Rise in Use of Weight Loss Medications Prior to Bariatric Surgery Highlights Changing Treatment Trends

Recent research has shown a remarkable increase in the use of weight loss drugs among patients preparing for metabolic and bariatric surgery, reflecting evolving approaches to obesity and type 2 diabetes management. Presented at the American College of Surgeons (ACS) Clinical Congress 2025 in Chicago, the study highlights how medications like GLP-1 receptor agonists — specifically semaglutide (Wegovy, Ozempic) and tirzepatide (Zepbound, Mounjaro) — are increasingly prescribed before surgery.

The analysis reviewed nearly 365,000 patients who underwent primary metabolic and bariatric procedures between 2018 and 2024. Using data from the Epic Cosmos database, which encompasses over 300 million patient records, researchers tracked prescription patterns and found that the proportion of patients receiving at least one GLP-1 prescription within a year before surgery surged from 1.8% in early 2020 to 29.4% by late 2024 — a 16-fold increase.

This trend was observed in both diabetic and non-diabetic patients. For those without type 2 diabetes, preoperative GLP-1 use rose sharply from 2.1% in early 2022 to 23.2% at the end of 2024, representing an 11-fold increase. Among patients with diabetes, usage increased from 11.3% to 45.2% over the same period. The typical patient was around 43 years old with a median BMI of 46, predominantly women (80%), with a third diagnosed with type 2 diabetes.

Lead author Dr. Stefanie C. Rohde emphasized that this shift signals a change in how patients view and pursue obesity treatments. "Patients now often utilize both medical therapy with GLP-1 receptor agonists and surgical options, rather than choosing exclusively one or the other," she explained. Using GLP-1 medications after surgery to enhance weight loss results is also becoming more common.

Looking ahead, the research suggests that real-world data from large healthcare databases like Epic Cosmos can help develop evidence-based guidelines for when and how to combine or transition between these treatments, improving patient outcomes. However, the study acknowledged certain limitations, such as potential inaccuracies in health records and uncertainty over medication adherence.

Overall, these findings demonstrate a significant shift in the landscape of obesity management, reflecting multidisciplinary approaches that integrate pharmacotherapy and surgical intervention for better patient care.