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

40% of U.S. adults are now considered obese, leading to a dramatic surge in the utilization of the popular but pricey weight-loss drugs 

PITTSBURGH, Sept. 17, 2025 /PRNewswire/ -- For obese patients, bariatric surgery achieves greater weight loss at lower ongoing cost when compared to the class of medications commonly known as GLP-1s, according to a new study authored by Highmark Health researchers and published through the Journal of the American Medical Association (JAMA).  

This unique retrospective study, which examined data from Highmark Health Plan insurance claims and Allegheny Health Network (AHN) medical records, included 30,458 patients treated between 2018 and 2023. The research compared the health care costs and clinical outcomes of patients who underwent metabolic bariatric surgery (MBS), such as a sleeve gastrectomy or gastric bypass, with those who received glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for obesity management.   

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 Sept. 17 in JAMA Surgery, part of the larger JAMA consortium, a collection of peer-reviewed general medicine and specialty publications that together comprise one of the world's most prestigious and influential medical journals. 

Key findings include: 

• Cost Savings with MBS: Over two years, bariatric surgery resulted in approximately 18 percent lower costs compared to medications, mostly because of sustained high pharmacy costs associated with medication use. This translates to an average cost savings of nearly $12,000 per patient.   
• 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: On average, patients who underwent bariatric surgery had 25 percent fewer inpatient stays and 38 percent fewer emergency room visits. MBS was also associated with a lower incidence of obesity-related comorbidities, such as hyperlipidemia and sleep apnea, compared to medication use.   

The findings are in line with other recent studies on the topic but those studies have largely been forward-looking and have used predictive modeling. The Highmark Health study is among the first to use historical claims and clinical data, made possible through Highmark Health's unique payor/provider integrated model.   

"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," said Tyson S. Barrett, PhD, Highmark Health Research Institute. "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. According to the Center for Disease Control and Prevention (CDC), adults ages 20 or older with a body mass index (BMI) of 35 to 39.9 are considered to have class II obesity (about 245 pounds for a 5-foot-10 man or 210 pounds for a 5-foot-4 woman), while a BMI of 40 or greater indicates class III, or severe, obesity (about 280 pounds for a 5-foot-10 man or 240 pounds for a 5-foot-4 woman). 

In the U.S., obesity rates continue to rise, affecting over 40 percent of adults. Meanwhile, the surging demand for GLP-1s is a significant cost driver for the nation's health carriers and employer-based health insurance plans. From 2019 to 2024, the number of people prescribed GLP-1 medications for weight management purposes – as opposed to diabetes management – has skyrocketed by nearly 600 percent.

The blockbuster drugs have shown promise for weight loss, but also require ongoing adherence, the cost of which compounds 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."  

Learn more about the JAMA Surgery study here. To hear directly from the authors, listen to the JAMA Surgery Author Interviews podcast at the study link, and click on the "media" tab.  

About Highmark Health  

Highmark Health, a Pittsburgh, PA-based enterprise that employs more than 44,000 people who serve millions of Americans across the country, is the parent company of Highmark Inc., Allegheny Health Network, and enGen. Highmark Inc. and its subsidiaries and affiliates provide health insurance to more than 7 million members in Pennsylvania, West Virginia, Delaware, and New York, as well as dental insurance, and related health products through a national network of diversified businesses. Allegheny Health Network is an integrated delivery network in western Pennsylvania comprised of 14 hospitals, more than 2,500 affiliated physicians, ambulatory surgery centers, an employed physician organization, home and community-based health services, a research institute, a group purchasing organization, and health and wellness pavilions. enGen is a wholly owned subsidiary of Highmark Health whose dynamic ecosystem of smart automation and technology supports and streamlines complex operations for health plans and their provider partners. To learn more, visit www.highmarkhealth.org.  

About Allegheny Health Network  

Allegheny Health Network (AHN.org), a Highmark Health company, is an integrated health care delivery system serving the greater Western Pennsylvania region. The network is composed of 14 hospitals, ambulatory surgery centers, Health + Wellness Pavilions, an employed physician organization, home- and community-based health services, a research institute, and a group purchasing organization. AHN provides patients with access to a complete spectrum of advanced medical services, including nationally recognized programs for primary and emergency care, cardiovascular disease, cancer care, orthopedic surgery, neurology and neurosurgery, women's health, diabetes and more. AHN employs approximately 23,700 people, has more than 2,500 physicians on its medical staff, and serves as a clinical campus for Drexel University College of Medicine and the Lake Erie College of Osteopathic Medicine. 

SOURCE Highmark Health