It’s a very exciting time in obesity and bariatric science. Weight Loss Surgery vs. Weight Loss Drugs?
In addition to highly effective, safe, and accessible weight loss surgeries, powerful new medicines have entered the market in recent years that can trigger profound weight loss.
Semaglutide (sold as Wegovy and Ozempic) and liraglutide (sold as Saxenda and Victoza) make up a new generation of type 2 diabetes medications that are making waves for their powerful weight loss effects. Some studies on these drugs show an impressive 15% bodyweight loss over six months, while studies on a newer drug called irzepatide (sold as Mounjaro) show an astounding 22% weight loss over 6 months. Astonishingly, even more powerful medications are in development, and will likely become available in the next few years.
Those weight loss numbers are significant. For context, we know that losing just 5% bodyweight has a tremendous metabolic benefit for high BMI individuals. Achieving triple or quadruple those results via these new medications has profoundly positive implications for that person’s health.
How Do Weight Loss Drugs Work?
What do these new drugs have in common? They all stimulate the production of Glucagon-like peptide-1, or GLP-1, a hormone made in the gut to help signal that you’re full, along with other weight loss benefits (fewer excess calories stored, slower movement of food through the GI tract).
We know from bariatric surgery that this hormone increases post-surgery. In effect, these new medicines are cloning the hormonal effects of bariatric surgery, allowing patients to absorb this hormone exogenously (via injections) for the first time.
Bariatric Surgery vs. GLP-1 Drugs
Due to the effectiveness of these drugs, bariatric surgeons, weight loss experts, and prospect patients are asking the question: should I try weight loss medication instead of weight loss surgery?
It’s worth noting that at this time, bariatric procedures like gastric sleeve and gastric bypass are significantly more effective at triggering and maintaining weight loss. In part, this is because the surgical effect of increasing GLP-1 is logarithmically higher than it is with exogenous injections. Weight loss surgery is also a permanent solution — provided the patient sustains the necessary lifestyle changes — which is very different than needing weekly intravenous injections indefinitely.
But there is another, bigger downside to these medications: many of our patients report that they are only available at extremely high cost. In fact, these drugs can sometimes cost a patient over $1,000 per month — for many people in need of a weight loss intervention, this is simply unaffordable.
Because demand for these drugs vastly exceeds supply — even at their high price, Big Pharma can’t get them on shelves fast enough — it is unlikely that these drugs will come down in price any time soon.
Consider this: after ten months of exogenous treatment via these weight loss drugs, the patient or their insurance company has paid for the equivalent of a gastric sleeve procedure, with the results from the surgery being notably better and longer-lasting.
Weight Loss Surgery vs Medication: Choosing the Right Option for You – The Best Weight Loss Option: Combo Therapy
At BMI, we don’t view weight loss surgery and weight loss drugs as either-or options. Instead, we believe that whenever possible, the best therapy is combo therapy: weight loss surgery and GLP-1 drug treatment.
For instance, if a patient begins with weight loss surgery, and six months later, begins taking a GLP-1 drug, they might improve overall weight loss results by 20-30% — a significant advantage in the battle against obesity.
It’s worth noting that these new drugs were developed using research conducted on weight loss surgery patients. In other words, they are proven to work effectively together.
Every Effective Solution Counts
GLP-1 drugs like Wegovy, Ozempic, Saxenda and Victoza represent an incredibly exciting breakthrough in bariatric science. With well over two thirds of the country suffering from over weight or obesity — not all of whom are eligible for bariatric surgery — it is unquestionably good to have more safe, effective weight loss solutions to combat obesity, no matter the financial cost.
That’s why we believe that choosing weight loss medication vs surgery is usually the wrong question: whenever possible, they should be combined together to maximize results.
Put another way: when suffering from obesity, nothing is more important than safeguarding your health by making changes now. The only wrong choice is sticking with the status quo: the lifestyle choices that have not been working for you in reaching your weight loss goals.