Surge in Preoperative Weight Loss Drug Usage Among Bariatric Surgery Patients

Recent studies reveal a notable rise in the prescription of weight loss medications among individuals preparing for metabolic and bariatric surgery, indicating a significant shift in the obesity management landscape.

This data was highlighted during the American College of Surgeons (ACS) Clinical Congress 2025, taking place in Chicago from October 4-7. The research underscores the evolving strategies in treating obesity and related conditions such as type 2 diabetes.

According to the senior author of the study, the approach to treating obesity is becoming increasingly multifaceted, moving beyond traditional methods. Acknowledging that each patient's needs are unique, the focus is shifting towards integrated care strategies.

The investigative team conducted a comprehensive analysis of glucagon-like peptide-1 receptor agonists (GLP-1s), specifically examining semaglutide (Wegovy, Ozempic) and tirzepatide (Zepbound, Mounjaro) among bariatric patients. Utilizing the Epic Cosmos database, which encompasses over 300 million patient records, they scrutinized prescription trends from 2018 to 2024.

Key findings from the study revealed a dramatic increase in patients receiving at least one GLP-1 prescription before surgery, escalating from 1.8% in early 2020 to an impressive 29.4% by late 2024, marking a 16-fold increase. This trend was evident among both diabetic and non-diabetic patients, highlighting the growing recognition of these medications in obesity treatment.

For those without type 2 diabetes, preoperative GLP-1 usage surged from 2.1% in early 2022 to 23.2% by the end of 2024, an 11-fold increase. Conversely, among patients diagnosed with type 2 diabetes, usage quadrupled, rising from 11.3% to 45.2% during the same timeframe.

The average age of the participants was 43 years, with a median body mass index (BMI) of 46. Notably, women comprised 80% of the study group, and one-third of the participants had a type 2 diabetes diagnosis.

The lead author of the study remarked on the changing perceptions among bariatric surgery candidates, noting that more individuals are now recognizing the potential benefits of using GLP-1 receptor agonists in conjunction with surgical interventions. This dual approach not only enhances weight loss outcomes but also offers new avenues for patient management post-surgery.

Looking ahead, the availability of real-world data, such as that derived from the Epic Cosmos database, is expected to aid in the establishment of evidence-based guidelines. These guidelines will inform healthcare professionals on the optimal timing and combination of treatment options, whether administered prior to surgery or during the recovery phase.

It is important to note the limitations highlighted by the researchers, which include potential inaccuracies in health records and the uncertainty surrounding whether patients adhered to their prescribed medication regimens.

In summary, the findings reflect a significant shift in the treatment paradigm for obesity and associated metabolic conditions, emphasizing the importance of individualized care pathways and collaborative management strategies.