Bariatric surgery is a key offering for many ASCs and gastroenterology practices, despite declines in inpatient surgical volumes for the procedure.
Here are five things to know about the recent clinical, legal and payer-related developments in bariatric surgery and GLP-1 use and what ASC and GI leaders can expect next:
1. The rise of GLP-1 medications has drastically changed the weight management landscape. Between 2022 and 2023, bariatric surgery rates fell 25.6% as GLP-1 prescriptions rose 132.6%, according to a study from researchers at Boston-based Harvard Medical School and Brigham and Women’s Hospital. Vizient projects inpatient bariatric surgery volumes will decline another 15% by 2034, driven in part by increasing GLP-1 use.
2. Arkansas recently joined a growing list of states that have expanded requirements for insurers to cover bariatric surgery since CMS first established a national coverage policy in 2006, according to the American Society for Metabolic and Bariatric Surgery.
3. An August 2025 study in JAMA Surgery found that the share of patients starting GLP-1 weight-loss drugs after bariatric surgery has climbed sharply in recent years. Among more than 113,000 adults who underwent bariatric surgery, 14% initiated GLP-1s postoperatively — most commonly women, patients who had sleeve gastrectomy and those with less weight loss after surgery. Use rose from 1.7% between 2015 and 2019 to 12.6% between mid-2020 and 2025.
4. Becker’s reported on at least four new bariatric surgery centers opening in 2025, including in the first ever in Arkansas.
5. A study published in May 2025 in the Journal of Hepatology found that simultaneous bariatric surgery and liver transplant for severely obese patients is safe and improves long-term health outcomes.
“We’ve been amazed by the transformation our patients experience,” Julie Heimbach, MD, director of Mayo Clinic Transplant Center and the study’s senior author said in a news release. “This dual approach prevents long-term obesity complications like diabetes, heart disease and cancer, while also preventing fatty liver disease recurrence.”
While GLP-1 medications have become a popular method for treating severe obesity and supporting patients pre- and post-transplant, Dr. Heimbach said that they may not be effective enough to serve as the only treatment for severely obese patients seeking a “lasting goal of a healthier weight.”
