A research letter published online July 20 in JAMA Pediatrics examined obesity treatment trends among adolescents and young adults between May 2022 and January 2026.
Here are four findings to know:
- Researchers analyzed electronic health record data for 204,148 patients ages 13 to 25 treated for obesity. Exclusive GLP-1 receptor agonist use increased from 88.2% in May-November 2022 to 96.1% in June 2025-January 2026.
- During the same period, metabolic and bariatric surgery completion fell from 11.6% to 3.7%, while combined use of GLP-1 drugs and surgery remained stable at 0.2%.
- Among patients who received both treatments, 72.3% initiated a GLP-1 receptor agonist before metabolic and bariatric surgery, while 27.7% began GLP-1 therapy after surgery.
- The authors said the findings suggest obesity treatment is shifting toward pharmacotherapy as the initial intervention for adolescents and young adults. They noted additional research is needed to determine whether declining bariatric surgery reflects substitution by GLP-1 drugs, insurance coverage, referral patterns or patient preferences.
The shift builds on trends already showing up in adult care. Since late 2022, rising uptake of GLP-1 medications for obesity has coincided with a decline in bariatric surgeries among adults. For instance, GLP-1 prescriptions increased from 0.22% to 24.17% of eligible adults between the fourth quarter of 2018 and the third quarter of 2025, while bariatric surgery volumes fell from 0.17% to 0.09% over roughly the same window, a 46.4% decline.
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