The landscape of obesity treatment is undergoing a shift with the rise of obesity management medications (OMMs). Drugs such as GLP-1 receptor agonists, including semaglutide and liraglutide, have gained popularity for their ability to suppress appetite and aid in weight loss. The global anti-obesity drug market is projected to reach $54 billion by 2030, reflecting growing demand for pharmaceutical weight management solutions. While these medications offer a non-surgical approach, they are not without limitations—weight regain is common after discontinuation, and their effectiveness varies between individuals.
For patients with severe obesity, the most effective and sustainable solution remains bariatric surgery. Clinical studies show that while OMMs may result in 10-15% body weight reduction, bariatric surgery achieves 30-40% sustained weight loss, alongside dramatic improvements in metabolic health. Dr. Harsh Sheth, a leading Bariatric Surgeon in Mumbai, explains why surgery continues to be the gold standard for long-term obesity treatment despite the emergence of new medications.
“Obesity isn’t just about excess weight—it’s a complex metabolic disease,” says Dr. Sheth. “Medications can help control appetite temporarily, but they don’t correct the underlying metabolic dysfunctions that cause obesity. Bariatric surgery, on the other hand, fundamentally alters how the body processes food, regulates hunger hormones, and maintains long-term weight loss. That’s why it remains unmatched in delivering sustained results and preventing disease progression.”
Unlike medications, which require lifelong use to maintain results, bariatric surgery provides permanent physiological changes that help patients keep the weight off. Procedures like sleeve gastrectomy and gastric bypass not only reduce stomach size but also alter gut hormone signalling, leading to increased satiety, improved insulin sensitivity, and long-term metabolic benefits. Studies indicate that up to 80% of patients with type 2 diabetes experience complete remission after bariatric surgery—an outcome no obesity drug has been able to replicate.
While medications may be suitable for patients with a BMI of 30-35, they fall short for those with severe obesity (BMI >40) or obesity-related complications such as type 2 diabetes, hypertension, or sleep apnea. Research from the American Society for Metabolic and Bariatric Surgery (ASMBS) confirms that bariatric surgery outperforms medications in both weight loss and remission of obesity-related conditions. “For a patient who is 50 kg overweight, relying on medication alone is unrealistic,” says Dr. Sheth. “Surgery is the only intervention that delivers predictable, lasting results with major health benefits.”
Adherence is another critical issue. Only about 40-50% of patients maintain long-term use of OMMs, often due to side effects such as nausea, vomiting, and gastrointestinal discomfort. Many patients discontinue use after a few months, leading to rapid weight regain. In contrast, bariatric surgery eliminates the dependency on daily medication, making it a one-time intervention with long-term benefits. “A big drawback of medications is that their effectiveness stops when you stop taking them,” Dr. Sheth explains. “Bariatric surgery is a permanent metabolic reset—it’s not just about weight loss, but about fundamentally improving how the body processes food and regulates energy.”
Another major advantage of surgery is its impact on obesity-related diseases. While OMMs can provide some improvement in metabolic markers, they are rarely curative. Bariatric surgery, however, has been proven to reduce mortality rates by up to 40%, with a significant reduction in cardiovascular disease risk. “Patients who undergo surgery often reduce or eliminate their need for diabetes, blood pressure, and cholesterol medications. This is not just about shedding weight—it’s about preventing serious health conditions that come with obesity,” Dr. Sheth adds.
Thanks to advancements in minimally invasive laparoscopic and robotic techniques, bariatric procedures today are safer, faster, and more efficient than ever before. The risk of complications is low, and most patients recover within a few weeks, making it an attractive option for those hesitant about surgery. “Surgery has evolved tremendously over the years,” says Dr. Sheth. “With modern techniques, patients experience less pain, shorter hospital stays, and quicker recovery times. This makes the decision to opt for surgery much easier for those who qualify.”
While obesity management should be personalized, the evidence is clear—for severe obesity, bariatric surgery remains the most powerful tool available. “This should not be a debate about choosing between medication and surgery,” Dr. Sheth concludes. “We need a patient-first approach, where we recommend the most effective treatment for long-term health. And in most cases of significant obesity, that treatment is still surgery.”
As one of Mumbai’s most trusted bariatric surgeons, Dr. Harsh Sheth continues to advocate for evidence-based obesity treatment, helping patients achieve lasting weight loss and improved health outcomes. While medications may play a role in obesity management, bariatric surgery remains the most definitive, scientifically backed solution for long-term success.
About Dr. Harsh Sheth:
Dr. Harsh Sheth is a successful and dynamic surgeon and a specialist in robotic and laparoscopic surgeries. He performs various procedures, such as gastro-intestinal surgeries, hernia repairs, HPB, splenectomy, and bariatric surgeries. He is a member of many important medical associations and has noteworthy research and publications in his name.
To schedule an appointment or inquiry with Dr. Harsh Sheth, please reach out to the following contact:
Genèse Clinic
G-14/15 8th Floor, Everest Building, Tardeo Rd, Janata Nagar, Tardeo, Mumbai, Maharashtra 400034
Contact no. 9137080299