Sleeve gastrectomy outperforms GLP-1 drugs in weight loss study

A large retrospective study in the United States has found that sleeve gastrectomy is more effective than GLP-1 medications, such as tirzepatide and semaglutide, for achieving and maintaining weight loss and glycemic control over a one-year period. The study analyzed data from 280 health systems, including 1,633 hospitals and 37,900 clinics, focusing on adults with a BMI of at least 35 kg/m² and HbA1c levels above 6.4%.

Researchers measured success based on a composite endpoint of 20% body weight loss and an HbA1c below 5.7%. The probability of achieving this endpoint was 24.0% for those undergoing sleeve gastrectomy, compared to 13.2% for those using tirzepatide and 3.0% for those using semaglutide. While surgery showed higher efficacy for weight and glucose management, it was also associated with more frequent emergency department visits within the first year compared to medication groups.

In addition to clinical treatments, medical experts emphasize that weight loss maintenance requires different skills than initial weight loss. Strategies for long-term success include establishing a realistic weight range rather than a single target number to account for natural fluctuations, and developing a reliable list of nutritious, easy-to-prepare meals to reduce decision fatigue.