With the growing popularity of GLP-1 (glucagon-like peptide-1 receptor) drugs for the treatment of obesity, there has been a significant shift in weight management strategies. A recent study found that the growing use of these medications has contributed to around 25% reduction in weight loss surgeries.

In a large-scale study involving data from over 17 million privately insured adults, researchers analyzed national trends in GLP-1 prescriptions and the frequency of metabolic bariatric surgeries. The results suggest that while anti-obesity medication prescriptions more than doubled between 2022 and 2023, the rate of weight loss surgeries experienced a notable decline of 25.6%. The results were published in Jama Network Open.

"Our study provides one of the first national estimates of the decline in utilization of bariatric metabolic surgery among privately insured patients corresponding to the rising use of blockbuster GLP-1 RA drugs," said senior author Dr. Thomas C. Tsai in a news release.

The study also noted that a vast majority of obese patients, strikingly 94.7%, received neither form of treatment, while 5% received GLP-1 RAs and 0.3% received surgery. Compared to patients who were prescribed GLP-1 RAs, patients who underwent surgery tended to be more medically complex.

"These results also highlight an opportunity to further expand the uptake of surgical and pharmacologic treatments for obesity and related comorbidities. Metabolic bariatric surgery and GLP-1 RAs are both effective interventions for patients with obesity, yet less than 6% of patients in our study received either form of treatment," said co-author Dr. Ateev Mehrotra.

The researchers also raised concern that although GLP-1 medications are effective in obesity treatment, high costs, limited supply, and gastrointestinal side effects of the drugs may prompt many users to discontinue treatment and result in weight regain.

"As patients with obesity increasingly rely on GLP-1s instead of surgical intervention, further research is needed to assess the impact of this shift from surgical to pharmacologic treatment of obesity on long-term patient outcomes. With the national decline in utilization of metabolic bariatric surgery and potential closure of bariatric surgery programs, there is a concern that access to comprehensive multidisciplinary treatment of obesity involving pharmacologic, endoscopic, or surgical interventions may become more limited," Dr. Tsai said.

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