Obese and want to lose weight? Wegovy is not the long-term answer, according to leading weight loss surgeon

A leading New Zealand bariatric surgeon has warned that Wegovy, a newly available weight-loss drug that regulates your appetite and contains semaglutide, is not a standalone solution to obesity and could prove harmful without proper support.

Dr Rowan French, a Waikato-based bariatric surgeon, said the drug, recently made available in New Zealand, may trigger initial weight loss, but long-term results depend heavily on accompanying lifestyle changes.

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What is wegovy?

Wegovy contains semaglutide, a synthetic version of a gut hormone (GLP-1) that regulates insulin and appetite. While it mimics some effects seen after bariatric surgery, such as reduced hunger, it is delivered via weekly injections into the systemic bloodstream rather than through natural gut pathways.

French explained that this difference, combined with the way the body builds tolerance to GLP-1 (a phenomenon called tachyphylaxis), means the drug may lose its effectiveness faster than surgery.

“In other words, as time goes on, the patient will get less and less benefit from the medication,” he said. “Any suggestion some people should stay on it for life is unlikely to be sensible or beneficial.”

Lifestyle and psychological support

He said that for weight-loss efforts using Wegovy or surgery to succeed, patients must address the psychological and behavioural roots of their eating habits. This includes understanding what triggers overeating and receiving nutritional counselling.

“Without external help to understand their drivers to eat and nutritional help to understand the sorts of foods they should be eating — particularly in the first 18–24 months — the medications could prove more harmful than good,” he said.

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Weight regain

The surgeon noted that many patients experience weight regain after initially losing weight on either medication or surgery, especially without proper follow-up.

In the case of Wegovy, stopping the drug often results in regained weight. But even staying on it may not guarantee sustained results due to increasing drug tolerance.

“We know that, when semaglutide is stopped, in most cases, weight is regained,” he said. “But we can also predict that if a patient stays on it, they will develop tolerance, because this occurs with bariatric surgery, albeit later in the piece.”

A chronic condition

French underscored that obesity should be treated as a chronic disease, often rooted in genetic, early life, and environmental factors. He explained that most people have a genetically determined weight “set point,” which the body subconsciously defends.

“Our primitive brain interprets weight loss from dieting as starvation and starts to fight back,” he said. “That’s why yo-yo dieting often results in regaining more weight than was initially lost.”

This process, he added, can raise an individual’s set point over time, making long-term weight control increasingly difficult without medical intervention and behavioural support.

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The role of ultra-processed foods

Another major factor driving obesity, French said, is the rise of ultra-processed foods (UPFs), which he described as “manufactured to make us eat as much as possible.”

“These foods make up about 50–60 percent of what we eat now,” he said. “We know from robust data that they cause metabolic disease, depression, dementia, and even cancer.”

He urged patients to focus on eating whole foods “at least 95 percent of the time,” describing them as items “your grandma would recognise as food.”

French warned that media and celebrity portrayals of Wegovy as a “miracle drug” may be misleading. While the medication is a powerful tool, he said, it must be part of a comprehensive, multidisciplinary approach involving psychology, nutrition, and exercise.