Reported in the Journal of the American Medical Association (JAMA): Bariatric surgery offers greater weight loss, lower costs over time compared to GLP-1s, Highmark Health research demonstrates

PITTSBURGH, Sept. 17, 2025 ~ A recent study conducted by Highmark Health researchers and published in the Journal of the American Medical Association (JAMA) has found that bariatric surgery is a more effective and cost-efficient option for weight loss compared to medications known as GLP-1s. The study, which was a retrospective analysis of data from Highmark Health Plan insurance claims and Allegheny Health Network (AHN) medical records, included 30,458 patients treated between 2018 and 2023.

Highmark Health is a Pittsburgh-based health services organization that includes a multi-state insurance services division (Highmark Health Plan) and a 14-hospital care provider (AHN). The research was published on September 17 in JAMA Surgery, which is part of the larger JAMA consortium, a collection of peer-reviewed general medicine and specialty publications.

The study compared the health care costs and clinical outcomes of patients who underwent metabolic bariatric surgery (MBS), such as sleeve gastrectomy or gastric bypass, with those who received GLP-1 receptor agonists (GLP-1 RAs) for obesity management. The key findings of the study include:

- Cost Savings with MBS: Over two years, bariatric surgery resulted in approximately 18 percent lower costs compared to medications. This was mainly due to sustained high pharmacy costs associated with medication use. On average, this translates to a cost savings of nearly $12,000 per patient.

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- Greater Weight Loss with MBS: In patients with a BMI of 40 or higher, bariatric surgery led to nearly three times as much weight loss compared to medications. On average, patients lost about 28 percent of their weight with surgery, compared to about 10 percent with medications.

- Reduced Healthcare Utilization with MBS: Patients who underwent bariatric surgery had 25 percent fewer inpatient stays and 38 percent fewer emergency room visits on average. MBS was also associated with a lower incidence of obesity-related comorbidities, such as hyperlipidemia and sleep apnea, compared to medication use.

These findings are consistent with other recent studies on the topic, but what sets this study apart is its use of historical claims and clinical data. This was made possible through Highmark Health's unique payor/provider integrated model.

According to Tyson S. Barrett, PhD, from the Highmark Health Research Institute, "This real-world study provides evidence on the long-term effectiveness and cost-efficiency of bariatric surgery compared to weight management medication for severe obesity. Our findings highlight the potential for bariatric surgery to offer a more durable and economically sound solution for this patient population."

The study specifically looked at the costs and clinical side effects of surgery vs. GLP-1s for managing class II and class III obesity, as well as weight loss outcomes for those with class III obesity. Class II obesity is defined by the Center for Disease Control and Prevention (CDC) as having a BMI of 35 to 39.9, while class III or severe obesity is indicated by a BMI of 40 or greater.

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In the United States, obesity rates continue to rise, affecting over 40 percent of adults. At the same time, there has been a significant increase in demand for GLP-1s which has become a major cost driver for health carriers and employer-based health insurance plans. From 2019 to 2024, there has been a nearly 600 percent increase in people being prescribed GLP-1 medications for weight management purposes rather than diabetes management.

While these drugs have shown promise for weight loss, they also require ongoing adherence which can compound costs over time. "With projections indicating that 50 percent of the adult U.S. population will have obesity by 2030, it's vital for physicians to have comprehensive data to inform their treatment decisions," said George Eid, MD, chair of the AHN Bariatric and Metabolic Institute. "This study should serve as a data point to help physicians make individualized care choices, optimizing each patient's weight management journey."

To learn more about the JAMA Surgery study, visit the link provided in the press release. Additionally, readers can listen to the JAMA Surgery Author Interviews podcast at the study link and click on the "media" tab to hear directly from the authors.

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