Preoperative GLP-1 Use Does Not Explain Bariatric Surgery Volume Decline

Document Type

Conference Proceeding

Publication Date

4-2026

Publication Title

Surgery for Obesity and Related Diseases

Abstract

Introduction: Bariatric surgery volumes have declined substantially across the United States amid rapid population-level adoption of GLP-1 receptor agonist (GLP-1 RA) medications for obesity management. However, whether patient-level GLP-1 RA use among surgical candidates predicts which programs experience volume loss remains unknown. This study examined statewide patient and program-level predictors of bariatric surgery volume decline. METHODS AND PROCEDURES: Retrospective cohort study of 40 bariatric surgery programs in the Michigan Bariatric Surgery Collaborative from January 2022 through December 2024, including 21,858 adult patients undergoing primary bariatric surgery. Volume loss was defined as .10% decline in annual primary procedures. Multivariable logistic regression identified independent predictors of site-level volume loss adjusting for patient case-mix, program characteristics, and preoperative GLP-1 RA use. Results: Overall volumes declined 27.9% while preoperative GLP1 RA use increased 5.8-fold from 1.8% to 10.4% (P,0.001). Twenty-eight programs (70%) experienced volume loss, 6 (15%) maintained volume, and 6 (15%) grew. In multivariable analysis, patient-level GLP-1 RA use was not associated with volume loss. Sites serving patients with higher metabolic disease burden (hyperlipidemia prevalence) experienced greater volume decline (OR 1.09 per 1%; 95% CI 1.02–1.19; P50.024). Geographic location, procedure type, payer mix, and complication rates (2.7–3.1%; P50.51) did not differ across volume categories. Conclusion: Preoperative patient-level GLP-1 use did not predict program volume loss. Programs serving populations with higher rates of hyperlipidemia experienced greater volume decline. Despite reduction in surgical volume at most sites, safety was maintained with similar complication rates.

Volume

22

Issue

4 Suppl

First Page

S58

Last Page

S59

Comments

American Society for Metabolic and Bariatric Surgery (ASMBS) Annual Meeting, May 3-7, 2026, San Antonio, TX

DOI

10.1016/j.soard.2026.02.197

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