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Despite the arrival of powerful new anti-obesity medications and growing evidence supporting weight-loss surgery for adolescents, the vast majority of eligible teens are receiving neither treatment, according to a new study from Ann & Robert H. Lurie Children's Hospital of Chicago published in JAMA Pediatrics.

"The motivation behind our paper was to look at the relationship between two exciting developments in the treatment of obesity in adolescence," said first author John B. Rode, a fourth-year resident physician at Lurie Children's. "The first is long-term evidence for the safety and efficacy of bariatric surgery in adolescents, and the other is FDA approval of GLP-1s in this age group."

In the current study, investigators analyzed electronic health records from more than 1.4 million U.S. adolescents who met guideline-based eligibility criteria for metabolic and bariatric surgery between 2017 and 2025.

They found that use of GLP-1s, including semaglutide and liraglutide, increased dramatically during the study period, while rates of bariatric surgery began to decline following the approval of semaglutide for adolescent obesity in late 2022.

The investigators found that bariatric surgery use among eligible adolescents increased steadily from 2017 through 2022, reaching a peak of 189 procedures per 100,000 eligible teens.

"Our study found that while bariatric surgery use increased between 2017 and 2022, it subsequently decreased about 29% through the end of 2025," Rode said.

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