Obesity continues to pose an urgent public health challenge in the United States, with prevalence among adults and significant associations with chronic conditions, including diabetes, cardiovascular disease, and nonalcoholic fatty liver disease. While bariatric surgery has established itself as the most effective long-term treatment for severe obesity, delivering consistent weight loss and notable improvements in obesity-related comorbidities, its utilization remains relatively low due to factors such as patient apprehension, access disparities, and insurance limitations. The recent emergence and widespread adoption of potent anti-obesity medications, particularly glucagon-like peptide-1 (GLP-1) receptor agonists like semaglutide and dual incretin agonists such as tirzepatide, have created new, non-surgical pathways capable of achieving substantial weight loss outcomes, thus prompting a reevaluation of the traditional obesity treatment landscape. This comprehensive review assesses the contemporary state of bariatric surgery and systematically examines the clinical efficacy, safety, and durability of emerging pharmacotherapies relative to surgical interventions. We also analyze the potential implications of these medications on patient preferences, surgical volumes, healthcare economics, and the bariatric surgery job market within the United States. Recognizing the evolving role of bariatric surgeons, we discuss how the profession may adapt through multidisciplinary care models, integrated pharmacological management, and adjusted surgical training programs. The goal of this manuscript is to inform clinicians, healthcare systems, policymakers, and patients regarding the anticipated impact of novel weight-loss medications on the future direction of obesity care and the professional landscape of bariatric surgery.

Keywords: bariatric surgery; bariatric surgery jobs; glp-1 receptor agonists; multidisciplinary care; obesity; obesity management; pharmacotherapy; semaglutide; tirzepatide; weight-loss medications.

Copyright © 2025, Louis et al.

肥胖继续在美国构成一个紧迫的公共卫生挑战，成人肥胖率持续上升，并且与包括糖尿病、心血管疾病和非酒精性脂肪肝病在内的慢性疾病有显著关联。虽然减肥手术已被确立为治疗重度肥胖最有效的长期治疗方法，能够带来一致的体重减轻以及对肥胖相关并发症的显著改善，但由于患者担忧、获取途径不均和保险限制等因素，其利用率仍然相对较低。近期，强效抗肥胖药物（特别是如司美格鲁肽等胰高血糖素样肽-1 (GLP-1) 受体激动剂和如 tirzepatide 等双受体激动剂）的出现与广泛应用，创造了一系列新的非手术治疗途径，能够实现显著的体重减轻效果，从而促使人们重新评估传统肥胖治疗方法。本综述全面评估了当前减肥手术的状态，并系统地审查了新兴药物疗法在临床疗效、安全性和持久性方面相对于外科干预的表现。我们还分析了这些药物对患者偏好、手术量、医疗经济和美国减肥手术就业市场可能产生的影响。鉴于减肥外科医生角色的演变，我们讨论了该职业如何通过多学科护理模式、整合药理学管理和调整后的手术培训项目进行适应。本手稿旨在向临床医生、卫生系统、政策制定者和患者提供有关新型减重药物对未来肥胖治疗方向以及减肥手术专业领域影响的信息。

关键词：减肥手术；减肥手术工作；GLP-1 受体激动剂；多学科护理；肥胖症；肥胖管理；药理学疗法；司美格鲁肽；tirzepatide；减重药物。

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