While GLP-1 drugs such as Ozempic and Zepbound have become popular for weight loss, new research suggests that weight-loss surgery may deliver superior long-term health benefits.
A study published Sept. 16 in Nature Medicine found that patients who underwent bariatric surgery lost more weight, lived longer, and had fewer serious health complications than those treated with GLP-1 medications.
Senior researcher Dr. Ali Aminian, director of the Cleveland Clinic’s Bariatric & Metabolic Institute, highlighted that the advantages went beyond weight reduction, including improved heart, kidney, and eye health outcomes.
Study Design and Patient Groups
Researchers examined nearly 4,000 patients with obesity and diabetes treated at the Cleveland Clinic between 2010 and 2017.
- 1,600+ patients underwent bariatric surgery (such as gastric bypass or sleeve gastrectomy).
- 2,300 patients were treated with GLP-1 drugs.
Follow-up lasted about six years, allowing comparison of long-term health outcomes.
Key Findings
Patients who underwent surgery experienced significant health advantages:
- 32% lower risk of death
- 35% lower risk of major heart problems
- 47% lower risk of serious kidney disease
- 54% lower risk of diabetes-related vision loss
In terms of weight loss, surgical patients lost nearly 22% of body weight over 10 years, compared to just under 7% for GLP-1 users. Surgery also led to better blood sugar control and reduced reliance on medications for diabetes, blood pressure, and cholesterol.
Expert Perspectives
Dr. Aminian emphasized that surgery should remain a cornerstone treatment option:
“These long-term benefits are harder to achieve with GLP-1 medicines alone, as many patients stop using the medications over time.”
Co-researcher Dr. Steven Nissen added that metabolic surgery may provide a survival advantage, even in an era of powerful new drugs.
Limitations and Future Research
The researchers cautioned that the study was observational, meaning it could not prove cause-and-effect between surgery and improved outcomes. They called for future clinical trials directly comparing surgery and GLP-1 drugs to confirm these findings.
Still, the results underscore that weight-loss surgery offers unique, durable benefits for people with obesity and diabetes — benefits that current medications may not fully match.
