Almost one in three American adults are overweight, making weight loss one of the most prominent health concerns in the U.S. today. Unfortunately, a healthy diet and regular exercise often aren’t effective for overweight and obese adults, leaving them at risk for conditions like high blood pressure, type 2 diabetes, and coronary heart disease.
In past years, bariatric surgery was one of the only available options for long-term weight loss in obese adults. But, with the rise of new weight-loss medications like Wegovy, patients may have a new treatment option to safely shed excess pounds.
Below, we’ll discuss new weight-loss medications and how they stack up to bariatric surgery in terms of price, safety, and efficacy.
The Rise of New Weight-Loss Medications
Ozempic and Wegovy are GLP-1 receptor agonist drugs that have rapidly gained popularity from celebrity endorsements and a flood of rave reviews on social media platforms, namely TikTok. As these weight-loss medications were thrown into the public spotlight, they also became subject to shortages.
Along with celebrity and influencer endorsements, news outlets including The New York Times and Medscape featured these new weight-loss medications after a study was released in 2021. Published in the New England Journal of Medicine, this study found that at 68 weeks, participants taking semaglutide (brand name Ozempic) lost an average of 14.9% of their initial weight.
How Do GLP-1 Receptor Agonist Drugs Work For Weight Loss?
GLP-1 receptor agonist drugs imitate the body’s natural GLP-1, which is a hormone produced in the intestines. The intestines release GLP-1 in reaction to food intake, and the hormone slows down the emptying of the stomach. It also curbs the sensation of hunger.
By mimicking natural GLP-1, GLP-1 receptor agonist drugs help the stomach empty slower and tell the brain that the stomach is full. This decreases appetite, reduces cravings, and allows patients to feel satiated with smaller portions.
In patients trying to lose weight, GLP-1 receptor agonist drugs can lead to greater success with low-calorie diets and an increased ability to make healthy choices, rather than giving in to cravings.
Which GLP-1 Receptor Agonist Drugs Are Used For Weight Loss?
Semaglutide and tirzepatide are the most widely-used GLP-1 receptor agonist drugs used for weight loss.
Semaglutide: Ozempic and Wegovy
Ozempic and Wegovy have arguably become the most talked-about weight loss medications in recent years. These drugs both contain semaglutide, which has been used for more than 15 years to manage blood sugar in patients with type 2 diabetes.
Ozempic isn’t officially considered a weight loss medication. It’s been around since 2017 as a diabetes medication in the form of a weekly injection, available in 0.5 mg, 1 mg, and 2 mg doses.
Though it hasn’t yet been approved by the FDA for weight loss, physicians can prescribe Ozempic off-label for weight loss. This is especially true after Wegovy, which also contains semaglutide, was approved by the FDA for chronic weight management in 2021. The FDA is currently reviewing Ozempic for weight loss when used in conjunction with exercise and a healthy diet.
Wegovy is an injectable prescription drug for weight loss in patients who are obese or overweight (BMI of 27 or above). After its FDA approval as a weight loss medication in 2021, Wegovy quickly gained attention for its potential as a long-term weight management solution.
Although Wegovy and Ozempic include the same drug, semaglutide, Wegovy is available in higher doses: 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg. Additionally, unlike Ozempic, Wegovy was specifically developed for weight loss in overweight and obese patients.
Tirzepatide, found in the prescription injectable Mounjaro, is another GLP-1 receptor agonist drug that’s now being used for weight management. Like Ozempic, Mounjaro was first developed to improve blood sugar in adults with type 2 diabetes. It also hasn’t yet been approved by the FDA for weight loss, but can be prescribed off-label to help patients with appetite, cravings, and satiety.
Mounjaro is a once-weekly injection available in 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg doses.
How Do GLP-1 Receptor Agonist Drugs Compare To Bariatric Surgery?
Many people consider bariatric surgery to be the most effective available treatment for long-term weight loss in obese patients. Patients can shed 30% to 50% of their excess weight within six months of the procedure. But, how does bariatric surgery compare to weight loss medications like Ozempic? Read on to learn more.
An Overview of Bariatric Surgery
Bariatric surgery is used for patients with severe obesity. It involves operating on the digestive system to limit food intake and promote significant weight loss.
During bariatric surgery, the surgeon seals the top of the stomach off from the lower portion of the stomach. This creates a pouch that can only hold a small portion of food. After the procedure, patients are satisfied after eating fewer calories.
