Bariatric surgeries in the United States have declined since 2022 despite reaching a peak that year, as patients increasingly turn to GLP-1 drugs like semaglutide and tirzepatide for weight loss. A study by Loyola University Chicago researchers, presented at the American Society for Metabolic and Bariatric Surgery Annual Meeting from May 3–7 in San Antonio, TX, analyzed data from 2020 to 2024 using the ACS-MBSAQIP national database. The findings show a steady drop in sleeve gastrectomy, the most common initial procedure, though it remains the top surgery performed. At the same time, Roux-en-Y gastric bypass surgeries have become more frequent, especially as conversion procedures for patients who previously had sleeve gastrectomies. The study also notes an overall rise in revision and conversion surgeries, suggesting growing complexity in patient care trajectories. While the total number of bariatric procedures climbed through 2022, it has since decreased, a shift researchers link to the rising popularity of non-surgical treatments. Dr. John DeBarros, Chief Medical Officer at Pivot Weight Loss Center and not involved in the study, said the trend is neither inherently positive nor negative. He emphasized that patient-centered care depends on informed decisions made after consultation with qualified surgeons. However, he expressed concern when patients avoid surgery simply because GLP-1 medications seem easier, especially for those with a BMI of 35 or higher and serious comorbidities. Dr. Sergey Terushkin, a bariatric surgeon who also did not participate in the research, acknowledged that GLP-1 drugs have transformed the field, noting patients in his practice are now losing weight after years of failed efforts with diet, exercise, and other medications.
The decline in bariatric surgeries coincides with the rise of GLP-1 drugs, yet the most at-risk patients—those with severe obesity and comorbidities—may be opting for less effective treatments based on ease rather than medical advice. Dr. DeBarros' concern that patients bypass surgery without understanding its superior efficacy in severe cases suggests a growing gap in informed decision-making. If convenience outweighs clinical appropriateness, outcomes for the most vulnerable could worsen despite pharmaceutical advances. This shift reflects not progress, but a potential misalignment between patient choice and medical necessity.
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