Your Specialist Report: Obesity and Type 2 Diabetes (Medication vs. Surgery)

Prepared for: J.M. · Location: Pittsburgh, Pennsylvania · Insurance: employer PPO (plan name to confirm) · Report date: November 1, 2026

Sample report. The person in it is fictional. The specialists, programs, phone numbers and links are real and were checked on November 1, 2026.

1. What this condition is

Obesity is a long-term (chronic) disease in which the body stores more fat than is healthy, and it often travels with type 2 diabetes. When the two come together, care is usually run by a team. That team can include an obesity medicine physician (a doctor trained to treat obesity with medicine, nutrition and behavior support) and a bariatric surgeon (a surgeon who does weight-loss and metabolic operations, such as the sleeve or the gastric bypass). There are two broad paths: (A) medication with ongoing medical care, and (B) surgery, which also needs lifelong follow-up. Published criteria: the 2022 surgical guideline from the two main bariatric surgery societies (ASMBS and IFSO) recommends surgery for adults with a BMI of 35 or more, with or without other conditions (guideline, Obesity Surgery), and the current FDA labels approve Wegovy and Zepbound for weight reduction in adults with obesity (Wegovy label, updated June 30, 2026; Zepbound label, updated September 2, 2026). Your insurer adds its own rules. Ask your doctor which of these apply to you. Your doctors will decide; this report helps you prepare for those conversations.

The two paths at a glance (taken from the programs' own pages):

Neither column is "the right one." Section 7 lists the questions that usually decide it. The paperwork row comes from AHN's insurance page.

2. Specialists to consider

First decision: which system does your PPO open? Pittsburgh has two big health systems, UPMC and Allegheny Health Network (AHN), and the name of the company on your insurance card decides which one you can use at in-network prices. What the systems' own pages said on November 1, 2026:

• Card says UPMC Health Plan: UPMC's page lists it as accepted. AHN's list for West Penn Hospital (last updated 09/21/2026) shows UPMC Health Plan commercial plans as in network there only for inpatient burn care and outpatient cancer care (AHN West Penn insurance list). The UPMC names here are #1 and #3.
• Card says Highmark: AHN lists Highmark commercial plans as accepted (same AHN list). UPMC says Highmark members with broad-network commercial plans have full in-network access to UPMC, but narrow-network plans have only limited access (UPMC access page). Ask Highmark which kind yours is. So with Highmark, AHN (#2 and #4) is listed as accepted, and UPMC (#1 and #3) depends on your plan type.
• Card says Aetna, Cigna or UnitedHealthcare: both UPMC's page and AHN's list name these insurers. Confirm the specific surgeon and hospital anyway.

We list five specialists: one per path in each system, plus one regional option.

Path A: Obesity medicine (medication and medical care)

1. David A. Rometo, MD: Endocrinologist and obesity medicine physician, UPMC / University of Pittsburgh

• Where they practice now: UPMC, Falk Medical Building, 3601 Fifth Avenue, Pittsburgh, PA. Checked on November 1, 2026 on: University of Pittsburgh Department of Medicine profile (lists him as "Clinical Lead, Endocrine Obesity Unit and Weight Management Program"); UPMC Physician Resources presenter page (© 2026); and a UPMC obesity medicine course page that names him and was last updated August 11, 2026. The ABOM diplomate search lists him as certified since February 2015, valid through 2035.
• Why selected: He is board certified in both endocrinology and obesity medicine, which suits someone managing obesity and type 2 diabetes together. His University of Pittsburgh Department of Medicine profile (the same text appears on his UPMC Physician Resources page) says he is the clinical leader of the medically supervised weight loss and obesity medicine program in the endocrinology division. It names a program aimed at "reversing diabetes and other metabolic complications of obesity" (called DROP), a very-low-calorie diet program, and a diabetes and weight program for patients after bariatric surgery. The Pitt profile also lists his work on a type 2 diabetes management protocol after bariatric surgery at Magee-Womens Hospital, and a 2016 paper on managing blood sugar around bariatric surgery. That matters if you start on Path A and later think about Path B, or the reverse.

