Is Weight Loss Surgery more effective than Ozempic?

Ozempic has quickly grown in popularity and has no signs of slowing down.

It is being used for weight loss and demand has grown so much that it is changing the diet industry and spurring a “marketing bonanza” among the dozens of telehealth start-ups that now prescribe it.

Ozempic itself is technically a diabetes drug.

But its active ingredient, Semaglutide, has been approved for weight loss under Wegovy. Through a weekly injection, it can reduce a person’s body weight by up to 20%.

Celebrities are reportedly using Ozempic and Wegovy to lose weight.

An even more powerful drug may soon be approved for weight loss.

But for people with obesity, Semaglutide is not the most effective weight loss treatment.

Bariatric surgery, which has existed for decades, is still significantly more potent.

This class of procedures reconfigure the digestive system so appetite is reduced.

Most people experience around 50% weight loss.

Despite the impressive abilities of new weight loss drugs, several doctors says that surgery will likely continue to be the top-line treatment for obesity, even if medications improve.

Shauna Levy, a professor specialising in bariatric surgery at Tulane University School of Medicine, said people may seek treatment with the new drugs because of their popularity, but “long term, there will be an increase in surgery”.

Drugs like Ozempic may be less of a revolutionary fix for obesity and more of a tool for treating it.

Bariatric surgery does more than reduce appetite.

It exerts a less visible but equally powerful effect on the many different hormones that control hunger.

Some procedures remove the part of the gut that produces the “hunger hormone” ghrelin, while the rerouting of food through a Roux-en-Y ramps up the release of “incretin” hormones that create the feeling of fullness after eating.

In addition to potency, surgery is also more affordable than weight loss drugs.

Unlike the drugs, bariatric surgery is available on the NHS if the patient meets certain criteria. This includes having a BMI of 40 or more.

It is also available privately, with prices starting from £4,000.

This is not cheap but it is cheaper than spending over £1,000 a month indefinitely.

Holly Lofton, an obesity-medicine physician at NYU, said:

“The patient must understand that they have to continue taking medication forever.”

Both courses of treatment come with side effects.

Semaglutide can cause temporary but severe side effects such as nausea, vomiting, and diarrhoea.

For people who undergo weight loss surgery, full recovery usually takes four to six weeks. But in the long term, complications such as hernias, gallstones and low blood sugar can develop.

Although bariatric surgery is more effective, not people undergo it.

People hesitate for many reasons, medical and otherwise, but the most pervasive issue is a lack of awareness that surgery is even a safe or realistic option for weight loss.

It faces stigma. For example, in the 1990s, it was labelled a “barbaric” way to address an issue that, many believed, could be treated with diet and exercise.

The advantages that surgery has over weight loss drugs may change as the drugs become more potent and eventually cheaper.

But right now, Semaglutide won’t dramatically shift the way obesity is treated.

In fact, these new drugs may act as a conduit to surgery itself.

According to Levy, their popularity will cause a brief dip in the bariatric surgery rate, but as price remains an issue, and people with obesity are unable to reach their weight-loss goals on the drugs alone, “they may start opening their mind to surgery”.

In some patients, weight loss drugs on their own could lead to lasting weight loss.

They can also benefit those who are overweight but are ineligible for surgery.

But more widely, these drugs will likely be used in tandem with bariatric surgery to produce more dramatic, longer-lasting results.

Drugs can help fill any gaps that surgery leaves behind.

Weight can increase after surgery because the body has a way of rebalancing itself.

But despite the hype, weight loss drugs and bariatric surgery are not perfect treatments for obesity.

Lofton said: “It is not a cure.”

She explained that a cure would ensure that hunger does not return and fat cells do not get bigger.

She added: “We have nothing that does that”—not even more potent next-gen drugs will provide a permanent fix. But the effect of combining surgery and medication could come close.”

Obesity had long been misunderstood as laziness or gluttony and this has led to inadequate care.

Off-label use of diabetes medication, Ozempic and other drugs for weight loss frame obesity as a condition that can be treated with drugs.

And although surgery is more effective, a collective understanding of obesity as an illness will have a more profound impact on people.