GLP-1 prescriptions increase by 364% whilst BMS declines by 42%

Over two percent of adult patients now take a GLP-1 drug to treat overweight or obesity, according to a FAIR Health white paper entitled, ‘Obesity and GLP-1 Drugs: A Claims-Based Analysis’. Among all adult patients, the percentage who had an overweight or obesity diagnosis and were prescribed a GLP-1 drug increased from 0.30 percent in 2019 to 2.05 percent in 2024, a relative increase of 586.7 percent. At the same time, the percentage of adult patients who had bariatric and metabolic surgery (BMS) decreased from 0.12 percent in 2019 to 0.07 percent in 2024, a relative decrease of 41.8 percent.

FAIR Health report examined data from 51 billion commercial healthcare claim records, the US’ largest such database, to examine trends in obesity and GLP-1 drug prescriptions among adult patients during the period 2019-2024. This study focuses on trends in diagnosis of overweight, obesity and type 2 diabetes, as well as GLP-1 drugs and other obesity treatment options (including bariatric surgery and behavioural health services).

From 2019 to 2024, among all adult patients with an overweight or obesity diagnosis, the percentage who were prescribed a GLP-1 drug but did not have bariatric surgery increased from 2.5 percent in 2019 to 11.2 percent in 2024, a relative increase of 339.5 percent.

In 2024, over 80 percent of patients with an overweight or obesity diagnosis did not receive a GLP-1 prescription, bariatric surgery or behavioural health service. Only 11.2 percent of such patients received a GLP-1 prescription, 6.3 percent received behavioural health services and 0.28 percent had bariatric surgery.

The use of behavioural health services decreased dramatically for patients prescribed GLP-1 drugs during the study period. Out of all patients with an overweight or obesity diagnosis who were prescribed a GLP-1 drug, the percentage of patients who had behavioural health services related to their condition declined from 2019 to 2024. In 2019, 47.2 percent of such patients had behavioural health services, but in 2024, only 12.4 percent of patients did, a relative decrease of 73.7 percent.

The percentage of adult patients prescribed a GLP-1 drug increased from 2019 to 2024 (Figure 1).

Figure 1: Percent of adult patients prescribed a GLP-1 drug by drug brand name and year, 2019-2024

For any type of GLP-1 drug, the relative increase was 363.7 percent, from 0.9 percent of patients in 2019 to 4.0 percent of patients in 2024. For Ozempic (semaglutide), a GLP-1 drug indicated for type 2 diabetes,  the increase was from 0.1 percent to 2.0 percent (a 1,504.4 percent rise) during the same period.  Mounjaro (tirzepatide), also indicated for type 2 diabetes, was not prescribed to any adult patients in the period 2019-2021. That changed in 2022 when 0.1 percent of patients had a prescription, coinciding with  Mounjaro’s approval by the FDA in 2022. By 2024, the percentage of patients with a Mounjaro prescription had risen to 0.9 percent; the increase from 2022 to 2024 was 785.5 percent. Saxenda, Wegovy and Zepbound are all indicated for overweight or obesity. The percentage of patients prescribed any of these three GLP-1 drugs increased from 0.03 percent in 2019 to 0.68 percent in 2024, a 2,029 percent rise. The large increase in prescriptions for these three GLP-1 drugs for overweight and obesity aligns with increasing public interest from 2017 to 2024 as demonstrated by other research.

Figure 2 shows what percentage of adult patients who were prescribed a GLP-1 drug had which diagnoses by year. The percentage of patients who were prescribed a GLP-1 drug and who had only a type 2 diabetes diagnosis declined from 40.7 percent in 2019 to 30.1 percent in 2024, a relative decrease of 26.0 percent. Concurrently, the percentage of patients who were prescribed a GLP-1 drug and had only an overweight or obesity diagnosis increased from 3.7 percent in 2019 to 16.5 percent in 2024, a 344.4 percent rise. These data support the findings of other researchers who showed GLP-1 drug use increased more than threefold from 2018 to 2022 in adult patients without type 2 diabetes. The percentage of patients prescribed a GLP-1 drug with both an overweight or obesity diagnosis and a type 2 diabetes diagnosis increased 17.4 percent (rising from 30.4 percent in 2019 to 35.7 percent in 2024).

Figure 2: Percent of adult patients prescribed a GLP-1 drug by diagnosis and year, 2019-2024

The percentage of adult patients who had bariatric surgery decreased from 2019 to 2024 (Figure 3). In 2019, 0.12 percent of patients had the surgery, whereas in 2024, 0.07 percent of patients had the surgery, a relative decrease of 41.8 percent. Despite the overall decline, from 2020 to 2022, there was an increase in the percentage of patients getting bariatric surgery, rising from 0.08 to 0.10 percent (26.0 percent increase), likely due to a rebound in elective bariatric surgery after it declined at the start of the COVID-19 pandemic in 2020.49 This was followed by another decline from 2022 to 2024, a 33.7 percent drop.

Figure 3: Percent of adult patients who had bariatric surgery by year, 2017-2024

Figure 4 shows 2019-2024 trends in the percentage of adult patients with a diagnosis of overweight or obesity who were prescribed a GLP-1 drug (patients who did and did not have bariatric surgery are compared) and patients who had bariatric surgery but were not prescribed a GLP-1 drug. Among all adult patients with an overweight or obesity diagnosis, the percentage who were prescribed a GLP-1 drug but did not have bariatric surgery increased from 2.5 percent in 2019 to 11.2 percent in 2024, a relative increase of 339.5 percent. In contrast, the percentage of such patients who had bariatric surgery but were not prescribed a GLP-1 drug declined from 0.6 to 0.3 percent, a 55.4 percent decrease over the same period. This inverse relationship aligns with other literature that shows an increase in the prescription of GLP-1 drugs from 2022 to 2023 accompanied a decline in bariatric surgery rates. The percentage of patients who were prescribed a GLP-1 drug and who also had bariatric surgery was low throughout the study period, but increased from 0.02 percent of patients to 0.04 percent, a 114.3 percent rise.

Figure 4: Percent of adult patients with an overweight or obesity diagnosis by GLP-1 drug prescription and/or bariatric surgery, 2019-2024

Out of all patients with an overweight or obesity diagnosis, relatively few received a GLP-1 drug prescription (11.2 percent), bariatric surgery (0.3 percent) or behavioural health services (6.3 percent) in 2024. Out of all patients with an overweight or obesity diagnosis who were prescribed a GLP-1 drug, the percentage of patients who had behavioural health services related to their condition declined 73.7 percent from 2019 to 2024.

“The findings in this report have implications for stakeholders across the healthcare spectrum, especially patients with a diagnosis of overweight or obesity and patients prescribed GLP-1 drugs,” the paper concludes. “The study is also important for the providers who care for these patients, as well as payors and policy makers. FAIR Health hopes that these findings will be starting points for further research on obesity and GLP-1 drugs.”

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