A recent study revealed a marked decrease in the desire for weight loss surgeries over the past year, coinciding with a significant rise in the use of anti-obesity medications such as Wegovy and Saxenda, which saw more than double its users.

This research is among the first to examine the relationship between the nationwide rise in weight loss drug usage and the choice of patients opting for surgical options to address obesity.

Researchers from Mass General Brigham leveraged a database containing health insurance claims from over 17 million adults to identify individuals diagnosed with obesity who did not have diabetes.

The findings indicated a 25.6% decline in the number of people choosing bariatric surgery in the last half of 2023 compared to the same timeframe in the previous year. The uptake of glucagon-like peptide 1 (GLP-1) medications for weight management soared by more than 130% during the latter part of 2023, as detailed in a study published in JAMA Network Open.

This study focused on weight loss drugs including semaglutide and liraglutide, marketed under the brand names Wegovy and Saxenda. Eli Lilly’s Zepbound, another common weight loss medication, was not assessed since the FDA only approved it in November 2023.

Lead author Thomas C. Tsai, a bariatric surgeon at Brigham and Women’s Hospital in Boston, initiated the study after noticing an increase in patients who canceled their surgeries in favor of GLP-1 medications for weight loss.

Tsai reported observing concerns from surgeons nationwide regarding a significant drop in surgical volumes.

He aimed to provide a national overview of how GLP-1 medications might impact consumer decisions against bariatric surgery. During an interview, he highlighted anecdotal evidence of hospitals discontinuing their bariatric surgery programs due to reduced patient interest, mentioning closures in locations like Boston and Norman, Oklahoma.

Should hospitals phase out these weight loss surgery facilities, it would limit options for patients in those areas. “Some patients could genuinely benefit from surgery, but they may be missing out,” cautioned Tsai.

According to the American Society for Metabolic and Bariatric Surgery, almost 280,000 metabolic and bariatric surgeries were conducted in the U.S. in 2022, accounting for around 1% of individuals eligible for such surgeries.

The number of weight loss surgeries rose in 2022, possibly due to a backlog created by delays during the COVID-19 pandemic, where lockdowns and postponements of non-emergency surgeries in 2020 and 2021 fueled demand. Tsai suggested that without the recent popularity of GLP-1 drugs, there would likely have been an increase in demand for weight loss surgeries in 2023.

Experts anticipate that the decline in bariatric surgeries may just be a temporary trend as patients adjust to considering GLP-1 medications as one of several weight loss solutions. The CDC estimates that nearly 40% of Americans are categorized as obese, with 1 in 10 individuals classified as severely obese.

“Most professionals I know in this field are not wary of GLP-1s,” remarked Ann M. Rogers, director of the Penn State surgical weight loss program. “We’re pleased to see these medications emerging, as they are raising awareness about medical weight issues and the potential treatments available.”

While medications might appear to be a straightforward solution for weight loss, they do come with their own challenges.

Weight loss surgeries carry risks but so do weight loss medications. Users of weight loss drugs have reported side effects such as stomach discomfort, diarrhea, and gallbladder complications. Additionally, many lack insurance coverage or find the costs prohibitive, with monthly expenses exceeding $1,300.

A report from the Blue Cross Blue Shield Association indicated that more than half of individuals prescribed weight loss medications like Saxenda and Wegovy in the past decade stopped their treatment prematurely, missing out on significant health improvements.

However, Rogers perceives a positive aspect related to the large number of individuals who experiment with weight loss drugs and ultimately discontinue their use.

“There exists a vast population of individuals who might either fear treatment, lack coverage, or feel embarrassed,” said Rogers, also president of the American Society for Metabolic and Bariatric Surgery. “If they encounter high costs, side effects, or the absence of insurance for these drugs, they might consider trying surgery instead.”