Claims study finds GLP‑1 use more than doubled as bariatric surgery use fell

What happened

A national insurance-claims study documented sharply different treatment trends from 2022 through 2024. Use of GLP-1 receptor agonists rose 140.4%, while use of metabolic and bariatric surgery declined 34.1% in the population the researchers analyzed.

The JAMA Surgery research letter used IQVIA PharMetrics Plus with Mortality data from 11.7 million U.S. adults. Participants had at least one diagnosis of overweight, obesity, or diabetes and continuous medical and pharmacy coverage through commercial insurance, Medicaid, or Medicare Advantage. The researchers excluded people who received both treatments during the period, then calculated quarterly treatment rates.

From 2022 to 2023, the rate of patients filling a GLP-1 prescription increased 71.8%, from 36.2 to 62.1 per 1,000. It rose another 39.9% in 2024. Surgery moved in the other direction: the rate fell 14.4% in 2023, from 2.0 to 1.7 patients per 1,000, followed by a further 23.0% year-over-year decline in 2024.

Across the full study period, 9.2% of the population received a GLP-1 medicine and 0.4% underwent surgery. More than 90% received neither treatment captured by the analysis. Surgical patients tended to have more medical complexity than GLP-1 users or people in the no-treatment category.

What it means

The study supplies a consistent claims-based view of the period after tirzepatide entered wider U.S. use. It shows that GLP-1 prescribing expanded quickly while billed surgery became less common in this insured population.

It also shows that the two treatment groups were not interchangeable. People who underwent surgery had a different burden of medical conditions, and a simple count cannot determine which treatment would have been appropriate for any one person.

What it does not mean

The analysis cannot prove that rising GLP-1 use caused the decline in surgery. It did not measure referrals, treatment preferences, insurance denials, medicine persistence, supply constraints, surgical eligibility, or why a patient received neither option.

Claims identify billed prescriptions and procedures, not weight outcomes, disease remission, complications, satisfaction, or long-term comparative effectiveness. The study therefore cannot rank medication and surgery on clinical benefit.

The percentages also should not be merged with separate ASMBS meeting reports that used Epic Cosmos or MBSAQIP data. Those analyses addressed related questions with different populations, years, denominators, and methods. Keeping them separate prevents one dataset's findings from being attributed to another.