News: Preoperative GLP-1s do not diminish bariatric surgery results, study finds

Bariatric surgery patients who took GLP-1 medications prior to surgery lost the same amount of weight after one year as individuals who were unexposed to GLP-1s, according to a retrospective review from JAMA Surgery.

Among 383 patients, those who took a GLP-1 drug before surgery lost 24% of their total body weight at 12 months, while non-users lost 25%. Average postsurgical weight loss didn't differ either, at 66 pounds and 71 pounds, respectively. No differences were noted in diabetes control or complications.

For the study, researchers analyzed primary bariatric surgeries at a single center from 2022–2024. Preoperative GLP-1 agents included oral semaglutide (Rybelsus), injectable semaglutide (Ozempic, Wegovy), dulaglutide (Trulicity), liraglutide (Victoza, Saxenda), and tirzepatide (Mounjaro, Zepbound). Most patients took semaglutide (63%); few were on tirzepatide (4%). The majority were not at the maximum dose.

The findings align with two recent retrospective studies that showed no difference in 12-month postoperative weight loss between GLP-1 drug users and non-users. However, another study found that patients who took preoperative semaglutide lost comparatively less weight after surgery than GLP-1-naive patients at 12 months.

A multivariate regression confirmed preoperative GLP-1 agonist use was not a predictor of total weight loss. Operative time, length of stay, 30-day emergency department visits, and complications were similar between groups. Excellent 12-month HbA1c control was also achieved in both groups (5.4% versus 5.3%).

"With the rise of GLP-1 receptor agonists for obesity treatment, questions have emerged about potential synergy with bariatric surgery," the authors wrote. "Many patients now present for surgery already taking these medications, prompting investigation into their impact on outcomes."

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