If you are researching effective weight loss options for a problematic weight issue, your shortlist most likely includes GLP-1 receptor medications like Ozempic and surgical interventions such as gastric sleeve or gastric bypass.
GLP-1 medications and surgical procedures need to be fully understood before a safe comparison can be made. Dr Puhalla has put together a guide for you so that you can make an informed decision on the best long-term weight loss solution.
High Discontinuation Rates of GLP-1 Medications
GLP-1 receptor agonists, including Ozempic, have gained global popularity for their role in weight management as well as their primary role for type 2 diabetes treatment. They are effective and patients do not have to go through an operation.
However, it is important to hear the other side of the story:
- Studies reveal significant discontinuation rates among users.
- A cohort study involving over 125,000 patients found that 46.5% of those with type 2 diabetes and 64.8% without type 2 diabetes discontinued GLP-1 therapy within one year.
- Another study reported that 45.2% of patients stopped treatment at 12 months, increasing to 64.7% by 24 months.
Factors Leading To Discontinuation
Several factors contribute to the high discontinuation rates of GLP-1 medications:
- Counselling: Many patients start GLP-1s obesity treatment without proper counselling on diet, exercise and managing the side effects. Significant periods of counselling before and during are essential.
- Lifetime Commitment: Starting on GLP-1 medications is a lifetime commitment; it is not a short or medium-term solution. Most patients cannot maintain or adhere to the lifetime commitment for reasons of consistency, side effects and cost.
- Side Effects: Users often experience gastrointestinal issues such as nausea, vomiting and diarrhoea, leading to discomfort and treatment cessation.
- Cost: The financial burden of GLP-1 medications is significant, with expenses ranging from AUD140 to AUD 645 per month before any potential insurance coverage. This excludes people with diabetes who qualify for the PBS. Such high cost makes long-term adherence challenging for many individuals.
- Variable Efficacy: While some patients achieve notable weight loss, others experience minimal benefits, leading to dissatisfaction and discontinuation.
The withdrawal from GLP-1 treatment can have lasting health effects, with all the health risks returning and even increasing. Researchers from the above studies noted that participants who left the studies had a voracious return of their hunger. It is thought this is due to the body being left in a GLP-1 deficit.
Long-Term Benefits of Weight-Loss Surgery
In contrast, bariatric surgeries like gastric sleeve and gastric bypass offer more sustainable weight-loss outcomes. These procedures result in significant and durable weight loss, with studies indicating continued benefits for at least ten years post-surgery.
Advantages of Surgical Interventions
- Sustained Weight Loss: Bariatric surgery leads to substantial and lasting weight reduction, outperforming non-surgical therapies.
- Improvement in Comorbidities: Many patients experience remission or significant improvement in obesity-related conditions, including type 2 diabetes, hypertension and sleep apnea, enhancing overall quality of life. Studies have shown that surgery resolves this comorbidities more likely than GLP-1 medications. They also showed that surgical patients were less likely to die compared to the patients treated with medications.
- Cost-Effectiveness: Although the initial cost of surgery is higher, the long-term financial benefits are notable. Surgery is a cost-effective option over time due to reduced reliance on medications and decreased healthcare expenses related to obesity-related conditions.
Next Steps To A Thinner You
While GLP-1 medications like Ozempic offer non-surgical weight-loss options, their high discontinuation rates due to side effects, costs and variable efficacy are significant challenges for long-term weight management.
Bariatric surgeries, such as gastric sleeve and gastric bypass, give you a more sustainable outcome with significant weight loss and improvement in comorbid conditions.
Lastly, don’t weigh up your weight loss strategies alone. Get in touch with a healthcare professional to evaluate the most effective and sustainable options tailored to your health needs.
Chat with Dr Puhalla today about sustainable weight-loss solutions with expert surgical care.