The rapid uptake of glucagon-like peptide-1 (GLP-1) receptor agonists such as semaglutide, tirzepatide, and liraglutide has coincided with a measurable slowdown in bariatric surgery in several markets. In the US, a peer-reviewed analysis on an estimated 17 million privately insured patients led by Thomas Tsai, assistant professor at Harvard T.H. Chan School of Public Health, found that GLP-1 prescriptions for obesity more than doubled from 2022 to 2023, at an increase of 105.6%, while the rate of metabolic bariatric surgery fell about 8.7% over the same period. Data presented at the 2026 meeting of the American Society for Metabolic and Bariatric Surgery (ASMBS) confirmed that US surgical volumes dropped in 2024 and in 2025 after seven years of growth. This trend is further supported by the gastric bands and balloons market, a subset of bariatrics, which was worth an estimated $49.1m in 2025 and is expected to decrease to $34.2m in 2035 at a negative compound annual growth rate (CAGR) of 3.54%, according to GlobalData, a leading data and analytics company.
Researchers have suggested that the decline may be concentrated among the highest-severity patients, who tend to benefit the most from surgery, raising concerns that some are forgoing the more effective option while others are using the drug as a bridge to future surgery. Meanwhile, 90%–95% of people with severe obesity still receive no treatment at all.
Go deeper with GlobalData
Access deeper industry intelligence
Experience unmatched clarity with a single platform that combines unique data, AI, and human expertise.
In Brazil, the same tension can be seen and is arguably more prominent. The Brazilian Society of Bariatric and Metabolic Surgery (SBCBM) reported an 18% drop in bariatric procedures in 2024 versus the prior year, against the backdrop of a booming weight-loss-drug market that reached roughly $2.2bn in 2025 and is projected to almost double in 2026 once semaglutide generics arrive in the market. Semaglutide lost patent exclusivity in March 2026, and opened the door to generics. Prices are expected to fall 30%–50%, and domestic makers such as Aché, Biolab, EMS, Eurofarma and Hypera and are set to enter the space. Cheaper drugs will broaden access well beyond the classes that dominate today, plausibly intensifying downward pressure on elective surgery demand.
The prevailing expert view is not that the drugs will eliminate the need for bariatric surgery, but that they are reshaping demand and acting as a substitute for some patients, as a complement or bridge for others, and leaving the highest-severity, treatment-resistant patients as the core surgical population. Access, cost, adherence, and the wave of cheaper generics will determine how durable the surgical decline proves to be. Because approximately 70% of patients may stop GLP-1 therapy within one year and weight tends to return after treatment discontinuation, several analysts expect a portion of the current drug-first patients to return to surgical pathways over time. As such, the current decline may partly reverse or plateau rather than continue in a linear fashion.
GLP-1 medications are associated with a measurable reduction in bariatric surgery volumes, leading to the estimated 18% single-year drop in bariatric procedures in Brazil and the first-ever declines in the US, but the relationship is better described as a re-segmentation of obesity treatment rather than a wholesale replacement of surgery.
