Obesity medication or metabolic surgery: comparing eligibility and long-term costs in Shanghai

EastMedGo Nov 6, 2026

If your weight is already affecting your blood glucose, blood pressure, sleep, or walking, first write down the health problems you most want to improve and how your weight and treatment have changed over the past few years. The endocrinology team can use this information to compare long-term medication with a surgical assessment. The surgical and nutrition teams can then assess whether surgery is suitable, which procedure may be appropriate, and how to arrange follow-up after you return to your home country.

Key points

Mazdutide and semaglutide are different medications; the adult BMI and comorbidity criteria in each prescribing information document need to be checked individually.
Compare ongoing prescription costs with postoperative nutrition and laboratory testing over the same period, as well as comparing drug prices.

Which medication fits my circumstances?

China has approved mazdutide (Xinermei) for long-term weight management alongside dietary control and increased physical activity in adults with an initial BMI≥28 kg/m², or BMI≥24 kg/m² with at least one weight-related comorbidity. It is a dual GCG/GLP-1 receptor agonist that Innovent licensed from Lilly and developed in China. China was the first country to approve it for this use, in June 2025; in September of the same year, it was also approved in China for blood glucose control in adults with type 2 diabetes. Another medication, Nuoheying (Wegovy), is semaglutide for weight management. Its Chinese indication for adult weight management requires an initial BMI≥30 kg/m², or BMI≥27 but below 30 kg/m² with at least one weight-related comorbidity. The two medications have different BMI requirements. Have a specialist assess eligibility using each medication’s Chinese prescribing information; do not substitute the packaging or doses of Nuohetai (Ozempic), the diabetes product with the same active ingredient.

Bring details of the doses and duration of medications you have previously used, weight changes, and reasons for stopping. Explain any gastrointestinal discomfort, previous abdominal surgery, plans for pregnancy, and other medications. The doctor will assess tolerability, expected benefits, and whether treatment can be sustained. Contact the medical team promptly if you develop persistent vomiting or significant abdominal pain, and do not restart at your pre-interruption dose on your own.

How do medication prices compare over the same four weeks?

For the Nuoheying (Wegovy) four-dose pen delivering 2.4 mg/dose (9.6 mg/3 mL), the reference medication price in China is CNY 1,284.36/pen, and the reference UK medication price excluding tax is GBP 175.80/pen. When the prescribed maintenance dose reaches 2.4 mg weekly, one pen provides four weeks of medication. When starting treatment or adjusting the dose, calculate costs separately using the strength prescribed for that month.

Mazdutide comes in boxes of two pens. Reference medication prices in China are: 2 mg/0.5 mL at CNY 449.50/box, 4 mg/0.5 mL at CNY 764.15/box, and 6 mg/0.5 mL at CNY 1,041.70/box. For example, if the doctor prescribes one pen weekly at 4 mg for four consecutive weeks, the total medication cost is CNY 1,528.30.

When is a joint surgical and nutrition assessment needed?

If adequate trials of nutrition, physical activity, and medication have left a substantial health burden or results are difficult to maintain, you can ask the endocrinology team for a surgical referral to discuss options. Sleeve gastrectomy changes the stomach’s capacity, while gastric bypass also changes the route food takes through the small intestine. Both require changes in eating habits. Surgery may involve bleeding, infection, leakage, or blood clots, and nutritional deficiencies also need to be prevented over the longer term. Include surgery and hospitalization, postoperative nutritional supplements, vitamins and minerals, and follow-up visits and laboratory tests in first-year costs. Also ask about managing complications and insurance coverage.

How can I continue care at home after an assessment in Shanghai?

Ruijin Hospital’s endocrine and metabolic specialty service can be an initial point of contact. Confirm separately with the department whether a surgical assessment can be arranged, which procedure may be offered, and the timing. If using medication, agree on a local doctor to handle repeat prescriptions, monitor side effects, and reassess weight and related conditions. If having surgery, take home the procedure and discharge records, a diet progression plan, a list of nutritional supplements and laboratory tests, and arrangements for local emergency care. The surgical team will determine the specific timing for progressing from liquids to soft foods and then solid foods. Also document hydration, protein, and nutrient targets, and who will adjust them based on blood test results. If prescriptions or follow-up cannot yet be coordinated, you can complete the assessment first and arrange treatment later.

Frequently asked questions

How are diabetes medications adjusted after weight-loss surgery?

Blood glucose may improve in some patients. The diabetes team must decide whether medication can be stopped based on follow-up tests, and long-term monitoring is still needed.

Can I book surgery directly in Shanghai using overseas BMI criteria?

First ask the receiving team to review comorbidities, previous treatments, and surgical risks against the applicable criteria. Overseas assessment criteria do not automatically establish eligibility in China.

When should I move from an endocrinology clinic to a surgical consultation?

Ask your doctor whether your current health problems, previous treatment results, and the ability to maintain those results support considering surgery. Also ask the surgical team to assess the procedure, risks, and requirements for nutritional care separately.

Should I specifically mention a family history of medullary thyroid carcinoma?

Clearly disclose this before a prescription is issued. The Chinese prescribing information for mazdutide lists a personal or family history of medullary thyroid carcinoma and MEN 2 as contraindications.

What if the medication supply is interrupted later?

Ask the prescribing team to document in advance when to contact them, how reassessment will be handled, and whether a change in treatment is possible. Continue nutrition and physical activity support. Do not use another brand’s pen or inject your previous high dose on your own to make up for missed treatment.