Although national bariatric surgical procedure volumes began to recover in 2021, regional changes in volume did not align with changes in obesity prevalence. The widespread use of semaglutide, both on- and off-label use, and the pediatric guideline changes for addressing obesity underscore the nation’s prioritization of curbing the prevalence of obesity. Whether clinicians and guardians will introduce surgical and medication intervention more commonly during childhood remains to be seen.
Similarly, whether medication management for weight loss will overtake bariatric surgery as the “gold standard” is an open question. The long-term side effects of these therapies, which are designed for lifelong use, and their cost implications, which can exceed $1,000 per month, are still being studied. With healthcare spending approaching 20% of U.S. GDP, the increasing demand for expensive weight loss drugs and weight loss surgical procedures will profoundly impact national healthcare expenditures.
Tracking the impact of weight loss drugs on bariatric surgery over time is crucial. To what extent are the patients taking semaglutide for off-label use widening the gap for patients with greater clinical need? What side effects may manifest from off-label use? Will drugs like semaglutide serve as a substitute or alternatives to bariatric surgery? Will the patient demographics of bariatric surgery patients be similar or vastly different to those using long-term weight loss medications? Monitoring these trends will be critical in understanding obesity disease burden and the associated costs to the U.S. healthcare system.
Thanks to Katie Patton and Austin Miller for their research support.
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