2. Fahad Zubair, MD: Medical Director of Obesity Medicine, Allegheny Health Network (AHN)

• Where they practice now: AHN Comprehensive Weight Management at Mellon Pavilion (4815 Liberty Avenue, Suite 215, Pittsburgh, PA 15224) and at the Health + Wellness Pavilion in Wexford. Checked on November 1, 2026 on his AHN provider page. Under the page's Reviews tab, the 10 most recent patient comments are dated July 2 to August 20, 2026 (4.9 out of 5 from 257 surveys). The ABOM diplomate search lists him as certified since April 2018, valid through 2028. ABOM still shows his old city, Danville, where he trained.
• Why selected: AHN names him medical director of Obesity Medicine. He did a fellowship in obesity medicine and clinical nutrition at Geisinger. His AHN page lists obesity medication, severe obesity, and weight regain after bariatric surgery among his areas of focus, so he covers medicine-first care and also follow-up care after surgery. The AHN program says its endocrinologists work closely with the surgeons when a patient has diabetes (AHN specialists page). He is also on the faculty of AHN's bariatric surgery fellowship, alongside the surgeons in #4.

Path B: Bariatric (weight-loss and metabolic) surgery

3. Anita P. Courcoulas, MD, MPH, FACS: Chief, Minimally Invasive Bariatric and General Surgery, UPMC

• Where they practice now: UPMC Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213. Checked on November 1, 2026 on: UPMC Magee bariatric surgeons page and the UPMC system-wide surgeons page (both © 2026; both name her as director); and the University of Pittsburgh surgery division page, which names her as chief and was "Revised 10/30/26."
• Why selected: She led a long-term study published in JAMA (February 2024) that compared bariatric surgery with medical and lifestyle treatment in adults with type 2 diabetes. Among the 262 people followed, 18.2% of the surgery group were in diabetes remission at 7 years, compared with 6.2% of the medical/lifestyle group. At 12 years the figures were 12.7% and 0% (JAMA article; UPMC Physician Journal feature, Dec 17, 2024). Those numbers show that remission happened for a minority even with surgery, and that it often faded over time. Ask her team what that means for you. Her program at Magee is MBSAQIP-accredited as a comprehensive center with obesity medicine qualifications. MBSAQIP is the national accreditation program for weight-loss surgery centers, run by the American College of Surgeons. The program says it does "more than 600 bariatric surgery procedures" a year at Magee (self-reported, not audited, not comparable between hospitals) (Magee bariatric page). The same Magee team also includes Bestoun H. Ahmed, MD; Karla Bernardi, MD; and Ramesh C. Ramanathan, MD. If the wait for Dr. Courcoulas is long, ask about them.

4. Cody J. McGee, MD: Bariatric and general surgeon, Allegheny Health Network (AHN)

• Where they practice now: AHN Bariatrics at Mellon Pavilion (4815 Liberty Avenue, Suite 215, Pittsburgh, PA 15224), at the Health + Wellness Pavilion in Wexford, and at 200 Quinn Drive, Suite 210, Pittsburgh, PA 15275. Checked on November 1, 2026 on his AHN provider page. Under the page's Reviews tab, the 10 most recent patient comments are dated March 31 to August 28, 2026 (4.9 out of 5 from 80 surveys).
• Why selected: He completed a fellowship in bariatric surgery at AHN West Penn Hospital, and he now teaches in AHN's program: AHN lists him on the faculty of its Bariatric and Minimally Invasive Surgery Fellowship. His profile lists sleeve gastrectomy, bariatric revision (redoing or changing an earlier weight-loss operation) and weight regain after surgery, which matters if you want a surgeon who also handles what can happen years later. He is board certified in general surgery. AHN's bariatric surgery is done at two hospitals on the American College of Surgeons' MBSAQIP list: West Penn Hospital and AHN Wexford Hospital (ACS hospital finder). AHN does not publish a yearly case count. Ask for it.
• Other AHN bariatric surgeons on the same faculty page, each with a current AHN profile checked on November 1, 2026: Kellen G. Hayes, MD, the fellowship's program director, who did his bariatric fellowship at Cleveland Clinic and lists sleeves and revisions as special interests; and George M. Eid, MD, whose profile lists sleeve, gastric bypass and revision surgery. If the wait for Dr. McGee is long, ask about them.

