When it comes to weight loss, surgery still dominates above. Research today shows that people under bariatric surgery tend to lose significantly more weight than people taking the latest, most effective GLP-1 drugs for obesity.
Scientists from New York University conducted the study that analyzed real-world data from patients with obesity. People who received surgery lost five times more weight for a two-year duration on average than those who were prescribed GLP-1 drug, they found. The findings also suggest that GLP-1 drugs are not as effective in the real world as they are in clinical trials, the researchers say.
“I think the removal is when you see a new popular drug coming out, you have to take it with a grain of salt. And I think you have to wait a few years for the actual world data to go out, as it may harden the results you see in tests,” Senior studio researcher Karan Chhabra, a bariatric surgeon and a grower grill boat from Growd Growd Growd Growd Growd Growd Growd Growd Growd Growd Growd Growd Growd Growd Growd Grow Growd Grosndo, from Growd’s Growd Fat.
Bariatric surgery – particularly the sleeveless gastric and gastric bypass – has long been considered the most effective treatment for obesity. People usually lose between 20% and 30% of their basic weight after surgery, and often experience long -term improvements in their overall health as a result.
But in recent years, the emergence of newer GLP-1 drugs as a semaglutide (the active ingredient in Ozempic and Wegovy) has dramatically changed the field of obese medicine. These drugs are typically more effective (and safer) than past non -surgical obesity treatments, with people on average losing between 10% and 20% of their weight in clinical trials. And they were also associated with healthy benefits That extends beyond weight loss.
At first glance, the data suggested that GLP-1 drugs could approach-or even exceeds– The effectiveness of bariatric surgery. But according to Chhabra, there was still no strict head-to-head comparison of these two different types of obesity treatments between real-world patients.
Chhabra and his colleagues attended the anonymous medical records of more than 50,000 people who have received surgery (whether sleeveless gastrictomy or gastric bypass) or GLP-1 therapy (whether semaglutid or tirzepatid) by NYU Langone Health or NYC Health + Hospital between 2018 and 2024.
On average, surgical patients lost 58 pounds (about 24% of their total weight) by the end of the second year, while GLP-1 patients on average lost 12 pounds (about 4.7% of their total weight)-fifthly difference. The results were slightly better for people who remained on their medicines for a full year (7% weight loss) and for those who took Tirzepatide, the latest and most effective GLP-1 drug available (8% to 9%). But the results were still diminished from the success seen with surgery – not to mention the results of earlier clinical trials.
The team’s findings were Presented This week at the annual meeting of American Society for Metabolic and Bariatric Surgery (ASMBS).
There are probably several reasons why these drugs are not successful as they seemed in trials, Chhabra noticed. Up to 70% of GLP-1 patients stop using the first year, for example. Some will stop because the side effects, typically gastrointestinal symptoms such as nausea and diarrhea, are too much to carry; Others may stop simply because they can no longer afford the drugs (GLP-1 drugs are often not covered by insurance and can cost more than $ 1,000 a month without coverage). Many of the GLP-1 patients in their study also never reached the maximum dose.
Chhabra also suspects that many people in the real world do not receive the supporting care and follow -up they will receive from doctors in a clinical test. GLP-1 drugs fed a growing telemedicine industry-for example, one in which people often prescribe the drugs remotely by medical professionals they will never interact with personally. (Until recently people could also easily put together compound versions of semaglutid and tirzepatid, with even less assurance of safety or efficiency.)
The researchers do not say that people with obesity should not take GLP-1 drugs, nor that bariatric surgery is the ideal option for everyone. Some people may prefer one-time treatment, for example, or may not have the insurance or resources needed to cover long-term GLP-1 therapy. Others may be nervous about going through any invasive procedure or have other pre-existing conditions that could complicate surgery but not GLP-1 therapy.
By the end of the day, people will have to ascertain the respective pros and opposites of these treatments, and those who choose to go with GLP-1s must manage their expectations, according to Chhabra.
“They must know that at least now in the real world, their weight loss will not be what we see with surgery and they must also know that it is lifelong treatment,” he said. “We still don’t have protocols for people to keep weight loss after they have stopped medicines, so it is important for people to only acknowledge those realities. And I care that many people start medicines without really knowing what they are in.”
The team later plans to sift more data to ascertain exactly why real-life patients on GLP-1 therapy do not lose as much weight as expected.
