ASMBS 2026
Most severe obesity remains untreated despite GLP‑1 growth
Clinical takeaway: Even as GLP‑1 prescribing accelerates, more than 9 in 10 patients with severe obesity receive no treatment—underscoring the need for proactive discussions about the full continuum of care, including surgery and medications.
Drawing on electronic health records from nearly 20 million patients with severe obesity, a real‑world analysis presented at ASMBS 2026 shows a dramatic rise in GLP‑1 use alongside a recent decline in bariatric surgery, while overall obesity treatment rates remain strikingly low.
Between 2018 and 2025, GLP‑1 prescriptions increased from fewer than 4,600 to more than 1.4 million, with utilization rising from 0.03% to 5.3%. In contrast, bariatric surgery volumes grew modestly—from just under 20,000 procedures in 2018 to nearly 43,000 in 2023—before declining to under 40,000 in 2024 and 2025. Utilization rates peaked at 0.24% in 2023 and fell to approximately 0.21% thereafter, marking the first downturn coinciding with widespread GLP‑1 adoption.
Despite these trends, the proportion of patients receiving no obesity treatment remained between 90% and 95% throughout the study period. Investigators noted the decline in surgery may be concentrated among patients with the highest disease severity, raising concerns about access and treatment selection.
“While it’s encouraging to see more patients accessing GLP‑1s and concerning that less are opting for surgery, this study exposes an even bigger issue – most people with severe obesity remain untreated,” said Richard M. Peterson, MD, FASMBS, MPH.
Source: Laverde R, Neel N, Reeves J. ASMBS 2026 Annual Scientific Meeting Abstract 4393. San Antonio, TX. Trends of bariatric surgery utilization in patients with severe obesity in the era of GLP‑1 use for weight loss