Cleveland Clinic study shows significant weight loss after bariatric surgery

A recent study published in the Annals of Surgery evaluated the 2-year weight loss outcomes after bariatric surgery among adults who experienced intolerable side effects or inadequate weight loss with semaglutide or tirzepatide. The research was conducted at Cleveland Clinic hospitals from 2018 to 2024 and included 4,929 adults with a body mass index (BMI) of 35 kg/m² or higher.

Among the participants, 4661 had no prior exposure to the medications, serving as a comparator group, while 61 patients discontinued semaglutide or tirzepatide due to intolerable adverse effects, and 207 had inadequate weight loss responses. Before surgery, the estimated weight change for the intolerance group was a 1.4% gain, while the inadequate-response group had a 1.5% total body weight loss (TBWL).

After undergoing bariatric surgery, the results showed that the intolerance group achieved a 2-year TBWL of 27.9% after Roux-en-Y gastric bypass (RYGB) and 20.1% after sleeve gastrectomy (SG). In contrast, the inadequate-response group experienced a TBWL of 35.8% after RYGB and 14.3% after SG. The comparator group had TBWL estimates of 33.3% after RYGB and 23.6% after SG.

The adjusted analysis indicated that RYGB was associated with a greater 2-year TBWL compared to SG in the inadequate-response group, with a difference of 14.9 percentage points (32.7% vs. 17.8%). These findings suggest that bariatric surgery can provide significant weight loss benefits for patients who do not respond adequately to pharmacotherapy.