Surgeries to manage obesity “declined substantially” for eligible patients starting in 2023, fueled by surging prescriptions for appetite-suppressing GLP-1 drugs, a new study finds.
The Ohio State University-led study examined the anonymous medical records of 3.1 million obese patients from 2017 through 2025. Patients had a median body mass index of 40.7, considered morbidly obese. The study was published on Wednesday in JAMA Surgery.
Prescription rates for weight-loss drugs known as GLP-1s jumped from 0.22% of those eligible for metabolic and bariatric surgery in the last three months of 2018 to 24.17% between last July and September, the study found.
Meanwhile, the metabolic and bariatric surgery rate dropped from a peak of 0.17% of qualifying patients aged 3 or older in the last three months of 2022 to 0.09% between July and September 2025.
A 46.4% drop in overall surgeries from the third quarters of 2022 to 2025 included a 44.3% drop in gastric bypass procedures and a 50.1% decline in sleeve gastrectomy operations, which remove up to 80% of the stomach.
Surgery rates dropped by 35% among morbidly obese patients with a body mass index of at least 55, lower than the 40.7% to 49.8% decline for less severe cases.
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Senior author Patrick J. Sweigert, a surgeon at Ohio State University Wexner Medical Center, called the results encouraging. But he warned that 3 in 4 people studied received neither medication nor surgery.
“One possibility is that medications will bring many more patients into treatment who previously never sought care because of stigma or lack of options,” Dr. Sweigert said in an email. “In that scenario, medications may actually serve as a gateway into comprehensive obesity care, including surgery when appropriate.”
He cautioned that the findings require further research to “predict where the numbers will settle.”
The Food and Drug Administration approved Ozempic as an insulin-boosting treatment for Type 2 diabetes in 2017, the start of the study period.
The appetite-suppressing drug produced dramatic weight losses, leading the FDA to approve Wegovy as a version prescribed for obesity in 2021. Other drugs have since followed.
The study published on Wednesday examined people with a median age of 55. Additionally, 60% were women and 30% had Type 2 diabetes.
Reached for comment, several medical experts not connected with the study disagreed on whether the findings will prove to be a fluke.
“It will be interesting to see if bariatric surgery cases increase again in a year or two, since many people end up stopping their GLP-1 use due to side effects, insurance coverage changes, out-of-pocket expenses, or other reasons,” said Evan Nadler, former head of the Childhood Obesity Program at Children’s National Hospital in the District of Columbia.
Several doctors noted that just 1% of people eligible for bariatric surgery ever pursue it, considering it a last resort even before GLP-1s hit the market.
“Most people would prefer a medication, even an injectable one, over a surgery that requires anesthesia, recovery time, and may impact nutrient absorption for life,” said Dr. Chrissie Ott, a California-based internist and obesity specialist.
Despite generating billions in revenue for the pharmaceutical industry, use of GLP-1 injections remains relatively rare.
KFF, an independent health policy think tank formerly known as the Kaiser Family Foundation, estimated that 12% of adults surveyed nationwide had ever used GLP-1s in 2024. That included just 5% using them for weight loss alone.
Doctors say painful side effects, high treatment costs, and inconsistent insurance coverage have kept most patients away from the drugs.
Common side effects include nausea, vomiting, diarrhea, and constipation, and the shots require years of prescriptions to maintain weight loss.
Dr. Wiljon Beltre, a Florida bariatric and metabolic surgeon, predicted that younger surgery candidates “influenced by social media” will be more likely than older adults with “severe joint pain, massive hernias, or those who need organ transplants” to stick with GLP-1s.
“Right now, jabs are hot, but I think it’ll come back around to surgery,” Dr. Beltre said.
• Sean Salai can be reached at ssalai@washingtontimes.com.
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