Keywords
Bariatric surgery
Gastric bypass
Glucagon-Like Peptide 1 receptor agonists
Weight gain
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Abstract
Objective: To investigate and compare long-term weight loss, weight regain, and comorbidity remission efficacy among Gastric Bypass, Vertical Sleeve Gastrectomy (Sleeve), and injectable therapies (semaglutide and tirzepatide). Methods: This is an integrative literature review. A search was conducted across PubMed, Embase, Web of Science, and Cochrane Library databases, selecting randomized clinical trials and observational studies published up to the time of the review. Articles evaluating long-term weight loss, weight regain, and metabolic control were included. Results: Gastric Bypass surgery demonstrated greater sustainability of weight loss (over 10 years) and type 2 diabetes remission compared to the Sleeve procedure, which showed higher rates of revisional surgery due to weight regain or reflux. Injectable therapies yielded substantial weight loss (up to 22.5%), rivaling surgery; however, discontinuation of treatment resulted in rapid weight regain. Final considerations: Gastric Bypass remains the most durable intervention. Medications show high efficacy but require continuous, lifelong use; the choice of treatment should consider BMI, surgical risk, reflux, costs, and patient adherence.
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