Bariatric surgery linked to lower risk of psychiatric disorders than GLP-1 drugs

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. 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."

Shauna Levy, MD, MS, study co-author, Assistant Professor, Chief, Division of MIS/Bariatric Surgery, Tulane University School Medicine

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.