Lurie Children's study: 90.4% of 1.4 million eligible US teens received neither GLP-1 drugs nor bariatric surgery

Most US adolescents who meet criteria for bariatric surgery receive neither surgery nor GLP-1 medications, according to a study by Ann & Robert H. Lurie Children's Hospital of Chicago published in JAMA Pediatrics and reported by newswise.com. newswise.comnewswise.comnewswise.comOpen source ↗ The authors analysed electronic health records of more than 1.4 million adolescents who met guideline-based eligibility criteria for metabolic and bariatric surgery between 2017 and 2025.

Surgery and GLP-1 prescribing trends

Bariatric surgery use among eligible adolescents grew steadily from 2017 to 2022 and peaked at 189 procedures per 100,000 eligible teens. After that it fell by about 29 percent through the end of 2025, the authors reported. The decline coincided with the FDA approval of semaglutide for adolescents aged 12 or older with obesity in late 2022.

Over the same period GLP-1 prescribing, including semaglutide and liraglutide, rose sharply: from 301 prescriptions per 100,000 eligible adolescents in early 2017 to 10,676 per 100,000 by the end of 2025, a 35-fold increase. Rates were highest among adolescents with the most severe obesity.

Treatment gap and insurance differences

Among the 1.4 million eligible adolescents, less than 1 percent underwent surgery during the study period, and 4.6 percent received at least one GLP-1 prescription. newswise.comnewswise.comnewswise.comOpen source ↗ By the fourth quarter of 2025, more than 1.29 million of them, or 90.4 percent of the study population, had received neither treatment.

The study also found differences in access to drugs. By late 2025, privately insured adolescents were prescribed GLP-1 drugs 2.4 times more often than uninsured or self-pay patients and modestly more often than publicly insured patients. Surgery rates were similar across insurance groups.

First author John B. Rode, MD, MS, a resident physician at Lurie Children's, said the data suggest that eligible patients likely lack access to safe and effective treatments, and that newer drugs could widen existing inequities in care. The authors call for further research on the reasons for limited access and on the possible complementary role of GLP-1 drugs and surgery. Justin Ryder, PhD, of Lurie Children's and Northwestern University Feinberg School of Medicine, was the senior author.