Researchers followed 53 patients with endometrial cancer who were receiving fertility-sparing treatment, meaning treatment intended to preserve the ability to have children. This was a study in people, not animals or cells. It was published in the Journal of Obstetrics and Gynaecology.
The goal was to compare three different approaches to weight management in this specific group. Patients were placed into one of three paths after a multidisciplinary assessment and shared decision-making with their care team. This was observational, so people were not randomly assigned.
What the three groups were
Ten patients had sleeve gastrectomy, a type of weight-loss surgery. Twenty-three received semaglutide therapy. Twenty received a structured lifestyle program the authors call DEAR, short for Diet, Exercise, Accompany and Refresh. The researchers tracked body measurements, metabolic markers, and tumour response over two years.
What the study reported
At one year, all three groups had lost weight. The surgery group had the largest reduction in body mass index. Compared with the semaglutide group, the difference was 4.04 kg per square meter, and compared with the lifestyle group it was 2.12 kg per square meter. Both differences were reported as statistically significant.
By two years, the picture shifted. Weight regain was least common in the lifestyle group at 14.3 percent, compared with 55.6 percent in the semaglutide group and 66.7 percent in the surgery group. The authors reported this difference as statistically significant.
The lifestyle group also showed what the authors described as more stable metabolic improvements and the highest rate of complete tumour remission at 85.0 percent. The semaglutide group was reported at 73.9 percent and the surgery group at 60.0 percent.
The authors summarized that surgery produced rapid short-term weight loss, while the lifestyle program showed better medium-term weight maintenance, metabolic stability, and tumour response. They suggested integrated lifestyle support may be useful as a medium-term strategy for patients seeking fertility preservation.
What this does and does not mean
This is a narrow study of one clinical situation: fertility-sparing endometrial cancer treatment. It does not tell you how any of these approaches performs for weight loss in the general population, and it says nothing about using semaglutide outside of the setting the study examined.
The tumour remission figures are especially specific to this cancer context. Nothing here should be read as evidence that a medication or a lifestyle program affects cancer outcomes for anyone else. The abstract reports associations within a single group of patients, not a general rule.
An honest limitation
The biggest limitation is size and design. With only 53 patients split into three groups, the surgery arm had just ten people, and patients chose their path rather than being randomly assigned. That means differences between groups could reflect who selected each option, not the option itself. Larger, randomized studies would be needed before drawing firm conclusions.
If you are weighing weight management options during cancer treatment or fertility-sparing care, talk with a licensed clinician who knows your full history. Decisions in this setting are complex and highly individual.