Interest in Treatment with GLP-1 Receptor Agonists for the Management of Insufficient Weight Loss or Weight Regain After Bariatric Surgery
Hussein Abdallah, Wissam Hadi Klink, Joseph Derienne, Cosmin Sebastian Voican, Gabriel Perlemuter, Rodi Courie, Ibrahim Dagher, Hadrien Tranchart
Abstract
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: . 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.