Scholarlink

Background <p>Bariatric surgery has long been established as an effective treatment option for obesity and diabetes [Kalainov et al. in J Am Acad Orthop Surg [32(10):427–438, 2025] and Ogden et al. in JAMA 311(8):806–806, 2025. 10.1001/jama.2014.732]. Recently, GLP-1 Receptor Agonists’ (GLP-1RAs) use has expanded as an alternative therapy for weight loss and diabetes management. While GLP1RAs are known to be safe and effective, few have compared long term outcomes of GLP-1RAs versus the “gold standard” of bariatric surgery among Medicare/Medicaid patients, who make up the largest payer group in the U.S. [Kalainov et al. in J Am Acad Orthop Surg [32(10):427–438, 2025].</p> Methods <p>This was a retrospective, multicenter study of obese, type-2 diabetic patients (T2D) ≥ 18&#xa0;years old, who initiated weekly injectable semaglutide or tirzepatide or underwent bariatric surgery between January 1st, 2018 to July 31st, 2024. Patients with a baseline BMI ≤ 35, those with prior GLP1-RA use, or any prior bariatric procedure were excluded from analysis. The primary outcome of interest was % total body weight loss 3&#xa0;months to 3&#xa0;years post intervention among bariatrics surgery patients vs. GLP1-RA patients (any GLP1-RA prescription and 12&#xa0;months continuous GLP1-RA prescription).</p> Results <p>7667 patients were included for analysis (7200 GLP1-RA, 467 bariatric surgery). Bariatric surgery patients were younger (median (IQR): 43 (34, 53) vs. 65 (54, 72); <i>p</i> &lt; 0.001) and more likely to be female (67.5% vs. 60.8%; <i>p</i> &lt; 0.01) and Hispanic (58.7% vs. 19.4%; <i>p</i> &lt; 0.001) while GLP1-RA users were more likely to be white (58.5% vs. 10.7%; <i>p</i> &lt; 0.001). In models adjusting for demographic and clinical characteristics, bariatric surgery was associated with a 22.9% total weight loss 3&#xa0;years following surgery compared to 2.3% for patients with any GLP1-RA use, and 15.9% vs 2.4% for patients with 12&#xa0;months consecutive GLP1-RA use (22.9 [21.0–24.8] vs 2.3 [0.5–4.1], 15.9 [6.9–24.9] vs. 2.4 [6.7–11.5].</p> Conclusions <p>Among obese, T2D, publicly insured patients, bariatric surgery was associated with greater weight loss than GLP1-RAs at all measured periods from 3&#xa0;months to 3&#xa0;years post op.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Bariatric surgery vs. GLP-1 receptor agonists among primarily medicare and medicaid patients with diabetes: a 3-year analysis

  • 期刊论文

  • 发表日期：

    2025年12月1日

查看全文
  • Avery Brown,
  • Suhani S. Patel,
  • Elizabeth Li,
  • Alexander Hien Vu,
  • Eduardo Somoza,
  • Jialin Chen,
  • Donglan Zhang,
  • Allan B. Massie,
  • Babak J. Orandi,
  • Dorry Segev,
  • Manish Parikh,
  • Karan Chhabra

摘要

Background

Bariatric surgery has long been established as an effective treatment option for obesity and diabetes [Kalainov et al. in J Am Acad Orthop Surg [32(10):427–438, 2025] and Ogden et al. in JAMA 311(8):806–806, 2025. 10.1001/jama.2014.732]. Recently, GLP-1 Receptor Agonists’ (GLP-1RAs) use has expanded as an alternative therapy for weight loss and diabetes management. While GLP1RAs are known to be safe and effective, few have compared long term outcomes of GLP-1RAs versus the “gold standard” of bariatric surgery among Medicare/Medicaid patients, who make up the largest payer group in the U.S. [Kalainov et al. in J Am Acad Orthop Surg [32(10):427–438, 2025].

Methods

This was a retrospective, multicenter study of obese, type-2 diabetic patients (T2D) ≥ 18 years old, who initiated weekly injectable semaglutide or tirzepatide or underwent bariatric surgery between January 1st, 2018 to July 31st, 2024. Patients with a baseline BMI ≤ 35, those with prior GLP1-RA use, or any prior bariatric procedure were excluded from analysis. The primary outcome of interest was % total body weight loss 3 months to 3 years post intervention among bariatrics surgery patients vs. GLP1-RA patients (any GLP1-RA prescription and 12 months continuous GLP1-RA prescription).

Results

7667 patients were included for analysis (7200 GLP1-RA, 467 bariatric surgery). Bariatric surgery patients were younger (median (IQR): 43 (34, 53) vs. 65 (54, 72); p < 0.001) and more likely to be female (67.5% vs. 60.8%; p < 0.01) and Hispanic (58.7% vs. 19.4%; p < 0.001) while GLP1-RA users were more likely to be white (58.5% vs. 10.7%; p < 0.001). In models adjusting for demographic and clinical characteristics, bariatric surgery was associated with a 22.9% total weight loss 3 years following surgery compared to 2.3% for patients with any GLP1-RA use, and 15.9% vs 2.4% for patients with 12 months consecutive GLP1-RA use (22.9 [21.0–24.8] vs 2.3 [0.5–4.1], 15.9 [6.9–24.9] vs. 2.4 [6.7–11.5].

Conclusions

Among obese, T2D, publicly insured patients, bariatric surgery was associated with greater weight loss than GLP1-RAs at all measured periods from 3 months to 3 years post op.