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As with other complex diseases, the next era likely involves precision, combination therapypairing antiamyloid agents with treatments aimed at metabolic, inflammatory, vascular, and synaptic pathways

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GLP-1 agonists may: Optimize high-risk patients before surgery Improve metabolic control Potentially reduce surgical risk But durable long-term outcomes in severe obesity still rely heavily on: Surgical intervention Lifelong follow-up Nutritional monitoring Multidisciplinary care The future may not be medicine vs surgery. It may be the intelligent integration of both