A brand new real-world comparability finds that bariatric surgical procedure results in dramatically extra weight reduction than fashionable injectable drugs. After two years, individuals who underwent sleeve gastrectomy or gastric bypass misplaced about 5 instances extra weight than these utilizing weekly GLP-1 receptor agonists corresponding to semaglutide or tirzepatide,* in keeping with analysis offered on the American Society for Metabolic and Bariatric Surgical procedure (ASMBS) 2025 Annual Scientific Assembly.
The research, performed by researchers at NYU Langone Well being and NYC Well being + Hospitals, confirmed that surgical procedure sufferers misplaced a median of 58 kilos over two years. In distinction, sufferers who had been prescribed a GLP-1 drug for at the very least six months misplaced about 12 kilos. That interprets to 24% whole weight reduction for surgical procedure sufferers in contrast with 4.7% for these utilizing treatment. Even amongst sufferers who stayed on GLP-1 remedy constantly for a full 12 months, common weight reduction reached solely 7%, nonetheless far beneath the outcomes seen with surgical procedure.
Actual-World Outcomes Fall Wanting Scientific Trials
“Scientific trials present weight reduction between 15% to 21% for GLP-1s, however this research means that weight reduction in the actual world is significantly decrease even for sufferers who’ve energetic prescriptions for a complete 12 months. We all know as many as 70% of sufferers might discontinue therapy inside one 12 months,” mentioned lead creator Avery Brown, MD, a surgical resident at NYU Langone Well being. “GLP-1 sufferers might have to regulate their expectations, adhere extra intently to therapy or go for metabolic and bariatric surgical procedure to realize desired outcomes.”
The findings spotlight a key hole between managed medical trials and on a regular basis use, the place uncomfortable side effects, prices, and long-term adherence can restrict the effectiveness of medication-based weight reduction.
How the Research In contrast Surgical procedure and GLP-1 Drugs
Researchers analyzed digital medical document information from sufferers handled between 2018 and 2024 throughout the NYU Langone Well being and NYC Well being + Hospitals programs. All individuals had a physique mass index (BMI) of at the very least 35 and both underwent bariatric surgical procedure (sleeve gastrectomy or Roux en-Y gastric bypass) or acquired a prescription for injectable semaglutide or tirzepatide.
After adjusting for components corresponding to age, BMI, and co-morbidities utilizing common therapy impact weighting, the crew in contrast outcomes for 51,085 sufferers throughout each teams. The research was supported by NYU CTSA grant KL2 TR001446 from the Nationwide Middle for Advancing Translational Sciences on the Nationwide Institutes of Well being (NIH).
Future Analysis and Therapy Choices
“In future research we are going to goal to determine what healthcare suppliers can do to optimize GLP-1 outcomes, determine which sufferers are higher handled with bariatric surgical procedure versus GLP-1s, and decide the function out-of-pocket prices play in therapy success,” mentioned senior creator Karan R. Chhabra, MD, MSc, a bariatric surgeon and Assistant Professor of Surgical procedure and Inhabitants Well being at NYU Grossman Faculty of Drugs.
GLP-1 medication have gained widespread consideration, with about 12% of People reporting they’ve taken one in some unspecified time in the future and 6% saying they at the moment use them. Nonetheless, persistence stays a significant problem. Latest analysis exhibits that 53.6% of sufferers with chubby or weight problems cease GLP-1 remedy inside one 12 months (53.6%), and that determine rises to 72.2% by two years.
On the identical time, bariatric surgical procedure stays underused. In response to the ASMBS, greater than 270,000 metabolic and bariatric procedures had been carried out in 2023, representing solely about 1% of people that meet BMI eligibility standards.
“Whereas each affected person teams drop some weight, metabolic and bariatric surgical procedure is far more efficient and sturdy,” mentioned ASMBS President Ann M. Rogers, MD, FACS, FASMBS, who was not concerned within the research. “Those that get inadequate weight reduction with GLP-1s or have challenges complying with therapy because of uncomfortable side effects or prices, ought to think about bariatric surgical procedure as an possibility and even together.”
Weight problems Stays a Main Well being Problem
In response to the U.S. Facilities for Illness Management and Prevention (CDC), weight problems impacts 40.3% of adults in america, whereas extreme weight problems impacts 9.4%. Analysis exhibits weight problems can impair immune perform, drive power irritation, and lift the chance of many severe circumstances, together with heart problems, stroke, kind 2 diabetes, and sure cancers.
*Semaglutide is the energetic ingredient in Ozempic and Wegovy and tirzepatide is the energetic ingredient in Zepbound and Mounjaro.
