At Sea Change Weight Loss Clinic, we understand that achieving sustainable weight loss is a personal journey, often involving complex decisions about the most effective treatment path.
Clinical obesity is a chronic systemic disease, and its management requires personalised strategies that consider individual health, lifestyle and long-term goals.
This article explores two of the most effective options available: weight loss medications (also known as obesity management medications or OMMs) and weight loss surgery (also known as metabolic bariatric surgery or MBS), and what we understand about their suitability and effectiveness.
Effectiveness of Weight Loss Medications vs. Weight Loss Surgery
Weight loss medications, such as GLP-1 receptor agonists like semaglutide and tirzepatide, have emerged as popular treatments for weight management. These medications work by mimicking hormones that regulate appetite and promote satiety, leading to clinically meaningful weight loss and health improvements when used continuously. Clinical trials have demonstrated that weight loss medications can lead to significant weight loss, for instance an average of 15% of initial body weight loss over 68 weeks when combined with a reduced-calorie diet and increased physical activity.1 However, real-world studies suggest that the actual weight loss experienced by patients on GLP-1s might be lower than in clinical trials, with one study showing an average of 4.7% total weight loss over two years.2
In contrast, weight loss surgery, including procedures like sleeve gastrectomy, is widely recognised as the most effective and long-lasting treatment for severe obesity. Studies consistently show the superior effectiveness of weight loss surgery. A landmark prospective study, the Swedish Obese Subjects study,3 indicated maximal weight loss of 20–32% at one to two years post-surgery, sustained at 18% even after 20 years. Weight loss surgery is also known to significantly improve or resolve conditions such as type 2 diabetes, heart disease and high blood pressure, and to reduce mortality, particularly from cardiovascular disease and cancer.
Suitability for Weight Loss Medications vs. Weight Loss Surgery
Weight loss medications are often suitable for obese individuals who have not achieved success with lifestyle modifications alone. They can be an excellent option for those who prefer a non-surgical approach or need to jumpstart a healthier lifestyle.
However, it’s crucial to acknowledge that weight loss medications typically require ongoing, lifelong use, as discontinuing them often leads to recurrent weight gain and the recurrence of complications.4 Challenges with weight loss medications can also include ongoing costs and potential side effects such as nausea and vomiting.
Weight loss surgery is generally considered for individuals with severe obesity or when comorbidities are inadequately controlled by other methods. It offers a permanent solution with lasting results, impacting hormones like GLP-1 in a way that medications cannot replicate, leading to a more sustainable outcome. While weight loss surgery has higher upfront costs, after approximately 2 years, it is generally more cost effective. This is due to reduced obesity-related complications and costs of lifelong medication. The safety profile of weight loss surgery is comparable to other commonly performed surgeries.
Integrating Weight Loss Medications and Surgery
The decision between weight loss medications and weight loss surgery should not be seen as mutually exclusive. Instead, these treatments can be complementary strategies within a comprehensive, sustainable weight management plan.
For individuals who have achieved substantial weight loss with weight loss medications but are unable to tolerate or adhere to pharmacotherapy, or who prefer a single, durable intervention, weight loss surgery offers an evidence-based alternative.
Starting Your Weight Loss Journey
At Sea Change Weight Loss Clinic, we recognise that obesity is a chronic disease, and our qualified bariatric surgeons and multidisciplinary team are dedicated to providing a holistic approach that aims to maximise each patient’s long-term success.
We offer both a medical weight loss program and surgical options for suitable patients. To embark on your weight loss journey, we encourage you to request a complimentary consultation with our surgeons.
1. Wilding, J. P. H., et al. (2021). Once-Weekly Semaglutide in Adults with Obesity. New England Journal of Medicine, 384(11), 989-1002.
2. Thomsen RW, Mailhac A, Løhde JB, Pottegård A. Real-world evidence on the utilization, clinical and comparative effectiveness, and adverse effects of newer GLP-1RA-based weight-loss therapies. Diabetes Obes Metab. 2025 Apr;27 Suppl 2(Suppl 2):66-88. doi: 10.1111/dom.16364. Epub 2025 Apr 8. PMID: 40196933; PMCID: PMC12000858.
3. Sjöström, L., et al. (2001). The Swedish Obese Subjects (SOS) study – Rationale and results. International Journal of Obesity, 25 Suppl 1(S1), S2-4.
4. Aronne, L. J., et al. (2023). Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial. JAMA.
