Weight loss injections vs. Weight loss surgery: Study finds surgery takes the lead over injections

In recent years, weight loss injections have become a global trend, with millions turning to popular GLP-1 medicines such as semaglutide and tirzepatide to manage obesity and type 2 diabetes.

These treatments have undoubtedly changed the conversation around weight management. However, a new study published in Nature Medicine has found that surgery still provides more powerful and lasting health benefits. The research looked at how people who underwent weight loss (metabolic) surgery compared to those who used GLP-1 medicines over several years and the results showed that surgery offered not only greater and more sustained weight loss but also better protection against serious health complications.

Weight loss surgery delivers greater and lasting benefits

For the study, researchers compared long-term outcomes in two large groups of people living with both obesity and type 2 diabetes. As stated in the journal, macrovascular and microvascular outcomes were compared in 1,657 patients (65.7% female) with type 2 diabetes and obesity who underwent metabolic surgery and 2,275 similar patients (53.5% female) who received treatment with GLP-1 RAs.What they discovered was striking. At the end of the study, patients who had metabolic surgery had a 32% lower risk of death, a 35% lower risk of major heart problems (such as heart attack, heart failure, or stroke), a 47% lower risk of serious kidney disease, and a 54% lower risk of diabetes-related eye damage (retinopathy).

These findings show that surgery offers long-term advantages that extend far beyond weight loss alone. “Even with today’s best medicines, metabolic surgery offers unique and lasting benefits for people with obesity and diabetes,” said Ali Aminian, M.D., director of Cleveland Clinic’s Bariatric & Metabolic Institute and primary investigator of the study. “The benefits we observed went beyond weight loss. Surgery was linked to fewer heart problems, less kidney disease, and even lower rates of diabetes-related eye damage.

”

Surgery helps with stronger, long-term weight control

While weight loss injections can help people lose weight quickly, the study found that their effects may fade over time if the medication is stopped or not taken regularly. Surgery, on the other hand, produced more consistent and lasting results. Patients who underwent metabolic surgery lost more weight overall and maintained it better through the years.This happens because surgery changes how the body processes food and controls hunger.

It helps reduce appetite and makes people feel full faster, supporting lasting lifestyle changes. Many patients who underwent surgery were able to make healthier food choices naturally and maintain active routines without the constant battle of cravings.Medicines, though beneficial, usually require long-term use to maintain their effects. Once stopped, the body often returns to its old patterns of appetite and weight gain.

This is one of the main reasons the research highlighted surgery as a more dependable long-term option for people with obesity and diabetes.

Weight loss surgery: Better health, fewer medicines, and improved energy

Beyond weight loss, surgery was found to help improve several aspects of daily health and wellbeing. Many patients were able to reduce the number of medicines they needed for diabetes, high blood pressure, and cholesterol. Better blood sugar control and improved heart and kidney function also meant a lower risk of long-term complications.Those who had surgery often experienced higher energy levels and an improved quality of life. Many could return to activities they had previously avoided, from simple daily movements to regular exercise. This boost in physical and emotional health demonstrates how weight loss surgery can transform more than just appearance. It can change how a person feels and functions every day.In comparison, while GLP-1 medicines can effectively help manage weight and blood sugar, they typically need ongoing use and may not deliver the same level of long-lasting improvement in overall health and energy.

Real-world impact: Surgery stronger than weight loss medicines

While newer GLP-1 medicines have revolutionised obesity care, the study makes it clear that weight loss surgery remains a powerful and proven option. In real life, people often struggle to stay on medications consistently or face side effects that make it hard to continue treatment long term. Surgery, though more demanding at first, offers results that last without the need for daily injections or lifelong prescriptions.The researchers noted that the findings came from real-world data rather than controlled experiments, meaning the results reflect how these treatments perform outside clinical trials. Even so, the differences were consistent and clear. For many people, surgery provided lasting improvements that medication alone could not match.As Dr. Aminian and his team emphasised, surgery should not be seen as a last resort but as a safe and effective treatment choice for people struggling with obesity and diabetes. It not only helps reduce weight but also protects the heart, kidneys, and eyes, three of the body’s most vital systems affected by long-term metabolic disease.While weight loss injections have changed obesity care, weight loss surgery continues to deliver stronger, longer-lasting benefits, helping people not only lose weight but live healthier, more active lives.Also Read | What most people miss about weight loss: How an AIIMS gastroenterologist lost 15 kg, reversed fatty liver, and boosted energy naturally