Ozempic and other semaglutide medications have shown impressive results for weight loss in many individuals. However, new research indicates that they fall short when compared to surgical options. It isn’t even a close comparison.
A team from New York University (NYU) examined the effectiveness of sleeve gastrectomy and gastric bypass surgeries against semaglutide or tirzepatide, drugs that act as glucagon-like peptide-1 (GLP-1) receptor agonists by mimicking the natural GLP-1 hormone, which plays a role in regulating appetite.
By analyzing health records, the researchers paired individuals who had taken the weight loss medications with those who underwent the bariatric surgeries, matching them by age, body mass index, and blood sugar levels.
The findings revealed that those who had surgery lost an average of 25.7 percent of their body weight over two years. In contrast, the medication group had a mere 5.3 percent reduction.
This difference can be attributed in part to the fact that patients often do not continue with their GLP-1 medications, while surgery offers a more permanent solution. Even in the short term, surgery consistently yielded better outcomes.
“Clinical trials indicate weight loss between 15 percent and 21 percent for GLP-1s, but our study suggests that real-world results are much lower, even for those with active prescriptions for a year,” said NYU surgical resident Avery Brown during the presentation of the findings in June.
Brown also noted that approximately 70 percent of patients might stop the treatment within a year. He suggested that GLP-1 patients may need to recalibrate their expectations, strictly adhere to their treatment, or consider surgical options for better results.
It’s essential to point out that the study received funding from the American Society for Metabolic and Bariatric Surgery (ASMBS), which has an interest in promoting surgical methods.
The researchers did not discount the benefits of semaglutide treatments, as they also showed positive results. With GLP-1 prescriptions having doubled from 2022 to 2023, it’s essential to explore how these compare to traditional surgical methods and determine which options suit individuals best.
“While both groups lose weight, metabolic and bariatric surgery is significantly more effective and sustainable,” stated ASMBS President Ann M. Rogers, who was not involved in the study.
Although GLP-1 drugs are more popular than surgery, compliance is a notable issue; many don’t stick to their prescribed treatments. Conversely, a limited number of eligible individuals choose surgery as an option.
Weight loss isn’t the only advantage of Ozempic. Initially approved for type 2 diabetes, it aids in lowering blood sugar levels, and research shows it may also reduce the risk of cancer and cardiovascular disease.
This study found that bariatric surgery led to even better management of blood sugar levels.
However, it’s crucial to understand that surgery isn’t a perfect solution either. Though generally safe, these procedures are invasive, permanent, and still require serious commitment to diet and exercise afterward.
“Future research will seek to find ways for healthcare providers to enhance GLP-1 outcomes, pinpoint which patients might benefit more from surgery versus GLP-1s, and analyze the impact of out-of-pocket costs on treatment effectiveness,” remarked Karan Chhabra, a bariatric surgeon at NYU Grossman School of Medicine.
The research was shared at the ASMBS annual meeting in 2025.
