WASHINGTON, DC – June 17, 2025 – People who have metabolic and bariatric surgery are significantly less likely to develop psychiatric disorders compared to those who take weekly injections of GLP-1 anti-obesity medications, according to a new study* presented today at the American Society for Metabolic and Bariatric Surgery (ASMBS) 2025 Annual Scientific Meeting . Over a five-year period, the risk of developing cognitive deficits was 54% lower and 18% and 17% lower for anxiety disorders and substance use disorders, respectively.
"The study shows metabolic and bariatric surgery confers a strong protective effect against common mental health disorders in a head-to-head comparison with GLP-1 pharmacotherapy," said study co-author Shauna Levy, MD, MS, Assistant Professor, Chief, Division of MIS/Bariatric Surgery, Tulane University School Medicine. "The data supports embedding psychiatric screening and support within both surgical and medical obesity programs to help reduce the potential mental health burden after treatment. Further investigation is needed, however, to determine why the psychological impact is so different between treatment modalities."
Researchers conducted a retrospective analysis of metabolic and bariatric surgery patients and patients on GLP-1 agonists, semaglutide, liraglutide, and dulaglutide, using the TriNetX database. After propensity score matching to balance demographic and clinical characteristics, 33,600 surgical patients and 33,600 pharmacotherapy patients were compared for the incidence of new psychiatric disorders. The follow-up period lasted up to five years.
"Maintaining mental health is important regardless of treatment choice. Even small differences can impact quality of life, so patients and their doctors should be proactive about monitoring mood, cognition, and substance use after starting any obesity therapy. Mental health is just as important as physical health and must be considered along with any treatment," said Ann M. Rogers, MD, MD, ACS FASMBS, President, ASMBS, who was not involved in the study.
About Metabolic and Bariatric Surgery
Metabolic, bariatric, or weight-loss surgery such as gastric bypass and sleeve gastrectomy has been shown to be the most effective and long-lasting treatment for severe obesity. The operations improve or resolve diseases including type 2 diabetes, heart disease and high blood pressure and leads to significant and durable weight loss. Its safety profile is comparable to some of the safest and most commonly performed surgeries in the U.S. including gallbladder surgery, appendectomy and knee replacement. The ASMBS reports more than 270,000 metabolic and bariatric procedures were performed in 2023, which represents only about 1% of those who meet eligibility requirements based on body mass index (BMI).
About Obesity
According to the U.S. Centers for Disease Control and Prevention (CDC), the prevalence of obesity and severe obesity is 40.3% and 9.4%, respectively. Studies show the disease can weaken or impair the body's immune system and cause chronic inflammation and increase the risk of scores of other diseases and conditions including cardiovascular disease, stroke, type 2 diabetes, and certain cancers.
About ASMBS
