Weight Loss Surgeries Decline as GLP-1 Drugs Surge: What This Shift Means for You

For decades, bariatric surgery was considered the gold standard—the go-to, first-line treatment for people struggling with severe obesity. Procedures like gastric bypass and sleeve gastrectomy helped millions lose significant amounts of weight and improve serious health conditions. But a new study suggests the landscape of weight loss treatment is undergoing a dramatic transformation. As GLP-1 medications like Ozempic, Wegovy, Mounjaro, and Zepbound skyrocket in popularity, the number of people choosing surgery is starting to fall.

Researchers from Loyola University Chicago recently analyzed national data from 2020 through 2024, and their findings, presented at the American Society for Metabolic and Bariatric Surgery (ASMBS) Annual Meeting in San Antonio, Texas, reveal a clear trend: bariatric surgeries peaked in 2022 and have been declining ever since. While the study has not yet been published in a peer-reviewed journal, it highlights a major shift in how patients and doctors are approaching weight loss—and raises important questions about what treatment is truly best for whom.

If you or someone you love is considering weight loss options, this evolving picture matters. Here’s what you need to know about the changing role of surgery, the rise of medications, and how to make an informed choice.

What the New Study Actually Found

The Loyola University research team turned to a large national database called the ACS-MBSAQIP, which tracks bariatric surgeries performed across the United States. They looked at all procedures—both initial weight loss surgeries and follow-up revision or conversion surgeries—from the beginning of 2020 through 2024.

The results showed that the overall number of bariatric surgeries hit its highest point in 2022. After that, the numbers dropped in 2023 and 2024. This decline suggests that more patients and their doctors are now choosing nonsurgical options, primarily GLP-1 medications, instead of going under the knife.

But the study didn’t just find fewer surgeries—it also found that the types of surgeries people are getting are changing. Sleeve gastrectomy, which involves removing a large portion of the stomach to make it smaller, is still the most common procedure. However, its share of all bariatric surgeries has been steadily shrinking since 2020. Meanwhile, Roux-en-Y gastric bypass—a more complex surgery that creates a small stomach pouch and reroutes part of the small intestine—is becoming more common, especially as a conversion surgery for people who previously had a sleeve gastrectomy and need additional help with weight loss or complications.

The study also noted an overall increase in other bariatric procedures, including lap-band surgeries and a wider variety of surgical options. This suggests that surgeons and patients are becoming more thoughtful about tailoring the type of surgery to each individual’s specific needs.

Why This Shift Is Happening Now

The rise of GLP-1 drugs is hard to ignore. Medications like semaglutide (the active ingredient in Ozempic and Wegovy) and tirzepatide (the active ingredient in Mounjaro and Zepbound) have become household names. They work by mimicking hormones in your body that regulate appetite and blood sugar, helping people feel fuller longer and eat less. For many, these drugs have produced dramatic weight loss results that were previously only achievable through surgery.

This has changed the conversation around obesity treatment. Instead of seeing surgery as the only powerful option, patients and doctors now have a new tool in the toolbox. And because taking a weekly injection can feel less intimidating than undergoing a surgical procedure, many people are choosing the medication route first.

Dr. John DeBarros, Chief Medical Officer at Pivot Weight Loss Center, who was not involved in the study, told Healthline that whether this trend is good or bad “depends.” He explained that if patients have done their research, talked with a qualified surgeon, and still feel a GLP-1 medication is the best choice for them, that is patient-centered care at its finest. But he also expressed deep concern about people who avoid surgery simply because it feels easier or less scary to take a drug.

“I think the decline in bariatric surgery becomes a grave problem when patients with severe obesity—those with a BMI of 35+ with serious comorbidities—make that choice without understanding that surgery may be infinitely more effective for them,” DeBarros said.

What Experts Say About Surgery vs. Medication

The debate between surgery and medication is not black and white. Dr. Sergey Terushkin, a bariatric surgeon with ThinEra who also was not part of the study, told Healthline that the conversation has become too extreme on both sides. “Some people act like bariatric surgery is suddenly obsolete. Other people dismiss the medications completely. Neither is true,” he said.

Terushkin acknowledged that GLP-1 drugs have absolutely changed the field. In his own practice, he has seen patients who struggled for years with diet, exercise, and medications that didn’t work for them finally lose weight on drugs like semaglutide or tirzepatide. “That’s a good thing,” he said. “Surgeons shouldn’t be angry that some patients are improving without an operation.”

However, he emphasized that bariatric surgery remains the most effective treatment for long-term weight loss, backed by years of data. “Surgery is not just ‘making the stomach smaller,’” he explained. “It alters hunger hormones, metabolism, diabetes progression, sleep apnea, blood pressure, and mobility.” He also noted that modern laparoscopic surgery—where a thin tube with a camera is inserted through small incisions in the abdomen—allows most patients to recover quickly and go home the same day or the next.

Terushkin’s biggest worry is patients who delay treatment for years, waiting for a perfect answer that may never come. “I’ve done revision surgeries on patients who spent ten years bouncing between diets, supplements, and medications, then came in with worsening diabetes and major health problems,” he said.

How This Affects You: Practical Takeaways

If you are considering weight loss treatment, this evolving landscape means you have more options than ever before—but also more decisions to make. Here are some key takeaways to keep in mind:

– There is no one-size-fits-all answer. The best treatment depends on your individual situation. Severity of obesity, medical history, and whether you can realistically stay on a medication long term all matter.

– Surgery is still the most proven option for long-term results. Decades of research show that bariatric surgery produces significant and lasting weight loss, and it can improve or resolve conditions like type 2 diabetes, high blood pressure, and sleep apnea.

– GLP-1 medications are powerful but require commitment. These drugs work well for many people, but they are typically meant to be taken long term. If you stop taking them, you may regain much of the weight you lost.

– Combination approaches may work best for some people. Some patients use medication before surgery to lose enough weight to make the procedure safer, or after surgery to maintain results. Talk to your doctor about what combination might work for you.

– Don’t let fear drive your decision. Both surgery and medication have risks and benefits. But making a choice based on what feels less intimidating—rather than what is most effective for your specific health needs—could lead to worse outcomes down the road.

The worst approach, according to Terushkin, is treating obesity like there is one universal answer for everybody. “Sometimes medications are enough. Sometimes surgery is the better option. Sometimes they work very well together,” he said.

What Comes Next in Weight Loss Treatment

The findings from Loyola University Chicago are just one piece of a much larger puzzle. As GLP-1 drugs continue to grow in popularity and new medications enter the market, the field of obesity treatment will keep evolving. Researchers are also studying how these drugs compare with surgery head-to-head over many years, and how they can be used together to maximize results.

For now, the most important thing you can do is have an open, honest conversation with your doctor. Ask questions. Get all the facts about both surgery and medications. Understand what your insurance covers. And most importantly, don’t wait years hoping for a perfect solution that may never arrive. As Terushkin put it, “The worst approach is treating obesity like there’s one universal answer for everybody.”

Whether you choose surgery, medication, or a combination of both, the goal remains the same: improving your health and quality of life. And with more tools available than ever before, there has never been a better time to take that first step.

Source: Healthline