Obesity Treatment for U.S. Adolescents and Young Adults Shifted Rapidly From 2022 to 2026

Increased use of GLP-1 RAs seen along with marked decrease in metabolic and bariatric surgery
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WEDNESDAY, July 29, 2026 (HealthDay News) -- Adolescents and young adults are increasingly using glucagon-like peptide-1 receptor agonist (GLP-1 RA) weight-loss drugs for obesity care, according to a research letter published online July 20 in JAMA Pediatrics.

Sarah E. Messiah, Ph.D., from University of Texas Southwestern Medical Center in Dallas, and colleagues examined patterns of combined or sequential use of metabolic and bariatric surgery (MBS) and GLP-1 RAs among U.S. adolescents and young adults. The analysis included 204,148 young people (aged 13 to 25 years) treated for obesity between May 2022 and January 2026.

The researchers found that 94.1 percent of participants were treated with GLP-1 RAs, 4.4 percent with MBS, and 1.5 percent with a combination of both therapies. There was an increase in the proportion of exclusive GLP-1 RA use from 88.2 percent in May to November 2022 to 96.1 percent from June 2025 to January 2026. Over time, MBS completion decreased from 11.6 percent to 3.7 percent, while combined GLP-1 RA use and MBS remained stable at 0.2 percent. Among individuals receiving both therapies, 72.3 percent initiated GLP-1 RAs prior to MBS, while 27.7 percent initiated GLP-1 RAs after MBS. Among young people receiving GLP-1 RAs, two-thirds (67.6 percent) were adherent (≥80 percent proportion of days covered), with higher adherence among male than female participants (72.5 versus 65.8 percent).

"The study advances the field by showing that obesity treatment sequencing strategies are already emerging in routine clinical care, even though evidence-based guidance for how to combine or sequence these therapies in youth remains limited," Messiah said in a statement. "These findings highlight the urgent need for evidence-based guidance for when GLP-1 RAs should be used relative to bariatric surgery in adolescents and young adults, including whether medications are most effective before surgery, after surgery, or as part of combination therapy."

One author disclosed ties to the pharmaceutical industry.

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