Cross-category comparison

Wegovy vs Gastric Bypass

Different categories, normalised only where comparison is meaningful.

Wegovy injection

STEP 1: mean -14.9% at 68 weeks with 2.4 mg; 7.2 mg is now a licensed maintenance option for adults with obesity if needed

VS

Roux-en-Y gastric bypass

Long-term evidence is extensive; ASMBS reports strong durable weight loss and 2024 long-term data show substantial maintenance out to 10–20 years

Shared dimensions

DimensionWegovy injectionRoux-en-Y gastric bypass
Relative weight-loss potential / intensity8/109/10
Typical speed / access to effect8/108/10
Lower procedural / medical burden5/103/10
Ease of stopping, reversing or changing route9/102/10
Lower cost / easier access4/106/10
Long-term maintenance simplicity6/104/10
Evidence maturity / depth10/1010/10
Day-to-day or pathway convenience8/105/10

Category-specific detail

IssueWegovy injectionRoux-en-Y gastric bypass
Anatomical changeNot applicableSmall stomach pouch connected to a lower segment of small intestine, bypassing part of the stomach and small bowel
Diabetes / metabolicNot applicableVery strong metabolic/diabetes evidence
Evidence anchorSTEP 1: mean -14.9% at 68 weeks with 2.4 mg; 7.2 mg is now a licensed maintenance option for adults with obesity if neededNot applicable
How it worksGLP-1 receptor agonistNot applicable
How takenWeekly injection — Once weeklyNot applicable
Main trade-offsInjection; GI effects; The new 7.2 mg option should not be compared using old 2.4 mg-only trial assumptions; NHS access remains pathway-limitedNot applicable
MaintenanceLong-term support/treatment matters; weight regain after stopping has been demonstratedNot applicable
NHS contextNICE-recommended in specialist weight-management pathways; access depends on pathwayEstablished NHS bariatric procedure
Nutrition burdenNot applicableHigher long-term micronutrient burden than sleeve; lifelong supplements and blood monitoring are important
Procedure typeNot applicableLaparoscopic surgery
RefluxNot applicableOften considered favourable where significant reflux is a major issue
ReversibleNot applicableTechnically revisable but not treated as a simply reversible procedure
RevisionNot applicableRevision is possible but complex and specialist
UK licenceUK weight management licenceNot applicable
Do not add the scores together.

The bars are there to expose trade-offs. They are not a validated overall suitability index.

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