Bariatric Surgery Outperforms GLP-1 Medications for Weight Loss: New Head-to-Head Study

A recent comprehensive real-world study comparing weight loss outcomes of bariatric surgery versus GLP-1 receptor agonists reveals that surgical options such as sleeve gastrectomy and gastric bypass lead to significantly greater and more sustained weight loss than weekly injections of GLP-1 drugs like semaglutide or tirzepatide. Conducted by researchers from NYU Langone Health and NYC Health + Hospitals, the study found that patients undergoing bariatric procedures lost about five times more weight after two years compared to those on continuous GLP-1 therapy.

Specifically, patients who had one of the surgical procedures lost an average of 58 pounds, representing approximately 24% total weight loss, while those on GLP-1 medications lost only about 12 pounds or 4.7%. Patients adhering to a year-long GLP-1 treatment saw more weight reduction, but still significantly less than the surgical cohort, with about 7% total weight loss. These findings underscore the superior effectiveness and durability of bariatric surgery in managing obesity.

The study analyzed data from over 51,000 patients, adjusting for variables like age, BMI, and co-morbidities. It highlighted that, despite the popularity of GLP-1 drugs, their real-world efficacy often falls short of clinical trial results, with many patients discontinuing therapy within a year. Lead researcher Dr. Avery Brown emphasized that healthcare providers should consider these differences when recommending treatment options, noting that surgery remains a highly effective route for long-term weight loss.

Obesity remains a major public health challenge, with over 40% of Americans classified as obese and 9.4% as severely obese. This condition is linked to increased risks of chronic diseases such as cardiovascular conditions, diabetes, and certain cancers. While GLP-1 drugs provide a non-invasive option for weight management, the study clearly supports the idea that surgical interventions could offer more substantial and lasting benefits for suitable candidates.

Despite the evidence, utilization of bariatric surgery remains low, with only about 1% of eligible patients undergoing procedures annually. Experts suggest that addressing out-of-pocket costs, improving access, and providing better patient education could help bridge this gap. As Dr. Ann M. Rogers, President of ASMBS, notes, surgery offers a much more effective long-term solution for those struggling with weight loss, especially when medication options do not deliver expected outcomes.

This research adds to the growing body of evidence that underscores the importance of individualized treatment plans combining pharmacotherapy and surgical options to combat obesity effectively.

Source: https://medicalxpress.com/news/2025-06-bariatric-surgery-superior-glp-drugs.html