Ozempic and similar weight loss drugs have helped many people shed pounds, but new research suggests they fall far short of surgery in delivering sustained weight loss.
A study by researchers at New York University compared two bariatric procedures—sleeve gastrectomy and gastric bypass—with popular medications semaglutide and tirzepatide. The drugs belong to a class known as GLP-1 receptor agonists, which suppress appetite by mimicking a natural hormone involved in blood sugar and hunger regulation.
Using health records, researchers matched patients who took GLP-1 drugs with those who underwent surgery based on age, body mass index, and blood sugar levels.
After two years, patients who had surgery lost an average of 25.7 percent of their total body weight. Those using medication lost 5.3 percent on average.
The gap was partly attributed to poor long-term adherence to GLP-1 drugs, while surgery produces more lasting changes. Even over shorter periods, however, surgery consistently led to greater weight loss.
“Clinical trials show weight loss between 15 and 21 percent for GLP-1s, but this study suggests real-world results are much lower,” said NYU surgical resident Avery Brown when the findings were presented in June. He noted that up to 70 percent of patients discontinue GLP-1 treatment within a year.
The study was funded by the American Society for Metabolic and Bariatric Surgery, an organization that supports surgical treatment, a factor the authors acknowledged.
Researchers stressed that GLP-1 drugs still provide meaningful benefits and remain an important option, especially as prescriptions have doubled between 2022 and 2023. Comparing medications with surgery, they said, is essential to help patients choose the most appropriate treatment.
“While both groups lose weight, metabolic and bariatric surgery is much more effective and durable,” said ASMBS President Ann M. Rogers, who was not involved in the research.
GLP-1 drugs remain more widely used than surgery, though many patients stop taking them. By contrast, only a small fraction of eligible patients opt for bariatric procedures.
Ozempic also offers benefits beyond weight loss. Originally approved to treat type 2 diabetes, it improves blood sugar control and has been linked to lower risks of cardiovascular disease and some cancers. Still, the study found that surgery produced even stronger blood sugar improvements.
Surgery is not without drawbacks. While generally safe, it is invasive, permanent, and requires strict long-term lifestyle changes.
Future research will focus on identifying which patients benefit most from medication versus surgery, how to improve adherence to GLP-1 drugs, and how treatment costs influence outcomes, said NYU bariatric surgeon Karan Chhabra.
Related topic：
