Metabolic Bariatric Surgery Takes a Backseat as GLP-1RA Use Rises: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On November 4, 2024, we reported on a study published in JAMA Network Open that examined national trends and characteristics of patients with obesity who were prescribed glucagon-like peptide-1 receptor agonists (GLP-1 RAs) compared with those undergoing metabolic bariatric surgery.

The study

In the cross-sectional study, researchers used deidentified claims from 17 million unique privately insured adults between 2022 and 2023. The final analysis only included people with obesity and without diabetes, and only GLP-1RA prescriptions with FDA indications as antiobesity medications (ie, semaglutide and liraglutide).

Researchers compared the characteristics (ie, age, sex, comorbidities) of participants who were prescribed GLP-1 RAs, those who underwent metabolic bariatric surgery, and those who received neither treatment. They then assessed trends in use of GLP-1RAs and metabolic bariatric surgeries per 1000 unique patients without diabetes and with obesity using a generalized linear regression model.

The findings

Results showed a 132.6% increase in patients prescribed GLP-1RAs between the last 6 months of 2022 vs the last 6 months of 2023 (1.89 vs 4.41 patients per 1000 patients). Conversely, researchers reported a 25.6% decrease in the rate of participants undergoing metabolic bariatric surgery during the same period (0.22 vs 0.16 patients per 1000 patients).

Authors' comment

"Policymakers and clinicians should continue to closely monitor trade-offs between pharmacologic and surgical management of obesity to ensure optimal access to effective obesity treatment."

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