Regional option (about 2 hours' drive)

5. Ali Aminian, MD: Director, Bariatric & Metabolic Institute, Cleveland Clinic (Ohio)

• Where they practice now: Cleveland Clinic Main Campus, 9500 Euclid Avenue, Cleveland, OH 44195. Checked on November 1, 2026 on his Cleveland Clinic provider page, which carries an industry-disclosure statement dated August 10, 2026.
• Why selected: His page says his research focuses on obesity and diabetes surgery and lists more than 250 peer-reviewed papers. He is board certified in general surgery and in the newer "focused practice in metabolic and bariatric surgery" (2023). The institute says it operated on 1,100 patients "last year" (self-reported, not audited, not comparable between hospitals) and offers both surgical and medical weight loss (institute page). Please note: his page reports that he receives consulting or speaking fees from Eli Lilly, a company that makes weight-loss medicines. Cleveland Clinic is out of state, so check your network before booking. His page offers online booking.

Closer to home (Pennsylvania)

All four Pittsburgh specialists above are in-state. If you would rather be treated closer to where you live or work, the American College of Surgeons lists these other MBSAQIP-accredited bariatric programs in western Pennsylvania (ACS list for Pennsylvania, checked November 1, 2026): AHN Wexford Hospital (Wexford), Heritage Valley Sewickley (Sewickley), Excela Health Westmoreland Hospital (Greensburg), Indiana Regional Medical Center (Indiana, PA) and UPMC Jameson (New Castle). We did not verify individual surgeons at these five, so ask each one for its surgeons' names and yearly case numbers. For obesity medicine near you, the ABOM diplomate search listed 42 certified physicians with a Pittsburgh address on November 1, 2026. Type "Pittsburgh" in the City box. Certification shows training, not whether a doctor is taking new patients.

Leads we checked and did not list

• Giselle Hamad, MD (UPMC): recommended by Pittsburgh patients in a 2021 online thread. She is not on UPMC Magee's current surgeon list, so we did not list her.
• Erin E. Kershaw, MD; Katrina Han, MD; Don Mathew, MD (UPMC): we found them only on third-party directories, or UPMC's directory blocked our check. A search listing describes Dr. Mathew as a hospital-based physician, not an outpatient weight clinic doctor. Not verified on an institution page.
• Michael Rawlins, MD (AHN): found only on a third-party site (2020). AHN's provider directory returned no results at the address we tried, and he is not on AHN's current bariatric fellowship faculty page. Not verified.

3. Next steps

How to reach each specialist (from each institution's own page):

• UPMC Center for Obesity Medicine (Dr. Rometo): 412-586-9780 · 3601 Fifth Avenue, Falk Suite 3B, Pittsburgh, PA 15213. UPMC Magee's separate Comprehensive Weight Loss Program (medical, non-surgical) is at 412-647-4545.
• AHN Comprehensive Weight Management (Dr. Zubair): 412-235-5900 (fax 412-235-5901) · Mellon Pavilion, 4815 Liberty Avenue, Suite 215, Pittsburgh, PA 15224 · AHN also tells patients a primary care doctor can start the medication conversation: (412) DOCTORS / 412-362-8677.
• UPMC Bariatric Services at Magee-Womens (Dr. Courcoulas): 412-641-3632 · online contact form.
• Information session: free. For Magee, UPMC offers an informational webcast you can watch from home, or you can call 412-641-3632. UPMC says sessions cover insurance and financial basics, and you can meet the team and fill in the first patient assessment form.
• What comes next: a surgeon consultation, then UPMC's six-month presurgical program: six monthly classes that UPMC says are built to meet insurance requirements. UPMC says class structure and fees vary by hospital, so ask what Magee charges. If you can't attend the classes, UPMC says your primary care doctor can supervise and document the six months instead, using UPMC's materials.
• AHN Bariatric and Metabolic Institute (Dr. McGee): 412-235-5900, option 1 · online appointment request (the form asks for your primary care doctor's details and lets you name a surgeon).
• Information session: free. AHN says to call the same number to find a session near you (AHN surgery page).
• Insurance help: AHN says its insurance coordinator handles the authorization request and, if your insurer says no, works with you on an appeal or self-pay options. AHN's insurance page links a one-page chart of what different insurers ask for (diet months, nutrition and psychology visits, labs). The chart shows no date and lists some old plan names, so ask the coordinator whether it is current for your plan.
• Cleveland Clinic Bariatric & Metabolic Institute (Dr. Aminian): scheduling 216-445-3030 · Ohio appointments 866-320-4573 · institute questions 216-445-2224 · medical weight loss 216-445-3136 · virtual visits: the institute page says to "ask your provider about what options are available."

