Anti-obesity drug consumption is increasing as weight-loss surgeries decline

Thank you very much. Listen to this article using the player above. ✖

A new study that examined a large sample of privately insured patients with obesity found that the use of drugs such as Ozempic and Wegovy as obesity medications more than doubled from 2022 to 2023. During the same period, there was a 25.6 percent decrease in the number of patients receiving metabolic bariatric surgery to treat obesity.

The study, by researchers at Brigham and Women's Hospital in collaboration with researchers at the Harvard TH Chan School of Public Health and the Brown School of Public Health, is published in JAMA Network Open.

“Our study provides one of the first national estimates of the decline in utilization of bariatric metabolic surgery among privately insured patients that has accompanied the increasing use of the blockbuster GLP-1 RA drugs,” said senior author Thomas C. Tsai, a metabolic researcher bariatric surgeon at Brigham and Women's Hospital.

Using a nationwide sample of health insurance claims data from more than 17 million privately insured adults, researchers identified patients diagnosed with obesity without diabetes in 2022-2023. The study found a large increase in the proportion of patients receiving glucagon-like peptide-1 receptor agonists, or GLP-1 RAs, during the study period, with GLP-1 RA use compared to the last six months of the year 2022 increased by 132.6 percent in the last six months of 2023 (from 1.89 to 4.41 patients per 1,000 patients). Meanwhile, there was a 25.6 percent decrease in utilization of bariatric metabolic surgery during the same period (from 0.22 to 0.16 patients per 1,000 patients).

Among patients with obesity, 94.7 percent received no treatment during the study period (while 5 percent received GLP-1 RAs and 0.3 percent received surgery). Compared to patients prescribed GLP-1 RAs, patients who underwent surgery tended to be medically more complex.

“Currently, metabolic bariatric surgery remains the most effective and durable treatment for obesity. “National efforts should focus on improving access to obesity treatment – ​​whether pharmacological or surgical – to ensure patients can receive optimal care,” said Tsai, who is also an assistant professor of surgery at Harvard Medical School and an assistant professor of health policy and management at Harvard Medical School is Harvard TH Chan School of Public Health.

Tsai notes that while GLP-1 RAs can effectively treat obesity and related diseases (such as diabetes), these drugs are limited by high cost, limited availability, and gastrointestinal side effects that can lead to treatment discontinuation and subsequent weight gain .

“As patients with obesity increasingly rely on GLP-1 rather than surgery, further research is needed to evaluate the impact of this shift from surgical to pharmacological treatment of obesity on long-term patient outcomes,” Tsai said. “Given the nationwide decline in utilization of metabolic bariatric surgery and the potential closure of bariatric surgery programs, there is concern that access to comprehensive multidisciplinary obesity treatment that includes pharmacologic, endoscopic or surgical interventions may become more limited.”

“These results also highlight the opportunity to further expand the use of surgical and pharmacological treatments for obesity and related comorbidities,” said co-author Ateev Mehrotra, chair of the Department of Health Services, Policy and Practice at the Brown University School of Public Health . “Metabolic bariatric surgery and GLP-1 RAs are both effective interventions for patients with obesity, yet fewer than 6 percent of patients in our study received either treatment.”

Given these findings, the authors encourage clinicians and policymakers to continue to monitor access to effective obesity treatment amid a rapidly evolving landscape of treatment options. Additionally, further research is needed to understand the trade-offs between the use of surgical procedures and the increasingly popular GLP-1 RAs for the treatment of obesity.

Reference: Lin K, Mehrotra A, Tsai TC. Metabolic bariatric surgery in the era of GLP-1 receptor agonists for the treatment of obesity. JAMA network opened. 2024;7(10):e2441380. doi: 10.1001/jamanetworkopen.2024.41380

This article is republished from the following materials. Note: Material may have been edited for length and content. For further information, please contact the source provided. Our guidelines for publishing press releases can be found here Here.