Weight Loss Drugs vs. Bariatric Surgery: Which Option Works Best?

We’ve all seen the headlines. When a celebrity loses weight, medications like Ozempic and Wegovy get all the credit. But are these medications really effective? And do they work over the long-term?

Researchers are trying to find out, and their results are interesting.

In a recent study by the American Society for Metabolic and Bariatric Surgery, researchers found that weight-loss surgery helped people lose and keep off weight better than GLP-1 drugs.

People taking GLP-1 agonists (Ozempic, Wegovy, Mounjaro or Zepbound) lost an average of 10-21 percent of their weight but regained about half a year after stopping the medications. This means they ended up with only 5-11 percent weight loss.

In comparison, people who have weight-loss surgery maintained around 55 percent weight loss.

Learn more about how GLP-1 agonists work and how they compare to weight-loss surgery.

How Do Medications Like Ozempic Work?

Medications like Ozempic and Wegovy are GLP-1 agonists that lower and help regulate blood sugar levels. They were first used to treat Type 2 diabetes, but they can also help people lose weight.

Using GLP-1 Drugs for Weight Loss

GLP-1 is a naturally occurring hormone in your body that can:

• Regulate your blood sugar through the hormones insulin and glucagon.
• Slow digestion and increase the feeling of fullness after eating.

GLP-1 agonist medications, taken as a pill or injection, copy these effects. As a result, people report feeling fuller and having a lower appetite, which can lead to weight loss. However, these changes only last while you take the medication.

Bariatric surgeon Joseph Melendez-Davidson, MD, notes that studies on weight loss medications are usually performed using brand-name drugs. However, many medications being sold contain diluted amounts of the active ingredient. Patients taking these medications are less likely to achieve their weight-loss goals.

As your body gets used to weight-loss medications, they become less effective. Patients often increase their dosage until they’re at the maximum limit.

The effects of medications only last as long as you take them. Once you stop using a GLP-1 agonist, your hormone and hunger levels return to normal.

How Does Weight-Loss Surgery Work?

Bariatric surgery helps you lose weight by permanently changing your digestive system. Several weight-loss surgery options exist, and they all work a little differently.

Typically, weight-loss surgery can:

• Make your stomach smaller, which limits the amount of food you eat
• Reduce the calories your body absorbs
• Lower your appetite

For example, during a sleeve gastrectomy surgery, doctors remove 75 percent of the stomach, including an area that makes a hunger-inducing hormone. As a result, you feel less hungry and eat less.

During a Roux-en-Y gastric bypass surgery, doctors make the stomach smaller and reroute it, so it bypasses part of your intestines. This means you eat less and absorb fewer calories.

Most people with a body mass index (BMI) over 35 are eligible for weight-loss surgery. People with a BMI over 30 may be eligible if they haven’t been able to sustain long-term weight loss.

Weight-Loss Surgery Leads to Long-Lasting Results

Surgery could be a smart choice for people wanting long-term weight loss, especially if they have a large amount of weight to lose.

Bariatric surgeon Brett Cohen, MD, encourages people to set goals based on expected weight loss for excess weight, not total weight. For example, a 250-pound person may be 100 pounds overweight. Years after stopping weight loss medications, they may only have lost 12-28 pounds. If that same person had weight-loss surgery, that would be closer to 63 pounds according to the results of the study. This puts them much closer to their 100-pound weight-loss goal.

So how can someone lose those last 37 pounds to reach their goal?

“The patients who do the best are involved in comprehensive weight-loss programs that include nutrition education, counseling and more,” says Dr. Cohen.

Memorial Healthcare System offers extra support to help people achieve their goals. Patients participate in bariatric surgery support groups, medical exercise training program, and nutritional guidance from a dietician.

Side Effects of GLP-1 Agonists

It’s important to consider the risks and side effects of any weight loss treatment. Here’s what you need to know about the risks of GLP-1 agonists and bariatric surgery.

People taking a GLP-1 agonist could experience:

• Allergic reactions
• Diarrhea
• Dizziness
• Headaches
• Increased heart rate
• Indigestion
• Nausea and vomiting
• No appetite

In rare cases, using GLP-1 agonists can lead to a pancreatic inflammation or pancreatitis, thyroid cancer, or kidney injury. In addition, in some patients, depending on your medical history, it may not be safe for use. For people with diabetes-related retinopathy, it can worsen this eye disease.

Side Effects of Weight-Loss Surgery

Minimally invasive bariatric surgery has a very low rate of complications and there is no risk of cancer; in fact, bariatric surgery may decrease your risk of developing certain types of cancer. But with any surgery, there is a risk of bleeding, infection and reactions to anesthesia.

People who get bariatric surgery could experience:

• Acid reflux
• Diarrhea
• Gallstones
• Hernias
• Low blood sugar
• Nausea and vomiting
• Ulcers

Talk with an Expert About Weight-Loss Surgery

It’s not easy to weigh your options and decide which weight loss solution is right for you. Weight-loss surgery remains the most effective and sustainable treatment for obesity to date. We can help you determine your best option.

Start by having a conversation with one of our medical weight-loss specialist. You can also request a consultation or call us at 954-276-1400.