Researchers propose using GLP-1 receptor agonists like semaglutide both before and after bariatric surgery, borrowing from cancer treatment models. Pre-surgical "neoadjuvant" GLP-1 therapy enhances early weight loss and improves dyslipidemia without compromising surgical safety, while post-surgical "adjuvant" treatment effectively prevents weight regain in suboptimal responders. This represents a fundamental shift from viewing bariatric surgery as a standalone procedure to treating obesity as a chronic condition requiring multimodal intervention. The framework addresses two critical limitations of current surgical approaches: perioperative risks in extremely obese patients and long-term weight regain that affects many surgical patients. While GLP-1 medications have shown remarkable standalone efficacy for weight loss, their integration with surgery could amplify benefits beyond what either intervention achieves alone. The proposal remains largely theoretical, requiring rigorous randomized trials to establish safety and efficacy protocols. However, it signals an important evolution toward personalized obesity medicine, where pharmacotherapy and surgery work synergistically rather than competitively, potentially transforming outcomes for millions facing severe obesity.