Your first call — three questions (none of the five specialists' pages says this, so ask the office directly)
1. Is Dr. [name] taking new patients for obesity and type 2 diabetes?
2. What is the current wait for a first visit, and is there a shorter wait with another doctor on the same team?
3. Do you need a referral from my primary care doctor, and will you review my records and labs before the first visit?

At the two surgery programs, also ask for a written self-pay price for the sleeve and for the bypass, and what it includes. Neither program publishes one.

Your 3 steps this week:

1. Ask your primary care doctor's office to send you: your last two years of A1c and kidney results, your current medication list, your weight and BMI from each visit for at least two years, and office notes that record past weight-loss efforts (dietitian visits, programs, medicines tried). AHN says insurers often want official records from the doctors who treated you, not just what you write on an intake form.
2. Call one obesity medicine office and one bariatric program above and ask the three questions in the box. Signing up for a free bariatric information session does not commit you to surgery.
3. Call the member number on your insurance card and ask the questions below. Write down the representative's name, the date and a reference number.

Questions for your insurer (PPO): ask them exactly as written:

Medication:

1. "Is [medicine name] covered for weight management, for type 2 diabetes, or only for diabetes?" A 2026 survey by the International Foundation of Employee Benefit Plans found that 60% of employers cover these GLP-1 medicines for diabetes only and 36% cover them for both diabetes and weight loss (IFEBP, July 2026). Your own plan's answer is the one that counts.
2. "If it is covered only for diabetes, is it still covered for me, since I have type 2 diabetes? Which medicines are on your list for diabetes, and which for weight?"
3. "Does it need prior authorization? What are the written criteria (BMI, A1c, other medicines tried first)?" Ask them to send you the criteria document.
4. "Is there step therapy, meaning do I have to try metformin or another medicine first? How do you count a medicine I already tried?"
5. "Once approved, how often must it be re-approved, and what does it take to stay approved?"
6. "What is my monthly cost at the pharmacy, and is there a preferred brand on your list?"
7. "If coverage for this medicine changes during the year, how much notice do I get, and how do I appeal?"

Surgery:

1. "Is bariatric surgery a covered benefit on my plan, or is it excluded?" Ask for the number of their bariatric surgery coverage policy, and ask them to send it.
2. "How many months of supervised diet history do you require? Do the months have to be in a row? Does it have to be a physician, or can a dietitian supervise it? Does a commercial program, such as WW, count?" UPMC's page says insurers "usually require at least three to 12 consecutive months of documented diet history" (UPMC cost and insurance page).
3. "Does any weight gain during those months count against me?"
4. "How many years of weight history do you need, and will office notes from each visit do, or do you need something else? Is a letter from my doctor enough?"
5. "Do you require a psychological evaluation and a nutrition consultation before approval?" UPMC says many plans require nutrition and psychiatric consultations.
6. "Does UPMC's six-month presurgical program, or a program run by my primary care doctor, meet your requirement?"
7. "Are UPMC Magee-Womens, AHN West Penn / AHN Wexford and Cleveland Clinic in network, and is each surgeon in network?" Ask about both Pittsburgh systems by name.
8. "Do you have a 'center of excellence' rule that limits where I can have the surgery?"
9. "If you deny the request, can my surgeon ask for a doctor-to-doctor review, and what is the deadline to appeal?"

4. Stories from people who have been there

These are three strangers' online posts: anecdotes, not typical results, and not checked by anyone. They show three different ways the same operation went. The study figures in #3 of section 2 are the better guide to how often each happens. We found no first-hand account from the Pittsburgh area that we could open and read.

