What happened
A study in Obesity retrospectively analysed 44,025 adults with BMI of at least 35 who received semaglutide, tirzepatide, sleeve gastrectomy or gastric bypass across two urban health systems.
What we know
Surgery was associated with larger weight changes at one, two and three years in the observed groups. The authors compared clinical records rather than randomly assigning treatments.
Limitations
Groups may differ in severity, eligibility, medicine continuation, access and follow-up. An observational association cannot establish which option is better for an individual and does not capture every risk or clinical goal.
Why it matters
The study helps frame routine-care expectations and persistence. Surgery and pharmacotherapy are different interventions and should not be reduced to a single weight figure.