The use of glucagon-like peptide-1 receptor agonists, or GLP-1s, among patients preparing for metabolic and bariatric surgery has surged, according to new research. The findings, which were presented at the American College of Surgeons Clinical Congress 2025, show a 16-fold increase in the prescription of these weight loss drugs to patients in the year leading up to their surgical procedures.
This dramatic rise highlights a significant shift in the treatment of obesity and type 2 diabetes, suggesting that patients and physicians are increasingly viewing pharmaceutical and surgical interventions as complementary rather than mutually exclusive options. The study, which analyzed nearly 365,000 patient records, indicates that this trend is prevalent among individuals both with and without a diabetes diagnosis, underscoring the expanding role of these medications in broader obesity management.
Evolving Treatment Paradigms
The study reveals a new era in weight management, one that increasingly involves a multidisciplinary approach. Patrick J. Sweigert, the study’s senior author and a bariatric surgeon at The Ohio State University Wexner Medical Center, emphasized that there is no single solution for treating obesity and related metabolic conditions. The data suggests a move toward integrated care pathways where medications like semaglutide and tirzepatide are used in conjunction with surgical options to optimize patient outcomes.
Researchers are observing that patients who previously saw a choice between GLP-1s and surgery are now utilizing both. This indicates a growing understanding that these drugs can be used not only as a standalone treatment but also as a tool to enhance weight loss after bariatric surgery. The study’s lead author, Stefanie C. Rohde, noted that this combined approach is still a relatively new frontier, and real-world data will be crucial for developing evidence-based guidelines for patient management.
A Closer Look at the Data
The cross-sectional study utilized the Epic Cosmos database, which contains over 300 million patient records, to examine prescription patterns for the GLP-1s semaglutide, known by brand names like Wegovy and Ozempic, and tirzepatide, sold as Zepbound and Mounjaro. The analysis covered patients who underwent primary metabolic and bariatric surgery between 2018 and 2024.
Key Prescription Trends
The proportion of patients who received at least one GLP-1 prescription within a year of their surgery increased from 1.8% in the first quarter of 2020 to 29.4% in the fourth quarter of 2024. This increase was observed across different patient populations, though the rate of increase varied. For patients with type 2 diabetes, GLP-1 use saw a four-fold rise, from 11.3% to 45.2%, over the last three years. In contrast, among patients without diabetes, the use of these medications increased 11-fold during the same period, from 2.1% to 23.2%.
Patient Demographics
The study sample consisted of patients with a median age of 43 and a median preoperative body mass index, or BMI, of 46. Women constituted a large majority of the patients, at 80%, and one-third of the individuals in the study had a diagnosis of type 2 diabetes.
Implications for Future Obesity Care
The surge in preoperative GLP-1 use signals a need for the medical community to adapt its approach to obesity treatment. As more patients use these medications before and after surgery, it becomes increasingly important to understand the optimal timing and combination of these therapies. The study’s authors suggest that ongoing analysis of real-world data will be essential for establishing clear guidelines on when to initiate, combine, or transition between different treatment modalities.
While the findings point to a clear trend, the investigators acknowledged certain limitations in their analysis. These include the potential for inaccuracies within health record data and the uncertainty of whether patients who received prescriptions actually filled them or adhered to the medication regimen. Despite these limitations, the research provides a valuable snapshot of the changing landscape of obesity management.
Broader Context of Weight Management
The increasing integration of GLP-1s into the bariatric surgery pathway reflects a broader evolution in the understanding and treatment of obesity. For many years, surgery was considered a last resort for individuals who had not found success with other weight loss methods. The advent of highly effective medications like GLP-1s has provided a powerful new tool in the clinical arsenal, and healthcare providers are now exploring how to best leverage all available options to personalize patient care.
This combined approach may offer several benefits, such as improving a patient’s health status before surgery or enhancing long-term weight maintenance after the procedure. As the use of these drugs continues to grow, further research will be needed to fully comprehend the long-term effects and best practices for this new, integrated model of care. The findings from this study represent an important early step in that direction, highlighting a real-world trend that is reshaping the future of obesity treatment.
