A recent systematic review of scientific data from 2020 to 2024 has highlighted bariatric surgery as the most effective and sustainable weight loss treatment compared to other methods. The review, presented at the 2024 Annual Scientific Meeting of the American Society for Metabolic and Bariatric Surgery (ASMBS), found that bariatric surgery leads to the most substantial and enduring weight loss, maintaining approximately 25% weight loss for up to 10 years.
The study compared bariatric surgery to treatments involving GLP-1 receptor agonists and lifestyle changes. While lifestyle interventions like diet and exercise resulted in an average weight loss of 7.4%, this weight was typically regained within 4.1 years. In contrast, GLP-1s and bariatric surgery demonstrated superior outcomes.
For example, five months of weekly injections of GLP-1 semaglutide resulted in a 10.6% weight loss, and nine months of tirzepatide produced a 21.1% weight loss. However, once treatment stopped, approximately half of the lost weight returned within a year, regardless of the drug used. Patients who continued injections of tirzepatide plateaued at a 22.5% weight loss at 17-18 months, while those on semaglutide plateaued at 14.9% during the same period.
Bariatric surgery procedures such as gastric bypass and sleeve gastrectomy demonstrated total weight loss of 31.9% and 29.5% respectively one year after surgery. Remarkably, weight loss of approximately 25% was maintained for up to 10 years post-surgery.
Despite the significant benefits of bariatric surgery, the treatment remains underutilized in addressing severe obesity. Dr. Marina Kurian from NYU Langone Health emphasized that bariatric surgery should be considered earlier in the disease process and not as a treatment of last resort, as it is currently viewed.
The ASMBS reported that in 2022, nearly 280,000 metabolic and bariatric procedures were performed in the U.S., representing only about 1% of those eligible based on BMI. With obesity affecting 42.4% of Americans, there is a pressing need to explore and utilize effective weight loss interventions like bariatric surgery to combat the obesity epidemic.
The study’s methodology included a systematic review of studies examining weight loss through lifestyle modification, GLP-1s, or bariatric surgery, involving approximately 20,000 patients in total.
