Systematic reviews from 2020 to 2024 show that bariatric surgery provides the most durable and significant weight loss compared to other treatments, with up to 25% weight loss up to 10 years. Despite its great importance, bariatric surgery is still not used to treat severe obesity.
Systematic reviews of scientific data show significant differences in weight loss results between different methods.
Systematic reviews of the medical literature from 2020 to 2024 indicate that bariatric surgery, also known as metabolic or weight-loss surgery, results in significantly more effective and durable weight loss compared to GLP-1 receptor agonists and lifestyle changes. These findings were presented at the 2024 Annual Scientific Meeting of the American Society for Metabolic and Bariatric Surgery (ASMBS).
Researchers found that lifestyle changes such as diet and exercise led to an average weight loss of 7.4%, but this weight was regained in a total of 4.1 years. GLP-1s and metabolic and bariatric surgery were found to be superior. Studies include thousands of patients from clinical studies and several randomized clinical trials.
Five months of GLP-1 semaglutide injection resulted in a 10.6% weight loss and nine months of tirzepatide resulted in a 21.1% weight loss. However, if treatment is stopped, about half of the weight lost is regained within a year regardless of the medication used. If the injections are continued, tirzepatide patients will experience a 22.5% weight loss over 17-18 months. Patients on semaglutide were seen in 14.9% during the same period.
Semaglutide
Semaglutide is a drug used to control type 2 diabetes and obesity. It belongs to a class of drugs known as GLP-1 receptor agonists, which mimic glucagon-like peptide-1, which is important for blood sugar control and appetite control. By increasing Semaglutide, it helps lower blood sugar levels Insulin release, decreased glucagon secretion, and decreased gastric emptying. In addition, it reduces appetite, helps to lose weight when used for obesity. Administered by injection, it is available under brand names such as Ozympic for diabetes and Wegovi for obesity. Common side effects are gastrointestinal discomfort.
Metabolic and bariatric surgery procedures, gastric bypass and sleeve gastrectomy showed a total weight loss of 31.9% and 29.5% one year after surgery. Approximately 25% weight loss was maintained up to 10 years after surgery.
“Metabolic and bariatric surgery remains the most effective and durable treatment for severe obesity. Unfortunately, it remains among the most underutilized,” said study co-author and bariatric surgeon Marina Kurian, MD, NYU Langone Health. Obesity plays an important role in the treatment and should be considered early in the course of the disease. It is no longer a last-resort treatment and should not be withheld until more severe disease develops. There is no medical reason for this. “
Tirzepatide
Tirezepatide is a novel drug used for the treatment of type 2 diabetes and more recently for the treatment of obesity. It is a dual GLP-1 and GIP receptor agonist, meaning it targets both glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide receptors, which play a key role in insulin secretion and blood sugar regulation. This dual action not only enhances the body’s natural ability to regulate blood sugar levels, but also helps suppress appetite and help with weight loss. Injectable tirzepatide has been shown to be highly effective in improving glycemic control and reducing body weight, making it a good option for patients with type 2 diabetes or obesity. Like other drugs in the class, it can cause gastrointestinal side effects such as nausea and diarrhea.
of ASMBS reports In the year Approximately 280,000 metabolic and bariatric procedures will be performed in the US by 2022, representing only about 1% of those who meet eligibility criteria based on BMI. According to the US Centers for Disease Control and Prevention (CDC), obesity affects 42.4% of Americans. Studies show that the disease can weaken or weaken the immune system and cause chronic inflammation and increase many other diseases and conditions. Cardiovascular diseaseStroke, type 2 diabetes and some cancers.
“While new drug treatments show great promise and are helping more people to be treated successfully, especially if prices drop and insurance coverage improves, we’re using the best tool we have to fight obesity – metabolic and bariatric surgery, which is safer. And more than ever before.” It’s effective,” said Ann Rogers, MD, ASMS president-elect and professor of surgery at Penn State College of Medicine, who was not involved in the study. “For many people, the risks of obesity, diabetes and heart disease outweigh the risks of surgery.”
Study method
The study included a systematic review of studies examining weight loss through lifestyle modification, GLP-1s (semaglutide or tirzepatide), or metabolic and bariatric surgery. The GLP-1 data included four randomized clinical trials conducted between 2021 and 2024, and conclusions about lifestyle modifications were based on a systematic review of eight studies. Thirty-five studies including two randomized clinical trials of metabolic and bariatric surgery (gastric bypass and sleeve gastrectomy) were reviewed. Overall, researchers evaluated the weight loss outcomes of approximately 20,000 patients.
Reference: “Effectiveness and sustainability of common weight loss methods” by Megan E. Jenkins, Julian Hafferman, Christine Fielding, Gerhard Prager, and Marina Kurian, 11 June 2024, American Society for Metabolic and Bariatric Surgery (ASMBS) 2024 Annual Scientific Meeting.