Real-world weight loss study finds surgery yields better results than Ozempic and other GLP-1 medications
In the world of weight loss, surgery remains the undisputed champion. Recent research shows that individuals undergoing bariatric surgery lose significantly more weight, on average, over a two-year period, than those relying on the latest GLP-1 medications for obesity.
New York University researchers conducted this study, examining real-world data from obesity patients. They found that surgical patients shed five times more weight than those using GLP-1 medication. The findings also hinted at GLP-1 drugs being less effective in real-life scenarios compared to their performance in clinical trials.
"The takeaway is simple," said senior study researcher Dr. Karan Chhabra, a bariatric surgeon at Bellevue Hospital and assistant professor of surgery and population health at NYU Grossman School of Medicine, speaking to Gizmodo. "When a new drug comes out, take it with a grain of salt. Wait for some real-world data to roll in, as it might soften the clinical trial results."
Bariatric surgery—particularly sleeve gastrectomy and gastric bypass—has long been regarded as the most effective treatment for obesity. Following surgery, individuals often lose between 20% and 30% of their initial body weight; they also tend to experience long-lasting improvements in general health.
In recent years, the emergence of newer GLP-1 drugs like semaglutide (found in Ozempic and Wegovy) has ignited a revolution in the field of obesity medicine. These drugs, generally, are more efficient and safer than previous nonsurgical treatments for obesity, with users commonly losing between 10% and 20% of their weight in clinical trials. These drugs, too, have been associated with health benefits beyond weight loss.
The data initially suggested that GLP-1 drugs might even match, or surpass, the effectiveness of bariatric surgery. However, Chhabra and his colleagues hadn't yet conducted a thorough, head-to-head comparison of these two methods of obesity treatment in real-life patients.
Chhabra and his team analyzed the medical records of over 50,000 people who received surgery (either a sleeve gastrectomy or gastric bypass) or GLP-1 therapy (either semaglutide or tirzepatide) through NYU Langone Health or NYC Health + Hospitals between 2018 and 2024. The patients' weight loss outcomes were tracked for two years, adjusting for factors like age, starting BMI, health conditions, and medications.
By the end of year two, surgical patients had lost an average of 58 pounds, while those relying on GLP-1 medication had lost an average of 12 pounds—a fivefold difference. The results improved for those who continued their medication for a full year (7% weight loss) and for those using tirzepatide (8-9% weight loss). However, the outcomes for both medication groups were still far from those achieved with surgery.
Chhabra attributed the drugs' lesser success to a myriad of factors. Approximately 70% of GLP-1 patients stop using the drugs within the first year due to side effects like gastrointestinal issues or financial constraints, as many insurance companies do not cover these medications. Moreover, it is common for patients to discontinue medication long before reaching the maximum dose.
Chhabra also believed that many people in the real world weren't receiving the same level of supportive care and follow-up they would get in a clinical trial, as the GLP-1 drug market has fueled a growth in telemedicine.
Chhabra and his team aren't advising against using GLP-1 drugs, nor advocating for bariatric surgery for everyone. They emphasized that individuals ought to consider a range of factors, and those choosing medication should have realistic expectations.
"They need to understand that, at least in the real world as of now, their weight loss won't be what we're seeing with surgery, and also be aware that it's a lifelong treatment," said Chhabra. "We still aren't sure exactly why real-life patients on GLP-1 therapy aren't losing as much weight as expected, so we'll be delving deeper into that data to find answers."
- The study conducted by New York University researchers, which compared weight loss results between bariatric surgery patients and those using GLP-1 medications, revealed that surgical patients lost five times more weight on average over two years.
- In the realm of health and wellness, not only is bariatric surgery effective in aiding significant weight loss, but it also contributes to long-lasting improvements in an individual's general health.
- Therapies and treatments like semaglutide, found in Ozempic and Wegovy, have emerged as more efficient and safer non-surgical options for obesity management, typically leading to weight loss between 10% and 20% in clinical trials.
- Despite the initial suggestion that GLP-1 drugs might match or exceed the effectiveness of bariatric surgery, a real-world comparison by NYU Langone Health and NYC Health + Hospitals researchers showed that surgical patients lost an average of five times more weight over two years compared to those relying on GLP-1 medications.
