Bariatric surgery is more effective for weight loss than GLP-1 agonists among patients with obesity or diabetes subject

A multidisciplinary team multidisciplinary specialists from area the Clínica Universidad de Navarra published astudy showing that patients who underwent bariatric surgery achieved greater weight loss than those who received pharmacological treatment with GLP-1 receptor agonists or modified their lifestyle by improving their per diem expenses increasing physical exercise.   

The study,published in the journalObesityin collaboration with specialists fromthe Imperial Weight Centre in London (Imperial College Healthcare NHS Trust), includes data randomized clinical trials involving more than 20,000 obese patients and evaluates parameters such as total weight loss percentage, body mass index (BMI), and body composition. According toDr. Lucas Sabatella, training specialist training department General and Digestive Surgery at the Clinic and first author of work, "the difference in favor of bariatric surgery is consistently observed in the three indicators studied."  

The meta-analysis includes two surgical techniques—tubular gastrectomy and gastric bypass—and three drugs (liraglutide, semaglutide, and tizepatide), which has made it possible to compare each intervention within the same network . The results show that,although GLP-1 agonists produce clinically significant weight loss, bariatric surgery remains the most effective strategy for reducing weight—which considers each patient's initial weight—at least two years after the start of surgery, drug treatment, or lifestyle change.  

"Drug treatment with tirzepatide showed particularly favorable results in clinical trials, but these programs of study conducted in a context of very close medical monitoring in which patients achieve their goals more easily," Dr. Sabatella points out. Likewise, programs of study patients who do not receive such continuous professional support report that more than half of patients discontinue treatment in the first few months, which limits its effectiveness.   

Added to this is "the lack of robust information on the long-term efficacy and safety of these drugs, while programs of study show that patients who discontinue treatment with GLP-1 agonists suffer a significant rebound effect, with partial or total recovery of lost weight."  

The Dr. Víctor Valentí, co-director of area the Clinic, emphasized that "bariatric surgery is a procedure with a very leave complication rate. It is the best option for appropriately selected patients. The drugs act on intestinal hormones that regulate appetite, metabolism, and glucose, increasing satiety, but they have a high withdrawal rate, withdrawal translates into weight regain." 

Results in patients with diabetes subject

The work the Clinic's specialists also includes a subanalysis of patients with subject diabetes, where it was observed that weight loss, BMI reduction, and waist circumference reduction were even greater among those who underwent bariatric surgery. However, the authors emphasize that GLP-1 agonists also significantly improve glycemic control and are an effective tool , especially in patients who are not candidates for surgery.  

The Dr. Manuel Landecho, a specialist in Internal Medicine in area and the Check-up Unit at the Clinic, explained that "obesity is a chronic disease in which the patient's expectations are central to the treatment and determine the best treatment option in each case. However,for people with greater accumulation of adipose tissue or those whose obesity more severely limits their daily lives, surgery is a clearly superior treatment, andit is essential that they evaluate all therapeutic alternatives. Specialists can and must personalize treatment as much as possible."