Rapid increase in use of GLP-1 drugs for obesity coincides with decline in bariatric surgery

Researchers from Massachusetts General Brigham and colleagues found that the use of GLP-1 drugs to treat obesity more than doubled from 2022 to 2023, and surgery rates fell by a quarter. I discovered that.

Important points

• Researchers at General Brigham in Massachusetts and colleagues evaluated national trends in the number of obese patients prescribed GLP-1 drugs and the number undergoing metabolic bariatric surgery.
• Researchers documented a 132.6% increase in patients prescribed GLP-1 drugs and a 25.6% decrease in patients undergoing bariatric surgery between 2022 and 2023.
• Only 6% of obese patients in the study population received GLP-1 drugs or surgery, suggesting that many more patients may be eligible for treatment.

A new study by researchers at Brigham and Women's Hospital, a founding member of the Massachusetts General Brigham Health System, in collaboration with researchers at Harvard University's T.H. Chan School of Public Health and Brown School of Public Health, will investigated a large sample of We found that the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) as anti-obesity drugs more than doubled from 2022 to 2023. During the same period, patients receiving metabolic obesity treatment decreased by 25.6%. Surgery to treat obesity. This research JAMA network open.

Our study provides one of the first national estimates showing decreased utilization of bariatric metabolic surgery among privately insured patients in response to increased use of blockbuster GLP-1 RA treatments did. ”

Thomas C. Tsai, MD, MPH, senior author, Metabolic Bariatric Surgeon, Department of Surgery, Brigham and Women's Hospital

Researchers used a national sample of health insurance claims data from more than 17 million privately insured adults to identify patients with the following symptoms: diagnosis Prevalence of obesity without diabetes in 2022-2023. The study found that the proportion of patients who received GLP-1 RAs increased sharply during the study period, with GLP-1 RA use increasing by 132.6% from late 2022 to late 2023 (1.89 to 4.41) patients per 1,000 patients). Meanwhile, bariatric metabolic surgery utilization decreased by 25.6% over the same period (from 0.22 to 0.16 per 1,000 patients).

Of the obese patient sample, 94.7% received neither treatment during the study period (while 5.0% received GLP-1 RA and 0.3% underwent surgery). Compared to patients prescribed GLP-1 RAs, patients who underwent surgery tended to be more medically complex.

“For now, metabolic bariatric surgery remains the most effective and long-lasting treatment for obesity. National efforts are continuing to improve pharmacological and pharmacological treatments to ensure patients receive optimal treatment. The focus should be on improving access to bariatric treatments, whether deaf or surgical,” Tsai said. He is an assistant professor of surgery at Harvard Medical School and an assistant professor of health policy and management at the Harvard T.H. Chan School of Public Health.

Tsai said that while GLP-1 RAs can effectively treat obesity and related diseases (such as diabetes), these drugs suffer from high cost, limited supply, and the potential to promote treatment discontinuation and subsequent weight gain. They point out that there are limitations due to certain gastrointestinal side effects.

“As obese patients increasingly rely on GLP-1 rather than surgical intervention, to assess the impact of a shift from surgical to pharmacological treatments for obesity treatment on long-term patient outcomes. Further research is needed,” Tsai said. “Comprehensive multidisciplinary bariatric treatment, including pharmacological, endoscopic, or surgical interventions, as utilization of metabolic bariatric surgery declines nationally and bariatric surgery programs may end. There are concerns that access will be further restricted.

“These results also highlight opportunities to further expand the use of surgical and pharmacological treatments for obesity and related comorbidities,” said co-author Atiev Mehrotra, M.D., dean of Brown University's School of Health Services, Policy, and Practice. said Dr. MPH. of public health. “While metabolic bariatric surgery and GLP-1 RA are both effective interventions for obese patients, less than 6% of patients in our study received either treatment.”

Given these results, the authors encourage clinicians and policy makers to continue monitoring access to effective obesity treatments as treatment options rapidly evolve. Furthermore, further research is needed to understand the trade-off between the use of surgical intervention and the increasingly popular GLP-1 RA in the treatment of obesity.