Comparing Bariatric Surgery and Incretin Agonist Therapy

Obesity rates are rising globally, leading to higher risks of cardiometabolic diseases, decreased quality of life, and reduced life expectancy. Effective treatments are crucial for significant and lasting weight loss, which can help prevent or mitigate obesity-related diseases. Bariatric surgery is a proven method for weight loss, with studies showing long-term results lasting over a decade. It also positively affects cardiometabolic risk factors, such as high blood sugar, type 2 diabetes, hypertension, and abnormal cholesterol levels. Additionally, patients who have undergone bariatric surgery experience lower rates of overall mortality, cardiovascular issues, and cancer compared to those who did not have the surgery.

New medications, particularly incretin agonists like semaglutide and tirzepatide, have shown strong effectiveness in achieving and maintaining weight loss. Like bariatric surgery, these drugs also improve outcomes for type 2 diabetes and reduce cardiovascular risks and other complications associated with obesity, though long-term data is still pending. This perspective article evaluates and compares the effectiveness of bariatric surgery versus incretin agonist therapies in terms of weight loss, impacts on obesity-related issues, risk profiles, costs, and access equity. The analysis can help in determining if these increasingly favored medications could potentially replace the need for bariatric surgery.

Source:Lah S, Hocking SL. Treatment of obesity: will incretin agonists make bariatric surgery a thing of the past? Intern Med J. 2025 Mar;55(3):369-375. doi: 10.1111/imj.16625. Epub 2025 Feb 21. PMID: 39981788.