Head-to-head study shows bariatric surgery superior to GLP-1 drugs for weight loss

Sleeve gastrectomy and gastric bypass had been related to about five-times extra weight reduction than weekly injections of GLP-1 receptor agonists semaglutide or tirzepatide, on the finish of two years, based on a brand new head-to-head real-world examine introduced at the moment on the American Society for Metabolic and Bariatric Surgical procedure (ASMBS) 2025 Annual Scientific Assembly.

Researchers from NYU Langone Well being and NYC Well being + Hospitals found sufferers who had one of many bariatric procedures misplaced a mean 58 kilos after two years, in comparison with 12 kilos for sufferers who acquired a GLP-1 prescription for no less than six months (24% complete weight reduction vs. 4.7%). Sufferers on steady GLP-1 remedy for a full 12 months misplaced extra weight, however considerably lower than bariatric surgical procedure sufferers (7% complete weight reduction).

“Medical trials present weight reduction between 15% to 21% for GLP-1s, however this examine means that weight reduction in the actual world is significantly decrease even for sufferers who’ve lively prescriptions for a complete 12 months. We all know as many as 70% of sufferers might discontinue remedy inside one 12 months,” stated lead examine creator Avery Brown, MD, a surgical resident at NYU Langone Well being. “GLP-1 sufferers may have to regulate their expectations, adhere extra carefully to remedy or go for metabolic and bariatric surgical procedure to realize desired outcomes.”

The examine was a retrospective comparative effectiveness examine utilizing the real-world digital medical report knowledge of NYU Langone Well being and NYC Well being + Hospitals sufferers with a physique mass index (BMI) of no less than 35 who had bariatric surgical procedure (sleeve gastrectomy or Roux en-Y gastric bypass) or had been prescribed injectable semaglutide or tirzepatide between 2018 and 2024.

After adjusting for age, BMI and co-morbidities utilizing common remedy impact weighting, researchers in contrast the outcomes of 51,085 GLP-1 and surgical sufferers. The examine was supported by NYU CTSA grant KL2 TR001446 from the Nationwide Middle for Advancing Translational Sciences on the Nationwide Institutes of Well being (NIH).

“In future research we are going to intention to establish what well being care suppliers can do to optimize GLP-1 outcomes, establish which sufferers are higher handled with bariatric surgical procedure versus GLP-1s, and decide the function out-of-pocket prices play in remedy success,” stated examine senior creator and bariatric surgeon Karan R. Chhabra, MD, MSc, Assistant Professor of Surgical procedure and Inhabitants Well being, NYU Grossman College of Medication.

About 12% of Individuals say they’ve ever taken a GLP-1 drug, together with 6% who say they’re at the moment in remedy. A current examine discovered that greater than half of sufferers with obese or weight problems (53.6%) discontinued GLP-1 remedy inside one 12 months (53.6%), a quantity that grows to 72.2% by two years.

In the meantime, utilization of metabolic and bariatric surgical procedure stays exceedingly low. In line with the ASMBS, greater than 270,000 metabolic and bariatric procedures had been carried out in 2023, which represents solely about 1% of those that meet eligibility necessities primarily based on BMI.

“Whereas each affected person teams reduce weight, metabolic and bariatric surgical procedure is way more efficient and sturdy,” stated ASMBS President Ann M. Rogers, MD, FACS, FASMBS, who was not concerned within the examine. “Those that get inadequate weight reduction with GLP-1s or have challenges complying with remedy resulting from uncomfortable side effects or prices, ought to take into account bariatric surgical procedure as an choice and even together.”

In line with the U.S. Facilities for Illness Management and Prevention (CDC), the prevalence of weight problems and extreme weight problems is 40.3% and 9.4%, respectively. Research present the illness can weaken or impair the physique’s immune system and trigger persistent irritation and enhance the chance of scores of different illnesses and circumstances together with heart problems, stroke, kind 2 diabetes, and sure cancers.

Offered by
American Society for Metabolic and Bariatric Surgical procedure