Bariatric Surgery vs. Anti-Obesity Medications: Which is Better for Long-Term Weight Loss Success?

Obesity is a chronic condition that impacts millions of people worldwide. In the United States, obesity rates have reached epidemic proportions with two-thirds of Americans classified as overweight. Obesity can lead to serious health problems such as diabetes, heart disease and some cancers.

While lifestyle changes can help some people achieve meaningful weight loss, they may not be enough on their own for those who are severely obese or have obesity-related medical conditions.

Sometimes, we need a leg up, which is why weight loss surgery has become a trusted, effective procedure for both significant, long-term weight loss and remission of obesity-related diseases. But with the introduction and rising popularity of prescription anti-obesity medications, known as Glucagon-like peptide-1 receptor agonists (or GLP-1 agonists), those in need of a long-term weight loss solution are weighing their options carefully.

If you’re considering your options, we’re here with expert answers to your questions about the differences between bariatric surgery and GLP-1 agonists from our world-class weight loss surgeon, Dennis Smith, MD, FACS, FASMBS.

What is Bariatric Surgery?

Bariatric surgery is a term that describes different types of procedures that reduce the size or function of your stomach, such as gastric bypass and sleeve gastrectomy. “These procedures can help people lose weight by limiting the amount of food they can eat, altering the hormones that regulate appetite and metabolism, or both,” explains Dr. Smith.

Also called weight loss surgery, bariatric surgery can improve or put into remission some obesity-related conditions, such as Type 2 diabetes, high blood pressure and sleep apnea.

Dr. Smith explains, “Bariatric surgery is not a quick fix for the short-term. It requires a lifelong commitment to follow a healthy diet, participate in physical activities and take vitamin and mineral supplements. Think of weight loss surgery as a whole health solution for the long term rather than a short-term quick fix.”

How Does Weight Loss Surgery Work?

Weight loss surgery has a metabolic effect that helps improve hunger, diabetes and other obesity-related conditions — making it effective for long-term weight loss.

Dr. Smith explains, “Bariatric operations work by a combination of restriction, malabsorption and changes in the way the body produces and suppresses gut hormones.”

What Are Weight Loss Medications?

Initially developed and approved for the treatment of Type 2 diabetes, the GLP-1 Agonist weight loss drugs were found to also produce substantial weight loss. While the amount of weight lost on weight loss drugs can come close to bariatric surgery results, it is evident that once the medications are discontinued, the pounds lost tend to be regained.

According to Dr. Smith, “The most popular weight loss medications are currently the GLP-1 agonists such as Ozempic, Wegovy and Mounjaro, and these medications supply manufactured versions of one or another of the gut hormones.”

Here is a further breakdown for convenience:

Semaglutide (Ozempic and Wegovy):

• Same medication, but one is FDA approved for diabetes and one for weight loss
• GLP-1
• Weekly injection

Tirzepatide (Mounjaro and Zepbound):

• Same medicine but one is FDA approved for diabetes and one for weight loss
• GLP-1 and GIP
• Weekly injection

How Do Weight Loss Drugs Work?

Dr. Smith says, “By supplying one or two of the gut hormones, the body can feel less hunger, more fullness on less food, and have some improvements in problems like diabetes.”

Weight Loss Surgery vs. Medication: Which is the Better Option?

All things considered, which is the better option, bariatric surgery or weight loss medication? Let’s weigh the pros and cons.

Bariatric Surgery is Associated With More Significant, Lasting Weight Loss

Weight loss surgery patients lose about of 25% to 35% of their body weight and 50% to 70% of their excess weight. GLP-1 agonists are associated with about 15% to 20% of total body weight loss, a less significant outcome.

Recent studies favor weight loss surgery for overall weight loss and Body Mass Index (BMI) reduction.

Weight Loss Drugs Will Cost You

It’s also important to consider that insurance carriers haven’t approved the use of weight loss drugs. Without insurance, they come with a high price tag, ranging between $800 and $1,200 per month.

Side Effects of Weight Loss Injections

Also, while weight loss medications can be effective for short-term weight loss, not only do patients experience unpleasant symptoms such as nausea, vomiting, headaches, dizziness, heartburn and more, weight regain is common once the drugs are discontinued.

“The most common side effects of the GLP-1 agonists are nausea, bloating, occasional vomiting, diarrhea or constipation,” clarifies Dr. Smith.

Bariatric surgery patients can enjoy long-term weight loss success by following their healthy lifestyle following the surgery.

The Better Choice

“Surgery alters many of the gut hormones at once, both stimulating and suppressing different ones, with each operation having a particular profile for how it affects the body’s hormones,” says Dr. Smith. He continues, “Surgery affects many more of the gut hormones than the medications can, and does so in a more lasting way. The operations also alter your anatomy, so there are physical effects on hunger and satiety, as well as changes in absorption. The operations are much more effective and the weight loss more durable than the medications.”

Factors to Consider

We want you to make the best choice for you and your unique circumstances. Important factors to consider when deciding on which path to take include:

• Cost and insurance coverage
• Degree of obesity
• Long-term maintenance
• Medical conditions
• Risks and side effects
• Sustainability

Dr. Smith gives his overall input with, “While the medications certainly have their place, surgery is by far more effective and permanent, not to mention cheaper for the long term than the medications. Once someone has exhausted non-surgical methods of weight loss and are ready to commit to it, surgery is by far the best option.”

Weigh Your Options

If you’re weighing your options and considering weight loss surgery, know that bariatric surgery can be a life-changing, life-saving choice for people who struggle with obesity and its effects. And at AdventHealth, we’re honored to help you reach your weight loss goals and maintain a healthy weight long-term so you can live your best life.

Visit AdventHealthWeightLoss.com to get started. You deserve to feel whole and live well.