Sleeve Gastrectomy Versus Semaglutide for Weight Loss in a Severely Obese Minority Cohort: A Propensity-Matched Study

The rising obesity rates in the USA have led to a surge in various weight loss treatments. Glucagon-like peptide-1 (GLP-1) analogues have shown promise in reducing weight but primarily studied in Caucasian populations. Sleeve gastrectomy (SG) has already proven successful weight loss outcomes. This study aimed to compare the weight loss outcomes between semaglutide and SG in a minority population over a 12-month period.

Two separate cohorts of patients were identified through a retrospective review of electronic medical records. The first cohort consisted of patients prescribed semaglutide from January to December 2022, and the second one included patients who underwent SG during the same period. Weight loss was the primary outcome of interest, measured at 3-, 6-, and 12-month post-intervention. Propensity score matching was used to ensure balanced characteristics between the two groups.

A total of 206 patients were included; 103 (50%) in the semaglutide group and 103 (50%) in the SG group. The entire cohort consisted mostly in African Americans (67%) and Hispanics (21%). The mean BMI was 55 kg/m² and 56 kg/m² for the SG and semaglutide groups, respectively. The SG group consistently outperformed semaglutide regarding weight loss at all follow-up periods, with the largest difference observed at 12-month post-intervention (total weight loss 32% vs. 2%, p < 0.001).

SG led to significantly more weight loss than semaglutide over a 12-month period. Our findings suggesting that GLP-1 agonists might be less effective for weight loss in African American and Hispanic patients with severe obesity warrants further research.