Study shows that compared with GLP-1 RAs, bariatric surgery was significantly associated with greater weight loss while saving approximately $11,689 in ongoing costs over 2 years.
Source: Tyson S. Barrett, PhD; Juliane O. Hafermann, PhD; Shannon Richards, MSN, JAMA Network, 7/17/2025
This cohort study of 30,458 patients from an insurance database in the US found that compared with GLP-1 RAs, bariatric surgery was significantly associated with greater weight loss while saving approximately $11,689 in ongoing costs over 2 years.
This cohort study used data from the Highmark Health insurance claims database and the Allegheny Health Network electronic medical record in the US. Participants were patients with class II or III obesity treated with either MBS or GLP-1 RAs who were enrolled in Highmark insurance for at least 6 months prior to index treatment and had follow-up data available for at least 12 months. Using propensity score weighting, the populations were adjusted for differences in baseline spending, health care utilization, age, sex, comorbidities, and smoking status. Data were analyzed from July 2024 to July 2025.
Study findings
- Analyses included 30,458 patients (mean [SD] age, 50 [11] years; 20 118 [66.1%] female), with 14 101 undergoing MBS (mean [SD] follow-up, 34 [16] months) and 16 357 receiving GLP-1 RAs (mean [SD] follow-up, 32 [17] months).
- After propensity score weighting, baseline characteristics were comparable. The mean (SE) total costs over 2 years were $63,483 ($1563) for GLP-1 RAs and $51,794 ($1724) for MBS (P < .001).
- The main driver of this difference was higher sustained pharmacy costs in the GLP-1 RA group throughout year 2 of follow-up.
- Comparing weight loss data of 257 patients using GLP-1 RAs and 1291 patients who underwent MBS, total weight loss was greater for the MBS group (mean [SE], 28.3% [0.3%]) than the GLP-1 RA group (mean [SE], 10.3% [0.5%]) (P < .001).
