USE OF GLUCAGON-LIKE PEPTIDE 1 AGONISTS (GLP-1RAS) BEFORE BARIATRIC SURGERY IN THE US
Author(s)
Abigail Zion, BS, Jodi Segal, MD, MPH, Hemalkumar Mehta, PhD, MS;
Johns Hopkins Bloomberg School of Public Health, Center for Drug Safety and Effectiveness, Baltimore, MD, USA
Johns Hopkins Bloomberg School of Public Health, Center for Drug Safety and Effectiveness, Baltimore, MD, USA
OBJECTIVES: Pre-operative use of GLP-1RAs has not been associated with improved weight loss or surgical outcomes. We characterize prescription of pre-operative GLP-1RAs prior to bariatric surgery using a large electronic health record (EHR) database.
METHODS: This retrospective cohort study used the TriNetX EHR data and included adults ≥18 years old who underwent first bariatric surgery from 2017 to November 2025. We defined prevalent prescription of a GLP-1RA as patients receiving a GLP-1RA prescription in 1-year before bariatric surgery and incident prescriptions as those with a prescription in 1-year prior but no prescription in months 13-24 before surgery. We identified patients' age, sex, race, ethnicity, body mass index (BMI), and comorbidities during the 1-year before surgery. We used descriptive statistics to characterize patients overall and by incident and prevalent GLP-1RA prescriptions.
RESULTS: We identified 176,458 adults who underwent bariatric surgery. Overall, 9.7% had at least one prescription for a GLP-1RA in the year prior to surgery and 6.0% newly received a GLP-1RA prescription during that year. Prevalent prescriptions for a GLP-1RA in the year prior to surgery increased from 3.4% in 2017 to 20.7% in 2025. Likewise, the incident prescriptions of GLP-1RAs increased from 2.2% in 2017 to 12.0% in 2025. GLP-1RA recipients and non-recipients were similar in demographic characteristics. Compared to non-users, GLP-1RA recipients had higher preoperative BMIs (mean ± SD: 45.4 ± 8.0 vs 42.5 ± 9.9) and higher rates of comorbidities, including hypertension (63.2% vs 46.1%), obstructive sleep apnea (56.2% vs 36.7%), and type 2 diabetes (58.0% vs 21.5%).
CONCLUSIONS: Prescriptions for GLP-1RAs before bariatric surgery are increasing, with 1 in 5 patients prescribed GLP-1RA in the 1-year before surgery in 2025. Further research is needed to understand the effectiveness of preoperative GLP-1RA use on surgical safety and long-term clinical outcomes.
METHODS: This retrospective cohort study used the TriNetX EHR data and included adults ≥18 years old who underwent first bariatric surgery from 2017 to November 2025. We defined prevalent prescription of a GLP-1RA as patients receiving a GLP-1RA prescription in 1-year before bariatric surgery and incident prescriptions as those with a prescription in 1-year prior but no prescription in months 13-24 before surgery. We identified patients' age, sex, race, ethnicity, body mass index (BMI), and comorbidities during the 1-year before surgery. We used descriptive statistics to characterize patients overall and by incident and prevalent GLP-1RA prescriptions.
RESULTS: We identified 176,458 adults who underwent bariatric surgery. Overall, 9.7% had at least one prescription for a GLP-1RA in the year prior to surgery and 6.0% newly received a GLP-1RA prescription during that year. Prevalent prescriptions for a GLP-1RA in the year prior to surgery increased from 3.4% in 2017 to 20.7% in 2025. Likewise, the incident prescriptions of GLP-1RAs increased from 2.2% in 2017 to 12.0% in 2025. GLP-1RA recipients and non-recipients were similar in demographic characteristics. Compared to non-users, GLP-1RA recipients had higher preoperative BMIs (mean ± SD: 45.4 ± 8.0 vs 42.5 ± 9.9) and higher rates of comorbidities, including hypertension (63.2% vs 46.1%), obstructive sleep apnea (56.2% vs 36.7%), and type 2 diabetes (58.0% vs 21.5%).
CONCLUSIONS: Prescriptions for GLP-1RAs before bariatric surgery are increasing, with 1 in 5 patients prescribed GLP-1RA in the 1-year before surgery in 2025. Further research is needed to understand the effectiveness of preoperative GLP-1RA use on surgical safety and long-term clinical outcomes.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH5
Topic
Epidemiology & Public Health
Topic Subcategory
Safety & Pharmacoepidemiology
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)