1. One person's post, r/gastricsleeve (about 2025): diabetes went away, so far. A 49-year-old man, newly found to have type 2 diabetes (A1c 9.2%, BMI 36), had a sleeve in March 2022. He reports an A1c of 5.6% three years later with no diabetes medicine, and writes: "I know relapse is possible." Thread
2. One person's post, r/gastricsleeve (about 2024): weight came back. A 49-year-old woman went from 212 to 150 pounds after a sleeve, then back to 195 six years later: "I feel like an idiot for letting this happen." She returned to her surgeon and, in a later update, had started a weight-loss medicine and was at 160. Thread
3. One person's post, r/gastricsleeve (about 2023): diabetes stayed. After more than 20 years of type 2 diabetes, nine months past a sleeve, this person was still struggling with blood sugar: "not sure I see it happening." Thread

5. Ready-to-send messages

Email to the specialist's office (copy it, fill in the brackets, send):

Subject: New patient request: obesity and type 2 diabetes, weighing medication and surgery
Hello, I am a 44-year-old woman in Pittsburgh with a BMI of about 41 and type 2 diabetes. I am trying to understand my options, including medication and weight-loss surgery. Dr. [name]'s work in [obesity medicine / bariatric surgery] is why I am contacting your program. Could you tell me:
(1) whether Dr. [name] is seeing new patients, (2) the current wait for a first visit, (3) whether a referral is needed, and (4) how I can send my recent lab results and records before the visit?
My insurance is [plan name, PPO]. Thank you, [name, phone]

Phone script (what to say in the first 30 seconds): "Hi, I'm calling to request a new patient appointment with Dr. [name]. I have obesity and type 2 diabetes, and I want to talk about [medication / surgery / both]. Is Dr. [name] seeing new patients? What's the wait? Do you need a referral, and how do I send my records?" Write down: the person's name, the date, the answer, the next step.

6. One-page summary to bring to the appointment

• What I'm here for: I have obesity (BMI about 41) and type 2 diabetes. I want to understand medication and surgery, and what fits my health and my life.
• My latest numbers: Height ____ Weight ____ A1c ____ (date ____) Blood pressure ____ Kidney test (eGFR) ____
• My diabetes medicines and doses: ____________________
• Other medicines and conditions (sleep apnea, reflux, blood pressure, mood, others): ____________________
• Weight-loss efforts I've tried (what, when, for how long, result): ____________________
• What my insurer told me (medication criteria, surgery requirements, in-network or not): ____________________
• My 3 most important questions: 1. ________ 2. ________ 3. ________
• What I want from this visit: ____________________

7. Questions to ask the specialist

1. How many patients with obesity and type 2 diabetes do you personally treat each year? And your team?
2. What results do you see for patients like me, on medication and after surgery? How often does diabetes go into remission, and how often does it come back?
3. How long is the wait for a first visit, and can you review my records beforehand?
4. The questions that usually decide between the two paths:
5. For my A1c, how long I've had diabetes, and the medicines I take now, what would you expect from medication alone, and from surgery?
6. If I start a medicine and later stop (because of side effects, cost or loss of coverage), what usually happens to my weight and blood sugar? What is the backup plan?
7. Which operation would you consider for me (sleeve or bypass), and why? What are the risks, including reflux, vitamin problems and the chance of needing another operation?
8. What does lifelong follow-up look like after surgery: visits, vitamins, blood tests?
9. Can medicine and surgery be combined, before or after an operation? When does that make sense?
10. How would each path affect my other conditions and my plans, such as work time off or a future pregnancy?
11. For the surgery team: how many of these operations does your program do a year, what is your rate of serious complications and readmissions, and do you report to MBSAQIP? Your 2024 JAMA results compared surgery with medical treatment. How do newer medicines change that picture for someone like me?
12. For the obesity medicine team: which medicines would you consider for me, what side effects should I expect in the first months, and how do you handle prior authorization paperwork?
13. What warning signs should make me call you or go to the ER? For example, very low blood sugar after starting a new medicine, severe belly pain, vomiting that won't stop, or chest pain.

8. Your support after this report

• 14 days of email questions about this report: reply to the delivery email.
• Day-30 check-in: we email you. If you could not get an appointment with any listed specialist, we research new options at no charge.
• Not helpful? Tell us within 7 days and we redo the research once at no charge; if it still doesn't help, we refund you in full.

This report is general information to help you find and talk to specialists. It is not medical advice, does not identify or confirm any condition, and does not recommend a treatment. Treatment decisions belong to you and your doctors. No doctor or hospital pays to be included in this report.