Bariatric surgery numbers in the United States reached their highest point in 2022 and have been falling ever since, according to a study from researchers at Loyola University Chicago. The findings, which have not yet appeared in a peer-reviewed journal, were presented at the American Society for Metabolic and Bariatric Surgery Annual Meeting held May 3 through 7 in San Antonio, Texas.
The researchers analyzed data from a large national database called the ACS-MBSAQIP, which tracks bariatric surgeries performed across the country. They focused on procedures carried out from the start of 2020 through 2024, covering both initial weight loss surgeries and follow-up revision or conversion procedures, which are operations performed to modify or adjust earlier surgeries.
The study found that the growing availability of GLP-1 medications and other nonsurgical weight management programs is likely driving the decline. Patients and doctors are increasingly choosing those alternatives over surgical intervention, the researchers concluded, reflecting a broad shift in how obesity is being treated.
The types of surgeries being performed have also changed over that period. Sleeve gastrectomy, a procedure in which a portion of the stomach is removed to reduce its size, remains the most commonly performed bariatric operation, but its share of total procedures has dropped steadily since 2020. Roux-en-Y gastric bypass, which creates a small stomach pouch and reroutes part of the intestines, has grown more common, particularly as a conversion surgery for patients who previously had a sleeve gastrectomy and are seeking further intervention, according to the report by Healthline.
Bariatric surgery has long been considered an effective long-term strategy for severe obesity, and experts note that procedural advancements, including laparoscopic techniques, have made recovery times significantly shorter than they once were. Still, the study makes clear that the landscape around weight loss treatment has changed substantially in a short period of time.
The research captures a moment when two very different approaches to treating obesity, one surgical and one pharmaceutical, are competing for the same patient population. Whether the decline in surgeries will continue as GLP-1 drugs become more widely prescribed remains an open question, though the data through 2024 points in a consistent direction.
The findings were shared before the full peer review process is complete, meaning the conclusions could be refined as the research moves toward publication.
