New Study Finds Weight-Loss Surgery Far More Effective Than Ozempic
New research from New York University suggests that bariatric surgery leads to substantially greater long-term weight loss than popular GLP-1 medications such as Ozempic and similar drugs. The analysis, based on real-world medical data, found that surgery may be about five times more effective over a two-year period.
The study compared patients who underwent sleeve gastrectomy or gastric bypass surgery with individuals treated using semaglutide or tirzepatide, two widely used GLP-1 receptor agonists. Researchers matched participants by age, body mass index, and blood sugar levels to minimize differences between the groups.
Study Results and Key Numbers
Over two years, patients who underwent bariatric surgery lost an average of 25.7 percent of their total body weight. By comparison, participants using GLP-1 medications lost an average of 5.3 percent, a difference researchers described as both clinically and statistically significant.
The researchers noted that lower real-world adherence to GLP-1 medications likely contributed to the gap. While clinical trials have reported weight loss of 15 to 21 percent with GLP-1 therapies, many patients struggle to remain on treatment long enough to maintain those results.
Avery Brown, a surgical resident at NYU involved in the research, said many patients discontinue the medications within the first year. According to Brown, up to 70 percent of users stop treatment during that time, limiting the long-term effectiveness of the drugs.
Benefits and Trade-Offs of Each Approach
The study confirmed that GLP-1 medications still provide meaningful health benefits, including weight reduction and improved blood sugar control. Originally developed for type 2 diabetes, these drugs have also been linked in other studies to lower risks of cardiovascular disease and some cancers.
However, bariatric surgery was associated with stronger long-term blood sugar control than medication alone in the NYU analysis. Researchers said this supports the idea that metabolic surgery influences not only weight loss but also hormonal pathways involved in diabetes.
Experts caution that surgery is not a simple or risk-free solution. Bariatric procedures are invasive and permanent, requiring lifelong dietary adjustments, exercise, and medical follow-up. Although complication rates are relatively low in experienced centers, surgical risks still exist.
Popularity, Bias, and Future Research
The study was funded by the American Society for Metabolic and Bariatric Surgery, an organization that supports surgical obesity treatment. The researchers acknowledged this potential conflict of interest but noted that the findings are consistent with earlier studies showing durable weight-loss results after surgery.
Despite its effectiveness, bariatric surgery remains significantly underused, with only a small percentage of eligible patients undergoing operations each year. Meanwhile, prescriptions for GLP-1 medications have rapidly increased worldwide as many people seek less invasive weight-loss options.
Ann M. Rogers, president of the ASMBS and not involved in the research, said both GLP-1 medications and bariatric surgery can help patients, but argued that surgery remains “much more effective and durable.”
Lead bariatric surgeon Karan Chhabra said future studies will focus on improving outcomes with GLP-1 drugs and identifying which patients are most likely to benefit from surgery versus medication. Researchers also plan to examine how treatment costs and insurance coverage affect adherence and long-term success.
The findings were presented at the ASMBS annual meeting in 2025 and add to growing evidence that, although GLP-1 medications are reshaping obesity treatment, bariatric surgery remains the most effective option for achieving substantial and sustained weight loss.
