Dr. Alexa Roth

Dr. Alexa Roth Bariatric Surgeon | Medical Weight Loss MD | Double Board-Certified | Patient-First Care for Southeast Idaho

09/17/2026

Novel concept ✨😉 knowing what to eat and being able to consistently eat that way are not the same thing.

Just because a person struggles with weight, it doesn’t mean they don’t know how to eat.

Obesity is so much more than poor food choices.

It’s a biologically defensible metabolic process.

It’s completely possible to have an excellent diet and still struggle with weight loss at the same time.

I’m a bariatric surgeon and obesity medicine doctor. I’ve helped thousands of people battling obesity reclaim their lives.

I can tell you with certainty that appetite is biologically regulated by our brains, guts, hormones, and reward pathways.

Effective obesity treatments target those systems—not just the food on the plate.

Follow along, and visit my website to learn more.
☎️ 208-239-2760
🌐 DrRothWeightLoss.com

09/16/2026

A GLP-1 non-response is usually defined as losing less than 5% body weight after an adequate trial at a therapeutic dose.

Published data suggests this occurs in approximately 1 in 10 people.

So what’s next for these patients?

If this is you or someone you love, please don’t give up.

First, its often helpful to understand the full picture: how long you took it, the dose you reached, side effects, other medications, sleep, medical conditions, and whether your appetite or weight changed at all.

Depending on the situation, a different medication or a different type of treatment may work better for you.

GLP-1–based medications aren’t all the same, and some produce greater average weight loss than others in head-to-head trials.

For patients open to a procedure, bariatric surgery can also be an effective option — particularly for patients with larger weight loss goals or a more resistant metabolism.

All people are different, but here’s the bottom line:

Not responding to one medication doesn’t mean there are no options.

Follow along for more honest, evidence-based conversations about obesity and its treatment.

This content is for general education only and is not medical advice. Treatment decisions should be made with your own healthcare professional.

09/14/2026

GLP-1s changed weight loss medicine in 2021. But did they change my bariatric surgery volume?

It’s surprising, but not really.

I practice in southeast Idaho.

I’ve always embraced every evidence-based treatment for obesity—including GLP-1 medications. I’ve never viewed medical and surgical weight loss as competing treatments. I see them as part of the same continuum of care, and the right treatment depends on the individual patient.

Things I’ve noticed in my own practice:

Most of the patients who were already coming to me for surgery had weight loss goals that exceeded what a GLP-1 could realistically do for them.

That didn’t change when these medications arrived.

Meanwhile, my medical weight-loss practice has thrived—and it’s allowed me to better support patients both before and after surgery.

And here’s the part I find most exciting:

Many of the patients I’ve started on medications are people who never would have never considered seeing me pre-GLP-1 era, because their weight-loss goals simply weren’t significant enough to warrant surgery.

Rather than replacing one treatment with another, GLP-1s have expanded the number of patients I can help.

So, no—I don’t think GLP-1s have made bariatric surgery obsolete.

What I do think they’ve done is force us to have a much bigger conversation about how we treat obesity.

That means we have more tools to treat more people.

And honestly? I’m all for that.

09/10/2026

I’m not here today to review the data again. I want to get into why people express these opinions on social media.

Because really, this isn’t really just a conversation about a medication.

Comments like this reflect a much bigger misunderstanding of obesity itself.

Obesity is a chronic disease. The biology that contributed to the development of obesity doesn’t simply disappear because someone loses weight.

Yet we continue to hold people with obesity to that standard.

It’s the same messaging many of my patients have heard for years.

“You just need more discipline.”

“Just eat less and move more.”

“You need to make better choices.”

“You lost the weight before—you should be able to do it again.”

And when the weight comes back, they blame themselves.

I have cared for thousands of people with obesity. I can tell you that these are not people who simply haven’t tried hard enough.

We have to stop asking why people can’t simply overcome the biology of this disease through willpower and start asking why our understanding of the disease—and the way we treat it—have been so slow to change.

09/08/2026

So many patients—and even physicians—think weight-loss surgery is only about eating less.

It’s not.

Surprisingly, it’s just as much a procedure for the brain as it is for the stomach.

Changes in gut hormones after surgery including endogenous GLP-1, PYY, and ghrelin influence signals traveling between the gut and brain.

Within the brain, these signals affect hunger, fullness, food preferences, motivation and reward.

This means that after surgery, people usually experience:

• Less hunger — changes in gut hormones can reduce the drive to eat.

• Earlier fullness — people usually feel satisfied with much smaller portions.

• Less food noise — food can feel less urgent, compelling, or constantly on your mind.

• Different cravings — changes in gut-brain signaling can alter how rewarding certain foods feel.

• Better appetite regulation — signals between the gut and brain that help regulate eating can become more favorable for weight loss.

And this is important:

Prior to surgery, the brain biology that regulates hunger, fullness, and energy balance usually works against sustained weight loss.

Adjusting this biology is of big part of what makes surgery so powerful.

09/07/2026

For the record, it was a VERY small hula hoop 😂😂

Happy Labor Day everyone! Try not to work too hard.

09/03/2026

Amazing people recognize fear as part of their story—but they rarely let it write the ending.

I understand this inherently when I meet a new patient.

Bariatric surgery is a commitment to change. It deserves thought, preparation, and real conversations.

I don’t ask patients to justify why they feel ready. And not everyone arrives with their mind made up. That’s okay.

Sometimes, the first step is just asking the question out loud.

09/02/2026

Going to be very real here, because this is the honest truth.

1. I feel every single patient outcome. Deeply. Personally.

If a patient struggles, I take it home with me. I live with those feelings. It’s gut wrenching. I really do care. I think that makes me a better and stronger doctor, but there are moments when I wish I could disconnect.

2. I have two beautiful daughters, but too often, I put work first.

More commitments. Saying yes when I should say no. Missed bedtimes. Late nights. Early mornings. Weekends. As I write this, I realize how much I wish that weren’t true. I love what I do and I want to be there for my patients and my career. I’m still struggling with how to balance that with being the mother my girls need. I don’t always get it right, and I’m still figuring out what needs to change—but I’m committed to being there for my girls in the best way I can.

3. Social media has been both a blessing and a curse.

I love sharing what I do. I love educating, connecting with my community, and the incredible friendships I’ve made here. But the time spent thinking about posts, filming, editing, and engaging are hours I’m not spending on my actual work or with my family. I’m still trying to figure out how to make it sustainable.

4. The constant time pressure of my life gets to me.

Every minute of every day feels 200% full. The more opportunities and responsibilities I take on, the harder it gets. Time pressure wears down my emotional reserves, increases my stress, and honestly, sometimes makes me wonder whether the intensity of the career I chose comes with a cost I’ll feel years from now.

5. I’ve struggled my entire life to accept “good enough.”

I chase perfection. That has made me a thorough, meticulous surgeon—and I’m proud of that. But perfectionism can also be a hindrance.

I’m sharing this because I think there’s value in being honest about the parts of medicine that people don’t always see.

To my amazing patients: thank you for entrusting me with your lives. I take that responsibility incredibly seriously. You are the reason I show up every single day. 🫶🏻

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777 Hospital Way, Suite 115
Pocatello, ID
83201

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