterns. Many bariatric programs lack structured protocols for monitoring protein and micronutrient status in patients using these medications, potentially trading short-term weight benefits for long-term metabolic complications. The evidence supports viewing these drugs as surgical adjuncts requiring specialized nutritional oversight rather than standalone solutions.