Bariatric surgery results in greater weight loss than GLP-1 drugs after two years

Bariatric surgery results in greater weight loss than GLP-1 drugs after two years

Sleeve gastrectomy and gastric bypass were associated with approximately five times more weight loss than weekly injections of GLP-1 receptor agonists semaglutide or tirzepatide, according to a new, head-to-head study presented today at the American Society for Metabolic and Bariatric Surgery (ASMBS) Annual 2025 Study End of two years in metabolic and bariatric surgery (ASMBS) (ASMBS) (ASMBS) (ASMBS) (ASMBS) (ASMBS) (ASMBS) 20555555555555555555555555555555525

Researchers from NYU Langone Health and NYC Health + Hospitals found patients with one of the bariatric procedures lost an average of 58 pounds after two years, compared to 12 pounds for patients who received a GLP-1 prescription for at least six months (24% overall weight loss versus 4.7%). Patients with continuous GLP-1 therapy for a full year lost more weight, but significantly less than patients with bariatric surgery (7% total weight loss).

Clinical studies show weight loss between 15% and 21% for GLP-1s, but this study suggests that real-world weight loss is significantly lower even for patients who have a full year of active prescriptions. We know that up to 70% of patients can stop treatment within a year. GLP-1 patients may need to adjust their expectations, adhere more closely to treatment, or opt for metabolic and bariatric surgery to achieve desired results. “

Avery Brown, MD, senior study author, surgical resident at NYU Langone Health

The study was a retrospective comparative effectiveness study using the real-world electronic medical records of NYU Langon Health and NYC Health + Hospitals patients with a body mass index (BMI) of at least 35 who underwent bariatric surgery (Weve Gastectomy or the Roux-By-Pass) or 20 up to 202 up to 202 up to 202 up to to 202 to 202 to the semaglutide gastric semaglten had. The researchers compared BMI and comorbidities using average treatment effect effects in 51,085 GLP-1 and surgical patients. The study was supported by NYU CTSA Grant KL2 TR001446 from the National Center for the Advancement of Translational Sciences at the National Institutes of Health (NIH).

“In future studies, we will determine which health care providers can optimize GLP-1 outcomes, find out which patients are better treated with bariatric surgery than GLP-1, and the role of the study and bariatric surgeon patient outcomes committee, KARAN R. Chhabra, MD, MSC, MSC, MSC, MSC, MSC, Assistant Professor of MSC, MSC, Assistant Professor of Medical Surgery, to be determined.

About 12% of Americans say they have ever taken a GLP-1 drug, including 6% who say they are currently on treatment. A recent study found that more than half of patients with overweight or obesity (53.6%) discontinued GLP-1 therapy within one year (53.6%), a number that increases by two years to 72.2%. Meanwhile, the use of metabolic and bariatric surgery remains exceedingly low. According to the ASMBS, more than 270,000 metabolic and bariatric procedures were performed in 2023, representing only about 1% of those meeting eligibility requirements based on BMI.

“While both groups of patients lose weight, metabolic and bariatric surgery are much more effective and longer lasting,” said Ann M. Rogers, MD, FACS, Fasmbs, ASMBS president, who was not involved in the study. “Those with GLP-1 compliance or no challenges due to side effects or cost should consider bariatric surgery as an option or even in combination.”

According to the US Centers for Disease Control and Prevention (CDC), the prevalence of obesity and severe obesity is 40.3% and 9.4%, respectively. Studies show that the disease can weaken or impair the body's immune system and cause chronic inflammation and increase the risk of other illnesses and diseases, including cardiovascular disease, stroke, type 2 diabetes and certain cancers.

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