Weight Loss Surgery vs. Medication: What’s Better for Long-Term Health?

New research reveals that weight loss surgery, specifically Bariatric Metabolic Surgery (BMS), can provide a significant survival advantage over the popular diabetes medication class, GLP-1 receptor agonists (GLP-1 RAs), for adults with obesity and diabetes of up to 10 years.

The Key Findings:

• Adults with obesity and diabetes for 10 years or less who underwent BMS had a much lower risk of death compared to those who only took GLP-1 RAs.
• The study followed patients for about 6.8 years on average. The results showed that those who had surgery were 62% less likely to die from any cause compared to those on medication.
• This significant advantage is likely due to greater weight loss achieved through surgery compared to medication alone.

How the Study Was Conducted:

Researchers looked at the health records of patients from Clalit Health Services, the largest healthcare organization in Israel. They focused on people aged 24 and older who had both obesity and diabetes but no prior heart disease. These patients either had BMS or were treated with GLP-1 RAs.

The main goal was to see how many people died from any cause. They also looked at the occurrence of major non-fatal heart issues. To compare the two groups fairly, researchers used statistical methods to balance out any differences between them.

Why Surgery Outperforms Medication:

Dr. Alexander Abkin, a bariatric surgeon from New Jersey, explains, “The study clearly shows that for people who’ve had diabetes for less than 10 years, weight loss surgery offers a significant survival benefit. This is likely because surgery can lead to more substantial and sustained weight loss.”

Patients who had the surgery saw their body mass index (BMI) drop by an average of 31.4%, compared to just a 12.8% reduction in those who took GLP-1 RAs.

Impact of Diabetes Duration:

For people who had diabetes for more than 10 years, the study found no significant survival benefit from surgery compared to medication. Dr. Abkin suggests, “The longer you have diabetes, the more damage it does to your body, which might overshadow the benefits of weight loss.”

Interestingly, the study found that both treatment options had similar effects when it came to preventing major non-fatal heart issues, regardless of how long the patients had diabetes.

Practical Implications:

“This research suggests that for those who have had diabetes for a shorter period, weight loss surgery is particularly beneficial,” says Dr. Abkin. “It can lead to a much lower risk of death compared to relying on medication alone.”