Ozempic and similar drugs have changed the conversation about weight loss. Millions of people now use semaglutide or tirzepatide to control appetite and shed pounds. According to new research out of New York University, these medications don’t come close to one option that’s been around for decades: bariatric surgery.
The NYU team compared outcomes from sleeve gastrectomy and gastric bypass to GLP-1 drugs like Ozempic and Mounjaro. Drawing on health records, they matched patients by age, body mass index, and blood sugar levels. What they found was striking: surgery produced five times the weight loss of medication. Here’s what the study showed, and what it might mean for people considering their options.
NYU study on weight loss
Researchers looked at two major categories: those who underwent bariatric surgery and those prescribed semaglutide or tirzepatide. Over two years, patients who had surgery lost an average of 25.7 percent of their body weight. In comparison, people on the drugs lost just 5.3 percent.
The gap was clear even at earlier check-ins. While clinical trials of GLP-1 drugs have reported losses between 15 and 21 percent, real-world data told a different story. Adherence played a major role. NYU surgical resident Avery Brown noted that “as many as 70 percent of patients may discontinue treatment within one year”. Unlike surgery, which is permanent, medications only work as long as people take them.
The study also highlighted another benefit of surgery: better blood sugar control. Both groups improved, but patients who had gastric bypass or sleeve gastrectomy showed stronger improvements in glucose levels, reinforcing the long-standing role of bariatric procedures in managing type 2 diabetes.
It’s worth noting that the research was presented at the American Society for Metabolic and Bariatric Surgery annual meeting and funded in part by the same group. That connection raises questions about bias, though the findings are consistent with previous comparisons between surgery and medical therapy.
What this means for weight loss options
GLP-1 drugs remain more common than surgery, in part because they’re non-invasive and widely prescribed. Prescriptions for semaglutide nearly doubled from 2022 to 2023, but the data suggest expectations should be realistic. Medications may help with appetite and blood sugar, but they’re less effective at driving large, lasting weight loss unless patients stay consistent for the long term.
Bariatric surgery, by contrast, has a proven track record for both weight reduction and metabolic improvements. That doesn’t mean it’s an easy fix. The procedures are invasive, irreversible, and still require lifelong changes in diet, exercise, and follow-up care. For some, surgery is not a preferred choice despite its effectiveness.
Experts like NYU bariatric surgeon Karan Chhabra stress the need for more research to identify which patients respond best to drugs and which to surgery. Cost is also something to keep in mind, as insurance coverage and out-of-pocket expenses influence treatment adherence.
The bottom line is that surgery currently delivers the most powerful results for people with severe obesity, but Ozempic and similar drugs remain valuable tools for those not ready—or not eligible—for an operation.