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Background <p>Bariatric surgery (BS) is the most effective treatment for severe obesity, but a significant proportion of patients experience insufficient weight loss (IWL) or weight regain. Glucagon-like peptide-1 receptor agonists (arGLP-1) have emerged as a promising adjunctive therapy for managing these suboptimal outcomes. This study evaluates the efficacy and safety of arGLP-1 in patients with IWL or WR after BS.</p> Methods <p>A retrospective analysis was conducted on 100 patients who underwent BS (96 sleeve gastrectomy, 4 gastric bypass) and received arGLP-1 therapy (semaglutide or dulaglutide) for IWL (defined as &lt;&#xa0;50% excess weight loss (EWL) from baseline), and WR (a ≥&#xa0;10 kg increase from the nadir weight post-surgery). Data on weight loss, comorbidities, and adverse events were collected over a median follow-up of 1 year. Statistical analyses included paired <i>t</i>-tests, Wilcoxon signed-rank tests, and chi-squared tests.</p> Results <p>At 1 year, patients achieved significant weight loss with a median total weight loss (%TWL) of 25.5% and a median excess weight loss (%EWL) of 66.3% compared to 16.6% and 40.8%, respectively, at treatment initiation with BMI reduction of 3.7 kg/m<sup>2</sup>. Significant improvements were observed in comorbidities, including reductions in obstructive sleep apnea (−&#xa0;30%), hypertension (−&#xa0;40%), and arthralgia (−&#xa0;56.5%). Glycated hemoglobin levels decreased by 0.8 points. Treatment was well-tolerated, with nausea being the most common side effect (5% discontinuation rate).</p> Conclusion <p>arGLP-1 are effective and safe for managing IWL or WR after BS, leading to significant weight loss, comorbidity improvement, and sustained %TWL. These findings support their use as a valuable adjunctive obesity management medication (OMMs) in post-bariatric care, though long-term adherence and cost-effectiveness require further investigation.</p> Graphical Abstract <p></p>

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Interest in Treatment with GLP-1 Receptor Agonists for the Management of Insufficient Weight Loss or Weight Regain After Bariatric Surgery

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月6日

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  • Hussein Abdallah,
  • Wissam Hadi Klink,
  • Joseph Derienne,
  • Cosmin Voican,
  • Gabriel Perlemuter,
  • Rodi Courie,
  • Ibrahim Dagher,
  • Hadrien Tranchart

摘要

Background

Bariatric surgery (BS) is the most effective treatment for severe obesity, but a significant proportion of patients experience insufficient weight loss (IWL) or weight regain. Glucagon-like peptide-1 receptor agonists (arGLP-1) have emerged as a promising adjunctive therapy for managing these suboptimal outcomes. This study evaluates the efficacy and safety of arGLP-1 in patients with IWL or WR after BS.

Methods

A retrospective analysis was conducted on 100 patients who underwent BS (96 sleeve gastrectomy, 4 gastric bypass) and received arGLP-1 therapy (semaglutide or dulaglutide) for IWL (defined as < 50% excess weight loss (EWL) from baseline), and WR (a ≥ 10 kg increase from the nadir weight post-surgery). Data on weight loss, comorbidities, and adverse events were collected over a median follow-up of 1 year. Statistical analyses included paired t-tests, Wilcoxon signed-rank tests, and chi-squared tests.

Results

At 1 year, patients achieved significant weight loss with a median total weight loss (%TWL) of 25.5% and a median excess weight loss (%EWL) of 66.3% compared to 16.6% and 40.8%, respectively, at treatment initiation with BMI reduction of 3.7 kg/m2. Significant improvements were observed in comorbidities, including reductions in obstructive sleep apnea (− 30%), hypertension (− 40%), and arthralgia (− 56.5%). Glycated hemoglobin levels decreased by 0.8 points. Treatment was well-tolerated, with nausea being the most common side effect (5% discontinuation rate).

Conclusion

arGLP-1 are effective and safe for managing IWL or WR after BS, leading to significant weight loss, comorbidity improvement, and sustained %TWL. These findings support their use as a valuable adjunctive obesity management medication (OMMs) in post-bariatric care, though long-term adherence and cost-effectiveness require further investigation.

Graphical Abstract