JAMA Pediatrics Publishes UT Southwestern Retrospective Cohort Study Monday July 20, 2026 Analyzing 204,000+ US Adolescents and Young Adults Ages 13-25 Treated for Obesity Between May 2022 and January 2026 in the Epic Cosmos Electronic Health Record Database: GLP-1 Receptor Agonist Monotherapy Share Rose From 88.2% (May-November 2022) to 96.1% (June 2025-January 2026), Metabolic and Bariatric Surgery (MBS) Share Fell From 11.6% to 3.7% Over the Same Window, and Combined GLP-1 + MBS Use Remained Rare at Approximately 0.2%; Severe Obesity Currently Affects Approximately 9% of Ages 12-18 in the US
JAMA Pediatrics published a UT Southwestern Medical Center retrospective cohort study Monday July 20, 2026 examining GLP-1 receptor agonist and metabolic and bariatric surgery (MBS) utilization patterns among 204,000+ US adolescents and young adults ages 13-25 treated for obesity between May 2022 and January 2026 in the Epic Cosmos electronic health record database. Key findings: the share of patients using only GLP-1 drugs rose from 88.2% (May-November 2022) to 96.1% (June 2025-January 2026); the share of patients undergoing MBS fell from 11.6% to 3.7% over the same window; combined GLP-1 + MBS use remained rare at approximately 0.2%. The study documents a substitution effect from surgical obesity treatment toward pharmacologic obesity treatment in the youth population over 44 months of coverage. Context: severe obesity currently affects approximately 9% of US adolescents ages 12-18. The findings raise questions about long-term efficacy, weight-regain risk after GLP-1 discontinuation in adolescents, and the appropriate role of MBS in adolescents whose obesity is unresponsive to GLP-1 pharmacotherapy. The study covers the pediatric analog of the earlier adult utilization-shift patterns already documented in the Kaiser Permanente and Optum electronic health record data.