Among patients eligible for metabolic and bariatric surgery (MBS), glucagon-like peptide-1 receptor agonist (GLP-1 RA) prescriptions increased from 2018 to 2025, while MBS use decreased beginning in 2023, according to a research letter published online March 4 in JAMA Surgery.
Stefanie C. Rohde, M.D., from Ohio State University Wexner Medical Center in Columbus, and colleagues conducted a retrospective, cross-sectional analysis to examine trends in the use of GLP-1 RAs and MBS through 2025.
The MBS-eligible cohort included 31,684,807 unique patients across all years and quarters. The researchers found that prescription prevalence rates increased from 0.22% in quarter 4 of 2018 to 24.17% in quarter 3 of 2025 among MBS-eligible patients. Use of MBS increased steadily to a peak of 0.17% in quarter 4 of 2022, aside from the pandemic-related dip in quarter 2 of 2020, followed by a decline to 0.11% and 0.09% in quarter 4 of 2024 and quarter 3 of 2025, respectively (46.4% decrease in use from quarter 3 of 2022 to 2025). A more pronounced decline was seen for sleeve gastrectomy than Roux-en-Y gastric bypass (50.1% versus 44.3%). When stratified by diabetes status, similar declines were seen in MBS use. Use of MBS declined least in patients with a body mass index of 55 kg/m2 or more (35.0%).
“Developing evidence-based, patient-centered, multimodal pathways that integrate pharmacological and surgical approaches is essential because MBS remains the most effective and durable treatment for severe obesity, and reduced use may delay definitive care for advanced metabolic disease,” the authors write.
One author reported receiving fees from Johnson & Johnson.
Publication details
Stefanie C. Rohde et al, Trends in Metabolic and Bariatric Surgery Use During the GLP-1 Receptor Agonist Era, JAMA Surgery (2026). DOI: 10.1001/jamasurg.2026.0049
Journal information:
JAMA Surgery
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