Medscape: Do New Weight Loss Meds Mean the End of Bariatric Surgery?

Medscape recently interviewed Miguel Burch, MD, chief of Minimally Invasive and Gastrointestinal Surgery at Cedars-Sinai, about the role of weight loss surgery—also known as bariatric surgery—now that patients have another treatment option in anti-obesity and diabetes medications like semaglutide (sold under the brand names Ozempic and Wegovy).

Burch told Medscape commentator Anne Peters, MD, that the class of medications called glucagon-like peptide 1 (GLP-1) receptor agonists is helping people achieve significant weight loss that once was only possible with bariatric surgery.  

“That was a previous era; we are now in a new one,” Burch told Peters. “As a bariatric surgeon, we’re seeing a 20% to 30% reduction in volume since the advent of these medications. And it’s wonderful, in fact, to have the opportunity to serve so many patients with something other than just surgery.

“The question is, when do you decide to consider that patient for bariatric surgery versus continued medical therapy with the glucagon-like peptide 1 (GLP-1) receptor agonists? It’s a difficult question.”

It can depend on each patient’s risk factors, Burch said, as well as weighing the cumulative cost of taking medications for a lifetime versus having surgery. But managing obesity could involve multiple approaches rather than a choice between surgery or weight loss medicines.

“For cancer, we totally think it’s normal to have surgery, plus chemotherapy, plus radiation, plus targeted therapies,” Burch told Peters. “I think obesity needs to be managed more like that, as well.”

Click here to watch the complete interview on Medscape.