Surge in GLP-1 drug use for weight problems coincides with drop in bariatric surgical procedure

Researchers from Mass Basic Brigham and collaborators discovered that use of GLP-1 medicine to deal with weight problems greater than doubled from 2022 to 2023 whereas charges of surgical procedure dropped by one quarter.

Key takeaways

• Researchers from Mass Basic Brigham and collaborators assessed nationwide traits within the variety of sufferers with weight problems prescribed GLP-1 medicine and the quantity who underwent metabolic bariatric surgical procedure.
• Researchers documented a 132.6% enhance in sufferers prescribed GLP-1 medicine between 2022 and 2023, and a 25.6% lower in sufferers present process bariatric surgical procedure.
• Solely 6% of sufferers with weight problems within the examine inhabitants obtained both GLP-1 medicine or surgical procedure, suggesting that many extra sufferers may very well be receiving remedy.

A brand new examine by researchers at Brigham and Girls’s Hospital, a founding member of the Mass Basic Brigham healthcare system, in collaboration with researchers at Harvard T.H. Chan College of Public Well being and the Brown College of Public Well being, examined a big pattern of privately insured sufferers with weight problems and located that use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) as anti-obesity drugs greater than doubled from 2022 to 2023. Throughout the identical interval, there was a 25.6% lower in sufferers present process metabolic bariatric surgical procedure to deal with weight problems. The examine is printed in JAMA Community Open.

Our examine gives one of many first nationwide estimates of the decline in utilization of bariatric metabolic surgical procedure amongst privately insured sufferers comparable to the rising use of blockbuster GLP-1 RA medicine.”

Thomas C. Tsai, MD, MPH, senior writer, metabolic bariatric surgeon, Division of Surgical procedure at Brigham and Girls’s Hospital

Utilizing a nationwide pattern of medical insurance coverage claims information from over 17 million privately insured adults, the researchers recognized sufferers with a prognosis of weight problems with out diabetes in 2022-2023. The examine discovered a pointy enhance within the share of sufferers who obtained GLP-1 RAs in the course of the examine interval, with GLP-1 RA use rising 132.6% from the final six months of 2022 to the final six months of 2023 (from 1.89 to 4.41 sufferers per 1,000 sufferers). In the meantime, there was a 25.6% lower in use of bariatric metabolic surgical procedure throughout the identical interval (from 0.22 to 0.16 sufferers per 1,000 sufferers).

Among the many pattern of sufferers with weight problems, 94.7% obtained neither type of remedy in the course of the examine interval (whereas 5.0% obtained GLP-1 RAs and 0.3% obtained surgical procedure). In comparison with sufferers who have been prescribed GLP-1 RAs, sufferers who underwent surgical procedure tended to be extra medically advanced.

“For now, metabolic bariatric surgical procedure stays the simplest and sturdy remedy for weight problems. Nationwide efforts ought to deal with bettering entry to weight problems treatment-;whether or not pharmacologic or surgical-;to make sure sufferers can obtain optimum care,” mentioned Tsai, who can also be an assistant professor of Surgical procedure at Harvard Medical College and an assistant professor in Well being Coverage and Administration at Harvard T.H Chan College of Public Well being.

Tsai notes that whereas GLP-1 RAs can successfully deal with weight problems and associated situations (comparable to diabetes), these drugs have been restricted by excessive prices, restricted provide, and gastrointestinal unintended effects which will immediate remedy cessation and subsequent weight regain.

“As sufferers with weight problems more and more depend on GLP-1s as an alternative of surgical intervention, additional analysis is required to evaluate the impression of this shift from surgical to pharmacologic remedy of weight problems on long-term affected person outcomes,” Tsai mentioned. “With the nationwide decline in utilization of metabolic bariatric surgical procedure and potential closure of bariatric surgical procedure packages, there’s a concern that entry to complete multidisciplinary remedy of weight problems involving pharmacologic, endoscopic, or surgical interventions might develop into extra restricted.”

“These outcomes additionally spotlight a possibility to additional develop uptake of surgical and pharmacologic therapies for weight problems and associated comorbidities,” mentioned co-author Ateev Mehrotra, MD, MPH, chair of the Division of Well being Companies, Coverage and Follow on the Brown College College of Public Well being. “Metabolic bariatric surgical procedure and GLP-1 RAs are each efficient interventions for sufferers with weight problems, but lower than 6% of sufferers in our examine obtained both type of remedy.”

Contemplating these outcomes, the authors encourage clinicians and policymakers to proceed to observe entry to efficient weight problems remedy amidst a quickly evolving panorama of remedy choices. As well as, additional analysis is required to know the tradeoffs between use of surgical intervention versus more and more standard GLP-1 RAs to deal with weight problems.