Surgery or medication... who wins at losing weight?

Ozempic and other drugs have achieved remarkable weight loss results for many people, but a recent study has confirmed that they are still significantly less effective than surgery when comparing long-term results.

According to a report published by the Science Alert website, researchers from New York University (NYU) compared gastric sleeve and gastric bypass surgeries with medications such as semaglutide or tirzepatide.

These medications are known for their ability to mimic the natural hormone GLP-1, which is responsible for controlling appetite.

Using health records, the team matched people who took a weight-loss drug with those who underwent a known weight-loss surgery, based on age, body mass index, and blood sugar levels.

The results showed that people who underwent surgery lost an average of 25.7 percent of their total weight over two years, while those who relied on medication lost only 5.3 percent.

This is partly due to patients' lack of adherence to GLP-1 medications, whereas surgery provides more lasting results.

However, the researchers also noted clear differences even in shorter time periods, where surgery was always the most effective option.

“Clinical trials show weight loss between 15 percent and 21 percent for people taking GLP-1, but the study suggests that real-world weight loss is much lower even for patients with active prescriptions for a full year,” said Avery Brown, a surgical resident at New York University, when presenting the results in June.

He added, "We know that up to 70 percent of patients may discontinue treatment within one year. GLP-1 patients may need to adjust their expectations, adhere more closely to treatment, or choose metabolic and surgical intervention to achieve the desired results."

It's worth noting that the study was funded by the American Society for Metabolic and Weight Loss Surgery (ASMBS), which may have an interest in promoting the surgical option.

GLP-1 medications remain more popular than surgery, but adherence is low, and only a small percentage of those eligible for surgery choose this option.

Besides weight loss, Ozempic also helps lower blood sugar levels, and studies have shown that it reduces the risk of cancer and heart disease.

The study showed that surgery was associated with better control of blood sugar levels.

Surgery is not a magic solution. It is a permanent surgical procedure that requires a strict diet and exercise regimen.

“In future studies, we will seek to determine what healthcare providers can do to improve GLP-1 outcomes, determine which patients benefit most from surgery compared to medication, and understand the impact of out-of-pocket costs on treatment success,” said Karan Chhabra, MD, a metabolic surgeon at NYU Grossman School of Medicine.