Metabolic and Bariatric Surgery Utilization in the Era of Glucagon-Like Peptide-1 Receptor Agonists among Adolescents versus Adults
Sarah E. Messiah, Deepali K. Ernest, Folefac D. Atem, Faisal G. Qureshi, M. Sunil Mathew, Jackson M. Francis, Alicia Wheelington, Marlyn A. Allicock, Bethany R. Cartwright, Benjamin E. Schneider, Nestor de la Cruz-Muñoz, Steven E. Lipshultz, Ildiko Lingvay, Jaime P. Almandoz, Sarah E. Barlow
- Even with the growing popularity of newer weight loss medications like semaglutide (Ozempic/Wegovy), the number of teenagers undergoing weight loss surgery continued to rise — increasing by about 15% from 2021 to 2023. This suggests that surgery remains an important and trusted treatment option for teens with severe obesity.
- Among adults, the trend was different: weight loss surgery numbers actually declined from 2022 to 2023, likely because more adults are choosing GLP-1 medications instead. For teenagers, surgery and medications appear to serve complementary roles rather than one replacing the other.
- For the first time, Hispanic and Black teenagers represented the highest share of adolescents receiving weight loss surgery — a meaningful shift suggesting access to surgical care is improving for communities most affected by severe obesity.
- Sleeve gastrectomy remained by far the most common procedure for teens, used in more than 86% of cases each year. Nearly 40% of adolescents did not have surgery until their BMI reached approximately 50 — highlighting the importance of earlier evaluation and intervention when medically appropriate.
- The best approach to treating severe obesity in teenagers will likely combine multiple tools — including weight loss surgery, GLP-1 medications, and strong lifestyle support — tailored to each patient's individual needs.
- This study was published in The Journal of Pediatrics and analyzed data from nearly 4,500 adolescent surgeries at accredited U.S. centers — one of the most comprehensive looks at teen weight loss surgery trends in the GLP-1 era.
This cross-sectional study analyzed adolescent metabolic and bariatric surgery (MBS) utilization before and after glucagon-like peptide-1 receptor agonist (GLP-1RA) medication approval, comparing trends across race and ethnic groups. Although both MBS and GLP-1RA are effective weight management strategies, adolescent MBS utilization increased, while adult rates declined from 2021 through 2023.
Messiah SE, Ernest DK, Atem FD, Qureshi FG, Mathew MS, Francis JM, Wheelington A, Allicock MA, Cartwright BR, Schneider BE, de la Cruz-Muñoz N, Lipshultz SE, Lingvay I, Almandoz JP, Barlow SE. Metabolic and Bariatric Surgery Utilization in the Era of Glucagon-Like Peptide-1 Receptor Agonists among Adolescents versus Adults. J Pediatr. 2025;282:114564.
