GLP-1 use rises 140.4% nationally

Harvard T.H. Chan School of Public Health said this week that use of GLP-1 drugs among insured U.S. adults with obesity, overweight or diabetes diagnoses rose 140.4% from 2022 to 2024, while metabolic bariatric surgery fell 34.1% over the same period. The analysis, published May 13 in *JAMA Surgery*, was conducted by researchers at Analysis Group, Harvard and Brigham and Women’s Hospital. The study drew on insurance claims from 11.7 million adults covered by commercial plans, Medicaid and Medicare Advantage. The findings add new national data to a shift many obesity specialists have been describing since newer GLP-1 drugs became more widely used. ### Which treatments were compared in the Harvard analysis? The study compared prescriptions for glucagon-like peptide-1 receptor agonists — including liraglutide, semaglutide and tirzepatide — with claims for metabolic bariatric surgery. Researchers looked at adults with at least one obesity, overweight or diabetes diagnosis between January 1, 2022, and December 31, 2024, and excluded patients who received both treatments during the study period. (hsph.harvard.edu) Harvard said the work was meant to update earlier estimates that were captured before the U.S. Food and Drug Administration approved tirzepatide, which the school described as a newer and increasingly popular GLP-1 drug sold under brand names including Mounjaro and Zepbound. ### How large was the shift? (jamanetwork.com) From 2022 through 2024, 1,068,885 patients in the study population filled GLP-1 prescriptions, equal to 9.2% of the 11.7 million adults analyzed, according to *JAMA Surgery*. Over the same period, 43,925 patients — 0.4% of the study population — had claims for metabolic bariatric surgery. More than 90% received neither treatment, Harvard said. (hsph.harvard.edu) The Harvard summary said bariatric surgery use did not just decline overall; the drop accelerated. Metabolic bariatric surgery fell 14.4% between 2022 and 2023 and then 23.0% in 2024, for a cumulative decline of 34.1% across the study period. ### Who was getting surgery rather than drugs? Harvard said patients who underwent surgery tended to be more medically complex than patients prescribed GLP-1 drugs or patients who received no treatment. (hsph.harvard.edu) The school did not frame the two approaches as interchangeable for every patient, and said surgery may remain an important option as insurance coverage for GLP-1 drugs becomes constrained by cost. The *JAMA Surgery* paper said researchers compared enrollee characteristics including age, sex and Elixhauser comorbidity index, a standard measure of disease burden. The paper’s methods section said trend significance was assessed by regressing treatment rates on time by year-quarter. ### Why are researchers and clinicians watching insurance coverage so closely? (hsph.harvard.edu) The *JAMA Surgery* paper said prior authorization requirements from many payors have increased for GLP-1 drugs. The authors wrote that trend data on surgery volumes can help inform strategies to preserve access to both pharmacologic and surgical obesity treatment. (jamanetwork.com) Harvard said clinicians and policymakers should continue monitoring how the shift affects long-term, multidisciplinary obesity care. That language reflects a market in which prescribing volumes are rising quickly, while surgery referrals and volumes are moving the other way. ### Where can readers find the underlying study? (jamanetwork.com) The study appears in *JAMA Surgery* under the title “Trends in Metabolic Bariatric Surgery Utilization in the Era of GLP-1s, 2022-2024.” Harvard published its school summary on May 18, 2026, and identified Thomas Tsai, an associate professor of health policy and management, as a co-author. (hsph.harvard.edu)