byAmerican College of Surgeons

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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 was presented at the American College of Surgeons (ACS)Clinical Congress 2025, held in Chicago, October 4–7.

"There's no one-size-fits-all approach to treating obesity,metabolic syndrome, ordiabetesand 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."

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 millionpatient recordsfrom institutions across the country, to examine prescription patterns for semaglutide and tirzepatide, two of the newest GLP-1s to hit the market.

The median age of patients was 43 years, the median preoperative body mass index (BMI) of these patients was 46. Women made up 80% of the sample, and 33% had a diagnosis of type 2 diabetes.

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 afterbariatric surgeryto 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.

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.

Mahmoud Abdel-Rasoul, MS, MPH, is study co-author.

More information: Sweigert P, et al. Preoperative Glucagon-Like Peptide-1 Receptor Agonist Utilization Has Surged Among Bariatric Surgery Patients, Scientific Forum, American College of Surgeons (ACS) Clinical Congress 2025.

Provided by American College of Surgeons