GLP-1 drugs have reshaped the obesity-treatment market and cut into bariatric surgery volumes — but Connecticut’s major health systems say the two approaches work better together than apart.
Drivers passing Exit 27 southbound on Interstate 91 in Hartford likely can’t miss the large purple billboard with white lettering that asks an odd question:
“GLP-1s failing you?”
The sign adds in smaller blue lettering, “You still have options at NYBG.com,” a reference to New York Bariatric Group, an obesity-treatment provider with offices in Fairfield, Farmington and Stamford, as well as in New York and New Jersey.
The ad promotes alternatives for patients who do not achieve the desired results from blockbuster weight-loss medications such as Ozempic, Wegovy, Mounjaro and Zepbound.
The billboard reflects a major shift underway in the obesity-treatment industry. The rapid rise of GLP-1 drugs has created new competition for bariatric surgery, which for decades has been a leading treatment option for severe obesity.
A study released in May by researchers at the Harvard T.H. Chan School of Public Health found that use of GLP-1 medications among patients diagnosed as overweight or with obesity or diabetes increased more than 140% nationwide between 2022 and 2024, while bariatric surgery procedures fell 34%.
Connecticut’s state employee health plan shows a similar trend. According to the state comptroller’s office, the number of plan members using GLP-1 medications nearly tripled between 2022 and 2025, rising from 5,551 to 16,614. During the same period, bariatric surgeries declined from 299 to 203.
Yet statewide bariatric surgery volumes overall have remained relatively stable, according to data from the Office of Health Strategy.
Hospital leaders say that’s because they don’t view medication and surgery as competing approaches. Instead, many patients now move between the two treatments rather than choosing one or the other.
Yale New Haven Health and Hartford HealthCare say they have reorganized their weight-management programs, bringing obesity medicine specialists, bariatric surgeons, dietitians, psychologists and other clinicians together under one umbrella.
Dr. John Morton, a professor of surgery at the Yale School of Medicine, says there is a role for both bariatric surgery and GLP-1 medications in treating obesity. Contributed Photo
“The key to the future for optimal care for patients is integrated care,” said Dr. John Morton, professor of surgery at the Yale School of Medicine and a bariatric surgeon who has performed more than 6,000 procedures over a career spanning two decades.
“There are some patients that come through that really should just go straight to surgery,” Morton said, “and there might be some patients that come through that should go straight to medications, and some that will need both.”
New York Bariatric Group did not respond to requests for comment on this story.
Not a competition
Hospitals, physician groups, specialty obesity clinics and drugmakers are all seeking a share of the growing obesity-treatment market, which reached a record $135 billion in 2025, according to market research firm Marketdata, driven largely by demand for GLP-1 medications, which have helped many patients achieve weight-loss levels previously seen mainly with bariatric surgery.
Dr. Darren Tishler
Still, both Morton and Dr. Darren Tishler, chief of metabolic and bariatric surgery at Hartford HealthCare, caution that the medications are not a universal solution.
Morton noted that roughly 10% of patients do not respond to GLP-1 medications, while another 10% experience side effects that prevent long-term use. Access also remains a challenge because insurance coverage varies widely.
Tishler said many patients eventually discontinue treatment because of cost, side effects or a reluctance to remain on the medication indefinitely.
That helps explain why both surgeons reject the idea that medication and surgery compete.
Morton said GLP-1s are simply another tool.
Tishler agrees.
“If someone comes to me with cancer, let’s say, when it comes to breasjt cancer, I would never say to her, ‘Try real hard on your own to make the breast cancer go away,’” Tishler said. “I would never say to someone, ‘choose between a surgery, or chemotherapy, or radiation therapy or hormonal therapy.’ We’re going to do all of those, because the combination works better.”
Comprehensive programs
The shift in weight-loss care has been many years in the making.
Tishler said Hartford HealthCare began integrating obesity medicine and bariatric surgery more than a decade ago, long before the current generation of GLP-1 medications became widely available.
What started as a partnership between himself as a surgeon and Dr. Devika Umashanker, an obesity medicine specialist, has grown into a systemwide program involving physicians, advanced practitioners, dietitians, psychologists, exercise specialists and researchers. Tishler said the program over the past five years has grown from two board-certified physicians and surgeons to eight.
“We recognized that there was more to the care, that patients needed more,” Tishler said.
HHC’s Comprehensive Weight Management Program treated just over 50,000 patients in 2025.
Yale New Haven Health has taken a similar approach through its Center for Weight Management, where obesity medicine specialists and bariatric surgeons work together.
Morton said YNHH has not seen its bariatric surgery volume go down.
“Our volume has been quite steady,” he said.
The health system employs 10 obesity medicine specialists and has added four in the past two years, including a culinary medicine physician. The program sees about 1,000 bariatric patients annually and performs roughly 700 procedures each year, while another 750 patients receive medical weight-loss treatment.
Both surgeons said bariatric surgery remains the most effective treatment for many patients with severe obesity.
“Bariatric surgery was GLP-1 before GLP-1 was cool,” Morton said.
Patients with a body mass index (BMI) above 40 often achieve greater weight loss through surgery than through medication alone, he explained.
Morton added that, to be a candidate for surgery, patients need to have a BMI over 35 with a related medical problem, or over 40, while candidates for GLP-1 medications must have a BMI of 27 with a medical problem or a BMI over 30.
“The vast majority of people who have obesity in this country — 90% — have a BMI that is less than 40,” he said.
The surgical procedure itself has also evolved significantly.
Tishler said nearly all bariatric surgeries today are performed using minimally invasive laparoscopic or robotic techniques. Most patients spend only one or two nights in the hospital before returning home.
Researchers are increasingly studying how GLP-1 drugs can be used before surgery, after surgery or alongside surgery to help patients maintain long-term weight loss.
“There’s never been a more exciting time to treat obesity,” Tishler said.
