Introduction Metabolic surgery is the most effective known treatment option for people with severe obesity, leading to marked sustained weight loss, improvement or remission of obesity-associated comorbidities, improved quality of life, and reduced all-cause mortality.1-3 While on a population level metabolic surgery is highly effective, on an individual level the response is highly variable.4,5 This variability impacts health as postoperative improvement or resolution of obesity-associated comorbidities are associated with weight loss.6-8 Poor weight loss or weight regain, resulting in less than 20% weight loss, affect up to 1 in 4 patients who undergo metabolic surgery.8,9 There is an unmet clinical need for effective therapeutic strategies for these patients. Metabolic surgery alters gastrointestinal signals that regulate energy and glucose homeostasis.10 In most patients, metabolic surgery results in supraphysiological nutrient-stimulated circulating levels of the satiety gut hormone glucagon-like peptide-1 (GLP-1).11,12 However, studies undertaken in patients with poor vs good postsurgery weight loss demonstrate that individuals with poor weight loss have increased appetite coupled with an unfavorable postoperative gut hormone profile, including lower circulating GLP-1 levels.10,11 Treatment with GLP-1 analogs may therefore benefit people with poor postsurgery weight loss.