For a very long time, bariatric surgery, in which doctors removed a portion of the stomach, was the standard procedure for helping patients lose weight and manage obesity, alongside metabolic disorders such as diabetes, high blood pressure, and high cholesterol. However, ever since GLP-1 medications like Ozempic became available on the market, there has been a shift in how people seek to lose weight.
A recent US-based study examining weight-loss treatment data of 11.7 million anonymous insurance enrollees diagnosed with obesity, overweight, or diabetes found that the use of GLP-1 medications surged by 140.4% between 2022 and 2024. During the same period, interest in surgical options declined significantly, seeing a 34.1% overall drop in utilization of metabolic bariatric surgery (MBS).
The findings are published in JAMA Surgery.
Surgery vs. injections
GLP-1 (Glucagon-Like Peptide-1) receptor antagonists or GLP-1 RAs—like liraglutide, semaglutide, and tirzepatide—mimic the naturally occurring hormone GLP-1, which is released by the gut post-meal and plays a key role in regulating blood sugar and appetite. These agonists hijack the body’s natural signaling pathway and activate the GLP-1 receptors in the digestive system, slowing how quickly the stomach empties. This suppresses hunger by making people feel full much faster and stay full longer.
At the same time, they signal the pancreas to release insulin when blood sugar levels rise. Together, these effects make the drug highly effective in managing weight and diabetes, which can lead to improvements in other metabolism-related issues, such as blood pressure, cholesterol, and mental health.
This surgery-free method has been quite effective for many people, so it is not surprising to see a rise in its use. As the use of GLP-1 drugs surged, particularly following the approval of newer medications like tirzepatide, a question remained: How would this shift affect bariatric surgery rates? Tracking these shifts isn’t just an academic need, it is essential for planning how obesity treatment reaches the people who need it most.
The researchers analyzed insurance records from millions of adults born before 2004 who had been diagnosed with obesity, overweight, or diabetes between early 2022 and late 2024. After extracting the data for both BMS and GLP-1, they used statistical models to compare the number of surgeries vs. the number of prescriptions for every quarter.
They observed a massive surge in the use of medications and a sharp decline in the number of surgeries. The use of GLP-1 medications like Ozempic, Wegovy, and Mounjaro was hitting record numbers, with nearly one in 10 patients eligible for weight-loss treatment choosing these medications, while just 0.4% opted for bariatric surgery.
The decline in surgeries wasn’t just steady, it was accelerating. The surgery rates fell by around 14% in 2023, then dropped by an even sharper 23% in 2024.
Despite the rapid rise of GLP-1 drugs, one fact remained: obesity is largely undertreated, as more than 90% of people with obesity or diabetes in the study still received neither medication nor surgery.
Written for you by our author Sanjukta Mondal, edited by Sadie Harley, and fact-checked and reviewed by Robert Egan—this article is the result of careful human work. We rely on readers like you to keep independent science journalism alive.
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Publication details
Robert J. Calzaretta et al, Trends in Metabolic Bariatric Surgery Utilization in the Era of GLP-1s, 2022–2024, JAMA Surgery (2026). DOI: 10.1001/jamasurg.2026.1343
Journal information:
JAMA Surgery
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