ASMBS

ASMBS 2025: Bariatric surgery may lower psychiatric risk vs. GLP-1 therapy

June 23, 2025

Data presented at the American Society for Metabolic and Bariatric Surgery (ASMBS) 2025 Annual Scientific Meeting suggest that bariatric surgery may confer a mental health advantage over GLP-1 receptor agonist (RA) therapy in patients with obesity. In a retrospective cohort study using the TriNetX database, researchers compared 33,600 patients who underwent metabolic surgery with an equal number treated with GLP-1 RAs—including semaglutide, liraglutide, and dulaglutide—after propensity score matching for baseline characteristics.

Over a five-year follow-up, surgical patients had a 54% lower risk of developing cognitive disorders, and 18% and 17% lower risks for anxiety and substance use disorders, respectively. The protective effect was most notable in younger individuals and those without prior psychiatric diagnoses.

While GLP-1 RAs remain a cornerstone of pharmacologic obesity treatment, these findings highlight the potential neuropsychiatric benefits of surgical intervention—possibly linked to more durable weight loss or metabolic changes. However, prospective studies are needed to better understand the mechanisms and to inform individualized treatment strategies, particularly for patients at elevated psychiatric risk.

Sources:

(2025, June 17). American Society for Metabolic and Bariatric Surgery. Psychiatric Disorders Less Likely After Weight-loss Surgery Than Treatment With GLP-1s. [News release]. https://asmbs.org/news_releases/psychiatric-disorders-less-likely-after-weight-loss-surgery-than-treatment-with-glp-1s/

Abdallah, A et al. Comparative risk of psychiatric disorders following GLP-1 receptor agonist therapy vs. bariatric surgery: Propensity score-matched analysis. Presented at American Society for Metabolic and Bariatric Surgery (ASMBS) Annual Meeting 2025. https://www.soard.org/article/S1550-7289(25)00200-X/pdf