Bariatric Surgery is Obsolete and Won’t Exist by 2031?

Bariatric surgery is obsolete and won’t exist by 2031.^{1, 2} This bold prediction has been circulating in recent medical conferences and discussions. As a bariatric surgeon, I find it both surprising and concerning. While GLP-1 medications like Ozempic and Wegovy are dominating the conversation right now, their long-term viability as a replacement for bariatric surgery seems far from feasible.

These medications are undoubtedly an exciting development, and for some people, they can be a helpful tool. But, based on what I’ve seen in my practice and from the stories my patients share, the reality is far more complex. From side effects to cost and long-term results, there’s a lot to consider before declaring bariatric surgery a thing of the past.

Let’s take a closer look at what’s really happening and why bariatric surgery continues to be one of the most effective and life-changing options available.

GLP-1s: A Trending but Challenging Solution

GLP-1 receptor agonists like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro) are medications designed to help regulate blood sugar levels and promote weight loss. While they have gained immense popularity, studies have shown that long-term compliance remains a significant hurdle. According to recent research, compliance rates drop to nearly 30% after three months of use.³

Moreover, the financial burden of these medications is difficult to overlook. A study published in JAMA revealed that for GLP-1s to be cost-competitive with bariatric surgery, their weekly price would need to drop to approximately $70—a nearly threefold reduction.⁴ Despite the FDA removing the shortage tag on semaglutide⁵, the prospect of widespread affordability remains uncertain.

The Reality of Generic GLP-1s

While Ozempic is set to become a generic drug in 2031, this won’t automatically translate to affordability.⁶ Compounding pharmacies, which previously offered cheaper versions of semaglutide during supply shortages, are no longer permitted to distribute it now that the FDA has lifted its shortage status. Additionally, oral GLP-1 formulations are still in development, further delaying the promise of a more accessible option.

Why Bariatric Surgery Remains Essential

Bariatric surgery remains the gold standard for sustainable and significant weight loss in patients with severe obesity. The procedures, including Gastric Sleeve, Gastric Bypass, and Mini Gastric Bypass, provide long-term metabolic changes that are not solely reliant on patient compliance. Here’s why it stands out:

1. 1. Sustainability: Unlike GLP-1s, which often see weight regain upon discontinuation, bariatric surgery offers permanent anatomical changes that support lasting weight loss.
   2. Cost-Effective: A single surgical intervention can be more economical in the long run compared to years of GLP-1 prescriptions.⁴
   3. Metabolic Benefits: Bariatric procedures have been shown to reverse type 2 diabetes, reduce cardiovascular risks, and alleviate obesity-related conditions.⁷
   4. Improved Quality of Life: Beyond physical benefits, patients often experience enhanced mental health, mobility, and overall well-being.
   5. The Halo Effect: A lesser-known but impactful benefit, the Halo Effect refers to the positive lifestyle changes observed in family members of bariatric surgery patients. Studies have documented significant weight loss among obese relatives who adopt healthier habits inspired by their loved one’s post-surgery routines.⁸

Looking to the Future

While GLP-1s certainly have a place in the obesity treatment landscape, predicting the end of bariatric surgery seems overly simplistic. Medical advancements often complement rather than replace existing procedures, and bariatric surgery remains a proven, life-saving solution for many patients.

For those considering their options, I encourage an open discussion about what works best for your individual needs. No single solution is right for everyone, but informed decisions are always the most powerful.

If you’re ready to explore how bariatric surgery could transform your life, submit your health questionnaire today. Let’s start this journey together.

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