SAN DIEGO – June 11, 2024 – Bariatric surgery, also known as metabolic or weight loss surgery, has been shown to result in the greatest and most sustained weight loss compared to GLP-1 receptor agonists and lifestyle interventions, according to a systematic review* of the medical literature from 2020 to 2024. The study was presented today at the American Society for Metabolic and Bariatric Surgery (ASMBS) 2024 Annual Scientific Session.
Researchers found that lifestyle interventions such as diet and exercise resulted in an average weight loss of 7.4%, but that weight was generally regained within 4.1 years. GLP-1 and metabolic and bariatric surgery proved to be much better. The studies included thousands of patients from clinical studies and multiple randomized clinical trials.
Five months of weekly injections of the GLP-1 semaglutide resulted in a 10.6% weight loss, while nine months of tirzepatide injections resulted in a 21.1% weight loss. But when treatment was stopped, patients regained about half of the weight lost within a year, regardless of which drug was used. With continued injections, patients taking tirzepatide saw their weight loss plateau at 22.5% over 17 to 18 months. Patients taking semaglutide saw their weight loss plateau at 14.9% over the same period.
The metabolic and bariatric surgeries gastric bypass and sleeve gastrectomy resulted in a 31.9% and 29.5% total body weight loss, respectively, one year after surgery. Approximately 25% weight loss was maintained for 10 years after surgery.
“Metabolic and bariatric surgery is the most effective and durable treatment for severe obesity. Unfortunately, it is also one of the most underutilized,” said study co-author and bariatric surgeon Marina Kurian, MD, of New York University Langone Medical Center. “Surgery needs to play a larger role in treating obesity and be considered earlier in the disease progression. Surgery is no longer a last resort and should not be withheld until more severe disease has developed. There is no medical reason for this.”
According to a report from the ASMBS, nearly 280,000 metabolic and bariatric surgeries will be performed in the United States in 2022, representing only about 1% of people who meet the eligibility requirements based on BMI. According to the Centers for Disease Control and Prevention (CDC), obesity affects 42.4% of Americans. Research has shown that obesity can weaken or impair the body's immune system and cause chronic inflammation, which can increase the risk of many other diseases and conditions, including cardiovascular disease, stroke, type 2 diabetes, and certain cancers.
“Although new drug treatments hold great promise and many more people will be successfully treated, especially as prices fall and insurance coverage expands, we are underutilizing the best tools we have to fight obesity: metabolic and bariatric surgery, which are safer and more effective than ever before,” said Anne Rogers, MD, president-elect of ASMBS and professor of surgery at Penn State College of Medicine, who was not involved in the study. “For many people, the risks of death from obesity, diabetes and heart disease outweigh the risks of surgery.”
research method
The study included a systematic review of studies that looked at weight loss with lifestyle modification, GLP-1 (semaglutide or tirzepatide), or metabolic and bariatric surgery. The GLP-1 data included four randomized clinical trials conducted between 2021 and 2024, and the conclusions on lifestyle modification were based on a systematic review of eight studies. Metabolic and bariatric surgery (gastric bypass and sleeve gastrectomy) were covered by the review of 35 studies, including two randomized clinical trials. In total, the researchers reviewed weight loss outcomes for nearly 20,000 patients.
About Weight Loss Surgery
Metabolic, bariatric, or weight loss surgeries, such as gastric bypass and sleeve gastrectomy, have proven to be the most effective, long-term treatments for severe obesity. These surgeries reverse or reverse diseases such as type 2 diabetes, heart disease, and high blood pressure, and result in significant, permanent weight loss. Their safety profile is comparable to some of the safest and most commonly performed surgeries in the United States, such as gallbladder surgery, appendectomy, and knee replacement.
About ASMBS
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