In the fight against obesity, surgery surpasses drugs

NEW YORK (HealthDay News)—A new study published in the journal Nature Medicine suggests that while newer drugs like Ozempic and Zepbound are gaining popularity for combating obesity, bariatric surgery may offer more lasting and profound health benefits for patients with obesity and diabetes.

The study, conducted by the Cleveland Clinic, analyzed nearly 4,000 people treated between 2010 and 2017. Of these, more than 1,600 underwent surgical procedures such as gastric bypass or sleeve gastrectomy, while nearly 2,300 were treated with GLP-1 drugs.

The results were overwhelming: those who opted for surgery lived longer and faced fewer serious complications.

“Even with today's best medications, metabolic surgery offers unique and lasting benefits for people with obesity and diabetes,” said Dr. Ali Aminian, director of the Cleveland Clinic Metabolic and Bariatric Institute. He emphasized that “the benefits we saw went beyond weight loss.”

The study data reveal that, after six years of follow-up, the patients who underwent surgery had a 32% lower risk of death, a 35% lower risk of major heart problems, a 47% lower risk of severe kidney disease, and a 54% lower risk of diabetes-related vision loss. These figures reinforce the idea that surgery not only transforms the body, but also the quality of life.

In terms of weight loss, surgery patients lost nearly 22% of their body mass over a decade, compared to less than 7% achieved by those taking GLP-1 drugs.

In addition, those who underwent surgery showed better blood sugar control and required fewer medications for diabetes, blood pressure, and cholesterol.

“These long-term benefits are more difficult to achieve with GLP-1 medications alone, as many patients discontinue the drugs over time,” Aminian cautioned.

His colleague, Dr. Steven Nissen, echoed this view: “Even in the era of these powerful new drugs for treating obesity and diabetes, metabolic surgery could provide additional benefits, including a survival advantage.”

However, the researchers clarified that the study was observational, so it cannot establish a direct causal relationship between surgery and improved outcomes. "Future clinical trials could increase the evidence by directly comparing surgery with GLP-1 drugs," they concluded.

This study reopens the debate about what should be the priority approach in the treatment of obesity and diabetes. While medications continue to evolve, bariatric surgery remains a solid and effective option, supported by clinical results that go beyond the scale.