The treatment landscape for obesity is changing rapidly, particularly among adolescents and young adults. New research suggests that GLP-1 medications have quickly become the most common medical treatment for younger people with obesity, while the use of metabolic and bariatric surgery has declined substantially.
A study published in JAMA Pediatrics found that the number of adolescents and young adults receiving GLP-1 medications increased sharply between 2022 and 2025-2026. During the same period, the proportion undergoing metabolic and bariatric surgery dropped significantly.
The findings offer a glimpse into how quickly obesity treatment has evolved as medications such as semaglutide have become more widely available. They also raise important questions about equitable access to treatment.
Researchers from the study examined real-world treatment patterns among more than 204,000 adolescents and young adults between the ages of 12 and 29 who received obesity treatment. The team compared treatment during two periods: May through November 2022, before semaglutide became widely available for adolescents with obesity, and June 2025 through January 2026, when GLP-1 medications were much more established in obesity care.
Researchers looked at whether patients received GLP-1 medications, metabolic and bariatric surgery, or both. They also examined differences related to age, sex, race and ethnicity, insurance status, and neighborhood socioeconomic conditions.
The results showed a striking change in how younger patients were treated. In 2022, 88.2% of patients receiving obesity treatment were treated exclusively with GLP-1 medications. By 2025-2026, that figure had risen to 96.1%. At the same time, the proportion of patients receiving metabolic and bariatric surgery declined from 11.6% to 3.7%.
Combination treatment remained uncommon. Only about 0.2% of patients received both GLP-1 medications and bariatric surgery during the study periods.
According to lead researcher Sarah Messiah, Ph.D., M.P.H., the study represents a major turning point in pediatric and young-adult obesity treatment. She said:
Our team’s study captures an inflection point in pediatric obesity treatment… While only a small proportion of adolescents and young adults currently receive both therapies, combination treatment was virtually nonexistent before GLP-1 medications became widely available. We’re now seeing clinicians integrate these therapies in different ways as obesity care continues to evolve.
Does this mean bariatric surgery is going away? Not necessarily.
The study does not establish that GLP-1 medications are superior to bariatric surgery, nor does it suggest that surgery is no longer an important treatment option. Instead, the findings demonstrate how the availability of highly effective medications has changed clinical practice.
Metabolic and bariatric surgery remains an established treatment option for some adolescents and young adults with severe obesity, particularly when other approaches have not produced sufficient results. GLP-1 medications offer another option that can be used without surgery, potentially changing how doctors and families approach treatment decisions.
For some patients, medication may be preferred because it avoids an operation. Others may benefit from surgical treatment based on their individual health needs, severity of obesity, response to previous treatments, and other medical considerations.
While the rapid growth of GLP-1 use is significant, the study also revealed disparities in who receives these medications. Older patients, patients with commercial insurance, and people living in higher-income neighborhoods were more likely to receive GLP-1 treatment.
Those differences suggest that simply having effective obesity medications available does not mean every patient has equal access to them. Insurance coverage, medication costs, healthcare availability, and socioeconomic circumstances can all influence whether a patient is able to receive treatment.
This is particularly important as obesity medications become a more prominent part of care for adolescents and young adults. If access remains concentrated among people with greater financial resources or more comprehensive insurance, existing health disparities could persist or widen.
For families navigating childhood or young-adult obesity, the research highlights how quickly treatment options are changing. Just a few years ago, bariatric surgery was one of the major medical interventions available for young people with severe obesity who needed more intensive treatment. Today, GLP-1 medications are increasingly becoming part of the conversation.
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Source: “GLP-1 drugs are changing how teens and young adults treat obesity,” Consumer Affairs, 8/4/26
Source: “GLP-1 use rising rapidly among U.S. adolescents, young adults,” UT Southwestern Medical Center, 7/20/26
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