Sleeve gastrectomy may produce greater and more durable weight loss than semaglutide in patients with obesity

1. Sleeve gastrectomy produces substantially greater and more durable weight loss than semaglutide over 12 months in patients with obesity.

2. Semaglutide is effective during treatment, but discontinuation frequently leads to clinically significant weight regain, highlighting the need for long-term treatment strategies.

Evidence Rating Level: 2 (Good) 

In this prospective, non-randomized study, sleeve gastrectomy (SG) was compared with once-weekly semaglutide for weight loss and metabolic outcomes in adults with obesity over 12 months. Thirty-six patients underwent SG and thirty-five received semaglutide following shared decision-making. SG achieved significantly greater weight loss at all time points, with a mean 12-month total weight loss of 28.6% compared with 11.3% for semaglutide. BMI reduction was also substantially greater after SG. Both interventions improved metabolic parameters, but SG resulted in greater triglyceride reduction and HDL-cholesterol increase. Semaglutide produced meaningful short-term weight loss; however, among patients who discontinued therapy after 6 months, weight regain was common, with nearly one-third returning to baseline weight. The study concludes that SG offers superior and more durable weight loss, while semaglutide is effective during active treatment but requires ongoing use to maintain benefit.

Click here to read this study in BMC Medicine

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