SE Messiah et al. JAMA Pediatr. Published online July 20, 2026. doi:10.1001/jamapediatrics.2026.2828. Open Access! GLP-1 Receptor Agonist and Bariatric Surgery Utilization Among Adolescents and Young Adults. 

Methods: This was a retrospective analysis among US adolescents and young adults (AYAs) that leveraged data from Epic Cosmos,⁴ a US-based electronic health record database representing more than 300 million patients. AYAs (aged 13-25 years) treated for obesity between May 2022 and January 2026 were included.

Key findings:

• The study included 204,148 AYAs (mean [SD] age, 21.3 [3.3] years; 150,051 females [73.5%]) who were treated with GLP-1 RAs (192,013 [94.1%]), metabolic and bariatric surgery (MBS) (9,060 [4.4%]), or a combination of both therapies (3,075 [1.5%])
• The proportion of exclusive GLP-1 RA use increased from 88.2% in May to November 2022 to 96.1% from June 2025 to January 2026 (P for trend < .001)
• MBS completion decreased from 11.6% to 3.7% (P for trend < .001)
• Exclusive GLP-1 RA use was observed in a larger proportion of adolescents vs young adults (97.2% vs 93.3%; P for trend < .001). In contrast, MBS completion was observed in a larger proportion of young adults vs adolescents (5.1% vs 1.7%; P for trend < .001).

My take (borrowed from authors): There has been “a rapid shift in treatment pathways, with pharmacotherapy increasingly functioning as the initial intervention for youths with obesity.”

Related blog posts:

• Bariatric Surgery Declines as GLP-1 Medications Rise (2024)
• Reduced Dosing of GLP-1 RAs May Work for Maintenance Treatment of Obesity
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• Ten-Year Outcomes of Adolescent Bariatric Surgery
• Diets for Obesity and Steatotic Liver Disease Plus Patient Information from FISPGHAN
• NY Times: Bariatric Surgery at 16 (2023)
• 75% of U.S. Adults Have Obesity When Using New Definition With Anthropometrics (2026)
• The Rise of Oral Obesity Therapies: Semaglutide and Orforglipron (2025)