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Washington D.C. , A new study presented this week at the American Society for Metabolic and Bariatric Surgery (ASMBS) scientific meeting reveals that bariatric surgery continues to outperform GLP-1 medications in achieving significant and sustained weight loss. The research, a real-world comparison analyzing data over several years, highlights a considerable difference in outcomes between the two approaches to obesity treatment.
Dr. Avery Brown, the study leader from NYU Langone Health, emphasized the discrepancy between clinical trial results and real-world effectiveness of GLP-1 drugs. “Clinical trials show weight loss between 15% to 21% for GLP-1s,” Dr. Brown explained, “but this study suggests that weight loss in the real world is considerably lower even for patients who have active prescriptions for an entire year.” The research team examined records of 38,545 patients prescribed injectable semaglutide or tirzepatide (GLP-1 medications) and 12,540 patients who underwent bariatric surgery, all with a starting BMI of at least 35.
After three years, the study found that patients who underwent bariatric surgery , either sleeve gastrectomy or gastric bypass , experienced an average weight loss of 24% of their initial weight. In contrast, patients using GLP-1 drugs for at least six months saw only about 5% weight loss, with a slight increase to 7% for those using them for a year. This represents an almost five-fold difference in weight loss outcomes.
“While both patient groups lose weight, metabolic and bariatric surgery is much more effective and durable,” stated Dr. Ann M. Rogers, President of ASMBS, who was not involved in the study. “Those who get insufficient weight loss with GLP-1s or have challenges complying with treatment due to side effects or costs, should consider bariatric surgery as an option, or even in combination.”
Why the difference? One crucial factor appears to be adherence. Dr. Brown noted that up to 70% of GLP-1 patients may discontinue treatment within a year, citing side effects, cost, and the need for continuous injections as potential barriers.
The findings have sparked debate online. A comment on X.com read, “So, surgery is still king? Guess the hype around Ozempic was just that—hype!” while on Facebook, a user wrote, “My doctor pushed me toward GLP-1s, but this makes me wonder if I should look into surgery again.”
- Bariatric surgery resulted in roughly five times greater weight loss than GLP-1 medications.
- Approximately 70% of patients discontinue GLP-1 treatment within one year.
- Surgery patients experienced a 24% average weight loss after three years.
- GLP-1 users saw only a 5-7% average weight loss over the same period.
- The study underscores the importance of considering long-term effectiveness and adherence when choosing a weight loss treatment.
The implications are significant for individuals struggling with obesity and for healthcare providers guiding treatment decisions. The *problemm* identified is that while GLP-1 medications offer a less invasive initial approach, their long-term effectiveness appears limited by adherence and potentially lower efficacy compared to surgery. The proposed solution is to ensure patients are fully informed about the long-term outcomes of both options, including the potential need for ongoing medication versus the more permanent nature of surgical intervention. The expected outcome is that individuals will make more informed choices aligned with their health goals and commitment levels, leading to improved long-term weight management and overall health.
The study does not diminish the role of GLP-1 medications as a treatment option. They can be beneficial for some patients, especially those who are not candidates for surgery or prefer a less invasive approach. However, the data underscores the importance of realistic expectations and a comprehensive understanding of the trade-offs involved.
One patient, Maria Rodriguez, shared her experience: “I tried semaglutide for six months. It helped me lose some weight initially, but the nausea was awful, and I eventually gained it back. I’m now considering surgery, and this study is really helping me think about it more seriously. A quiet turn in events,” she added, reflecting on her initial reluctance towards surgery.
Beyond weight loss, the researchers emphasize the broader health benefits of bariatric surgery, including improvements in blood sugar control, blood pressure, and cholesterol levels. These benefits can translate into a reduced risk of diabetes, heart disease, and other obesity-related complications. The *sturdy* results reinforce the role of bariatric surgery as a powerful tool in the fight against obesity and its associated health problems. It is a procedure that requires careful consideration and commitment, but for many, it offers a path to lasting weight loss and improved quality of life.
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