The recent study, presented at the American Society for Metabolic and Bariatric Surgery 2025 Annual Scientific Meeting, provides an in-depth comparison between bariatric surgery and GLP-1 medications in the context of obesity management. The study, which analyzed real-world data from 51,085 patients at NYU Langone Health and NYC Health + Hospitals, revealed that surgery results in significantly greater weight loss than injectable medications like Ozempic and Mounjaro. Patients who underwent bariatric surgery experienced an average of 24% total weight loss, whereas those on GLP-1 drugs saw only 4.7% weight loss. This disparity underscores the potential shortcomings of injectable treatments in achieving sustained weight loss and highlights the need for more effective long-term strategies. The findings were based on data from patients with a BMI of at least 35 who had either undergone bariatric surgery or were prescribed injectable medications between 2018 and 2024. The real-world data suggests that clinical trial results may not fully reflect the actual efficacy of GLP-1 medications in everyday practice.
Researchers reported that patients who had undergone bariatric surgery, which includes procedures such as sleeve gastrectomy and gastric bypass, lost an average of 58 pounds over two years, compared to 12 pounds for those on GLP-1 drugs. This significant difference in weight loss outcomes raises important questions about the long-term effectiveness of injectable treatments and the potential advantages of surgical interventions. According to the lead study author, Avery Brown, MD, a surgical resident at NYU Langone Health, the real-world effectiveness of GLP-1 medications is notably lower than the results observed in clinical trials. Brown emphasized that many patients who start GLP-1 therapy may discontinue it within a year, with up to 70% stopping treatment after one year. This highlights the need for better adherence strategies and the potential value of considering surgical options for patients seeking more substantial and lasting weight loss outcomes.
The study also noted that while GLP-1 drugs are becoming increasingly popular, their long-term adherence rates remain low. Research indicates that over 72% of patients discontinue GLP-1 therapy within two years, which raises concerns about the sustainability of these treatments as a primary solution for obesity management. In contrast, the adoption rate of bariatric surgery remains relatively low, with less than 1% of eligible patients undergoing the procedure in 2023, according to the American Society for Metabolic and Bariatric Surgery. This disparity in treatment adoption suggests a need for further exploration of the reasons behind the low uptake of surgery and the potential barriers patients face when considering these procedures. The study, funded by the National Institutes of Health, also underscores the importance of understanding patient preferences and treatment adherence in the context of obesity management and the search for effective, long-term solutions.
Additionally, the study highlights the potential challenges and limitations associated with GLP-1 treatments, particularly in terms of patient retention and long-term effectiveness. The findings suggest that while injectable medications may offer some benefit, they may not be as effective as surgical interventions for achieving significant weight loss over the long term. As researchers continue to explore the optimal approaches for obesity management, the study serves as a critical reminder of the need to consider both medical and surgical options in tailoring individualized treatment strategies. The study’s emphasis on the importance of adherence to treatment regimens and the potential benefits of surgical interventions could influence future guidelines and recommendations for the treatment of obesity, particularly in populations where GLP-1 medications are currently the primary option.