Bariatric Surgery Rates Down by 26% in Recent Years: Report

Over the past few decades, Americans who want to lose weight have often turned to bariatric surgery. However, a new study suggests that more people are now turning to prescription medications like Ozempic, Wegovy, Mounjaro and Zepbound to take the weight off.

Bariatric surgeries include gastric sleeve procedures, like LapBand, and gastric bypass. Gastric sleeve procedures remove roughly 80% of the stomach, which reduces the size of the stomach and forces patients to eat much less. Another procedure, known as Roux-en-Y Gastric Bypass, involves the stomach being divided and rerouted to the lower portion of the small intestine, effectively closing off a part of the stomach.

Doctors often recommend bariatric surgery to obese patients to help them lose large amounts of weight and improve conditions like diabetes and hypertension. These types of surgeries are used when traditional methods like diet and exercise no longer work, and patients are severely overweight.

However, findings published last month in JAMA Network Open, show that in recent years obese patients who want to lose weight are turning to a class of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists, such as Ozempic and Mounjaro, which started out as diabetes medications and are now being used more and more for weight loss.

Ozempic (semaglutide) is a Novo Nordisk type 2 diabetes drug approved by the FDA in December 2017, as a once-weekly injection. However, the manufacturer has convinced the FDA to expand the drug’s approval over the years, including indications for the prevention of diabetes-related heart disease, and the approval of increasingly more powerful doses.

Novo Nordisk has also introduced a separate version of the drug under the brand name Wegovy, which is approved and marketed for weight loss, but there have been growing concerns about side effects of Ozempic and Wegovy in recent years, including reports that users have been left with stomach paralysis and severe gastrointestinal problems, which lawsuits now allege was not adequately disclosed on the drug label.

Mounjaro (tirzepatide) is a similar GLP-1 receptor agonist that was introduced by Eli Lilly in May 2022, and approved for treating type 2 diabetes. Following the success of Novo Nordisk’s Wegovy product, Eil Lilly created its own weight loss version of Mounjaro, which is marketed as Zepbound.

Over the past few years, sales for these new weight loss drugs has risen dramatically, and some estimates suggest that GLP-1 sales are expected to surpass $100 billion per year by 2029.

Bariatric Surgery Demand Decreasing

In this new study, researchers from Harvard and Brigham and Women’s Hospital in Boston analyzed national trends involving obese patients who were prescribed GLP-1s, and compared those with bariatric surgery.

A team of researchers led by Dr. Thomas C. Tsai used anonymous medical records from 2022 to 2023, comparing nearly 82,000 patients using GLP-1 drugs with 5,200 patients who underwent bariatric surgery.

According to the findings, use of GLP-1 drugs like Ozempic and Wegovy doubled during that time period. In addition, the data also showed a 26% decrease in the number of patients who had bariatric surgery.

The researchers noted that use of drugs like Ozempic and Zepbound jumped 133% between the last six months of 2022, and the last six months of 2023.

They determined that, during that time period, more patients began opting for weight loss drugs. Researchers also said the GLP-1 drugs were an effective treatment for obesity and diabetes, but were more costly and resulted in high rates of gastrointestinal side effects.

As a result of these complications, researchers indicated many patients are quitting the drugs, and looking for other ways to lose weight.

Study authors said more research is needed to assess the trends in bariatric surgery use compared to weight loss drugs. They also noted that doctors should closely monitor the trade-offs between the use of weight loss drugs and bariatric surgery to ensure patients are given the most effective obesity treatment in the long run and weigh all the risks and benefits.

For example, a study published in 2019 by French researchers found bariatric surgeries increase the risk of a person suffering gastrointestinal complications. They faced a higher risk of hospital admission, needing invasive gastrointestinal surgery later, and suffering nutritional disorders.

A study published the same year by Swedish researchers indicated many patients who have bariatric surgery often need revision surgery to correct problems, reverse the surgery completely, or convert the surgery to other types of bariatric surgery.

GLP-1 Side Effects Concerns

Dr. Tsai’s findings come as more and more concerns are raised over the potential side effects of drugs like Ozempic and Mounjaro, indicating that while the drugs are effective at treating diabetes and helping promote weight loss, they appear to lack adequate warnings about the risks of severe gastrointestinal problems, such as intestinal obstructions and gastroparesis.

Gastroparesis, also known as delayed gastric emptying or stomach paralysis, weakens the normal muscle movement in the stomach. These stomach contractions are necessary to push food through the digestive tract.

When gastroparesis occurs, the stomach is slow to empty, resulting in symptoms like nausea, vomiting undigested food, abdominal pain, abdominal bloating, severe dehydration, feeling full after only a few bites, undigested food hardening in the stomach, acid reflux, fluctuating blood sugar levels, lack of appetite, weight loss, malnutrition and decreased quality of life.

As a result of the drug makers’ failure to disclose these side effects to users and the medical community, there are currently hundreds of Ozempic lawsuits, Wegovy lawsuits and Mounjaro lawsuits being filed in federal courts nationwide. Given common questions of fact and law raised in the claims, all federal GLP-1 lawsuits have been centralized as part of an MDL, or multidistrict litigation, where U.S. District Judge Karen S. Marston is overseeing coordinated discovery and pretrial proceedings.