There are several types of bariatric surgery, including:
Sleeve gastrectomy involves removing roughly 80% of the stomach. It’s considered a simple, safe procedure and doesn’t involve the risks associated with operating on the small intestines. For this reason, sleeve gastrectomy may be an option for patients with high-risk health conditions.
Gastric bypass surgery may also be referred to as Roux-en-Y gastric bypass, or RYGB. During this procedure, the surgeon makes a small pouch from the stomach and connects it to the small intestine. This way, food will move into the small pouch, then go straight to the small intestine. Since food bypasses most of the stomach, patients absorb fewer calories after this procedure.
RYGB works in multiple ways to promote weight loss. In addition to lower calorie absorption, the procedure promotes reduced food intake. This is because the pouch is small and holds less food than the stomach. However, the procedure is considered more complex than sleeve gastrectomy and poses a risk of small intestine complications. \
Biliopancreatic diversion with duodenal switch
Biliopancreatic diversion with duodenal switch, or BPD/DS, involves removing approximately 80% of the stomach to form a small tube-shaped stomach pouch. After creating this pouch, the surgeon detaches one part of the small intestine from the stomach.
Then, another part of the small intestine is attached to the new stomach pouch. This causes food to move through the pouch and into the lower portion of the small intestine.
BPD/DS allows food to bypass around 75% of the small intestine to decrease caloric absorption. Additionally, with the smaller stomach pouch, patients can eat less food and still feel satisfied.
Side Effects of Bariatric Surgery vs. GLP-1 Receptor Agonist Drugs
As an invasive procedure, bariatric surgery presents various risks. Many of these risks are associated with any form of surgery, including complications from anesthesia, infection, and blood clots. However, these complications are rare. In one long-term study of bariatric surgery for obesity, only 4.1% of patients experienced one or more negative outcomes, such as blood clots or repeat surgeries.
More common side effects of bariatric surgery include:
- Acid reflux
- Sensitivity to certain foods
- Stomach obstruction
- Dilation of the esophagus
In the aforementioned study about semaglutide for weight loss published in The New England Journal of Medicine, 74.2% of the participants experienced side effects. The most common side effects of semaglutide include:
The most common side effects of tirzepatide are similar to those of semaglutide, including nausea, vomiting, diarrhea, constipation, stomach upset, loss of appetite, and fatigue.
Bariatric surgery can cost between $7,400 and $33,000, depending on the operation and provider. Most health insurance covers the cost of bariatric surgery, but this coverage can vary depending on your policy. Weight-loss procedures including gastric bypass and BPD/DS are covered by Medicare.
The key difference between the cost of bariatric surgery and weight-loss medications is that surgery is a one-time expense. Semaglutide and tirzepatide must be continued in the long term to provide lasting results. So, patients must continue paying for the medications month after month, year after year.
Insurance plans, as well as Medicare, generally don’t cover the cost of weight loss medications, including semaglutide and tirzepatide. So, most patients must pay for these medications out-of-pocket.
- The list price of Wegovy is $1,349.02 per package (one-month supply).
- The list price of Ozempic is $892.06 per pen injector (one-month supply).
- The list price of Mounjaro is $974.33 per fill (one-month supply).
Patients may be able to save on the cost of weight loss medications with various coupons and savings programs. Specifically, Americans can save up to 90% on medications like Ozempic through buycanadianinsulin.com.
Average 10-year cost
|Bariatric Surgery||$7,400 to $33,000|
|Wegovy||$161,882.40 (based on list price)|
|Ozempic||$107,047.20 (based on list price)|
|Mounjaro||$116,919.60 (based on list price)|
How Effective Are GLP-1 Receptor Agonist Drugs When Compared To Bariatric Surgery?
Pricing aside, how do the results of GLP-1 receptor agonist drugs compare to bariatric surgery?
In a study published by the National Institute of Diabetes and Digestive and Kidney Diseases, patients lost an average of 28.4% of their body weight after gastric bypass surgery. This percentage was measured at the 7-year follow-up. Another study showed that patients can maintain 50% to 60% weight loss 10 to 14 years after bariatric surgery.
As mentioned in a previous section, a clinical trial showed that patients taking semaglutide lost an average of 14.9% of their body weight by week 68. In a study of tirzepatide for obesity treatment, the average weight change at week 72 was 15%.
When deciding between weight loss medications and surgery to overcome obesity, there are numerous factors to consider. Consult your physician to learn more about the treatment options available to you.