Weight Loss Drugs Redefine Bariatric Surgery Path

Research presented at the American College of Surgeons Clinical Congress 2025 reveals that the use of weight loss drugs before bariatric surgery has skyrocketed over the past four years. The findings point to a changing landscape where medications like semaglutide and tirzepatide are becoming common steps prior to surgery in both diabetic and non-diabetic patients.

Between 2020 and 2024, usage of these drugs increased significantly, suggesting a paradigm shift in how clinicians and patients approach obesity and metabolic disorders. Experts say this trend highlights the growing role of pharmacotherapy alongside surgery in long-term weight management.

Key Takeaways

• Rapid uptake of weight loss drugs before metabolic and bariatric surgery: Between 2020 and 2024, the use of weight loss drugs before surgery rose sixteenfold among metabolic and bariatric surgery patients, highlighting their growing popularity and perceived effectiveness.
• Substantial Increase Among Patients Without Diabetes: Use of GLP-1s, a class of drugs used to treat both Type 2 diabetes and weight loss, rose elevenfold in patients without diabetes, reflecting growing weight-focused use before surgery.

New research findings show a significant increase in the use of weight loss drugs among patients undergoing metabolic and bariatric surgery, signaling an evolution in the management of obesity and Type 2 diabetes.

The research will be presented at the American College of Surgeons (ACS) Clinical Congress 2025 in Chicago.

“There’s no one-size-fits-all approach to treating obesity, metabolic syndrome, or diabetes and its related conditions,” said Patrick J. Sweigert, MD, senior author of the study and a bariatric and foregut surgeon at The Ohio State University Wexner Medical Center in Columbus, Ohio. “We’re entering a new world of multidisciplinary care pathways and a new frontier of weight management that is important for patients and surgeons to think about.”

What Did the Study Find?

The research team performed a cross-sectional study looking at glucagon-like peptide-1 receptor agonists (GLP-1s) semaglutide (Wegovy, Ozempic) and tirzepatide (Zepbound, Mounjaro) among patients undergoing metabolic and bariatric surgery.

Dr. Sweigert and colleagues analyzed nearly 365,000 patients who underwent primary metabolic and bariatric surgery between 2018 and 2024. They used the Epic Cosmos database, which includes more than 300 million patient records from institutions across the country, to examine prescription patterns for semaglutide and tirzepatide, two of the newest GLP-1s to hit the market.

How Are Patients Responding?

Lead author Stefanie C. Rohde, MD, a general surgery resident at The Ohio State University Wexner Medical Center, noted that the findings reflect a shift in how bariatric surgery candidates perceive their treatment options.

“While patients previously believed they had to choose between GLP-1 receptor agonists and surgery, we’re now seeing that people are using both,” Dr. Rohde said. “We know that patients can use GLP-1s after bariatric surgery to amplify their weight loss. But all of this is still very new in terms of how to manage patients effectively.”

Going forward, she added, real-world data such as that from Epic Cosmos can support the development of evidence-based guidelines for when to start, combine, or transition between treatment approaches, whether before surgery or during the postoperative period.

What Are the Study’s Limitations?

The investigators acknowledged limitations in their analysis, including potential inaccuracies in health record data and uncertainty about whether patients filled or took their prescribed medications.

Source-American College of Surgeons