Preoperative GLP-1 Receptor Agonist Use and Weight Loss Outcomes Following Bariatric Surgery

Mar 3, 2026Annals of surgery

Using GLP-1 Medicines Before Weight Loss Surgery and Their Link to Surgery Results

AI simplified

GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗

Abstract

Among 2,379 metabolic and bariatric surgery patients, 8.1% had preoperative GLP-1 exposure.

Patients using GLP-1 had a higher adjusted BMI 12 months before surgery compared to non-users (47.0 vs. 44.4 kg/m²; P<0.001).
At the time of surgery, the BMI was similar between GLP-1 users and non-users (45.9 vs. 46.1; P=0.81).
Postoperative trajectories for BMI and percent total weight loss (%TWL) were comparable between GLP-1 users and non-users through 12 months (%TWL 20.7% vs. 22.0%, P=0.19).
In patients with type 2 diabetes, %TWL trajectories were also similar between those on GLP-1 and active comparators (21.5% vs. 23.1%, P=0.39).
Preoperative GLP-1 therapy was not associated with compromised weight loss outcomes after metabolic and bariatric surgery.

AI simplified

OBJECTIVE: Evaluate associations between preoperative glucagon-like peptide-1 receptor agonist (GLP-1) use and postoperative weight loss after metabolic and bariatric surgery (MBS).

SUMMARY BACKGROUND DATA: Recent literature suggests reduced postoperative weight loss following preoperative GLP-1 use. However, these single center studies suffered from key design limitations.

METHODS: This retrospective cohort study utilized a statewide health information exchange enrolling adults undergoing MBS from 2020-2024. In the primary analysis, patients with ≥1 GLP-1 order in the 6 months preoperatively were compared with those with none. In a subgroup analysis of patients with type 2 diabetes, preoperative GLP-1 therapy was compared with non-GLP-1 antihyperglycemic therapy. Outcomes included BMI trajectory from 12 months pre- through 12 months postoperatively and percent total weight loss (%TWL) at 3, 6, 9, and 12 months. Associations were estimated using multivariable linear mixed-effects models.

RESULTS: Among 2,379 MBS patients, 193 (8.1%) had preoperative GLP-1 exposure. Adjusted BMI was higher for GLP-1 users 12 months pre-op (47.0 vs. 44.4 kg/m²; P<0.001) but similar at surgery (45.9 vs. 46.1; P=0.81). Postoperative BMI and %TWL trajectories were similar through 12 months (GLP-1 users %TWL 20.7% vs. 22.0% nonusers, P=0.19). In the diabetes cohort (n=256; 149 GLP-1, 107 active comparators), trajectories were also similar (GLP-1%TWL 21.5% vs. 23.1% active comparators, P=0.39).

CONCLUSIONS: Preoperative GLP-1 use was not associated with postoperative weight loss in a statewide, multi-system cohort, including in an active-comparator analysis among patients with type 2 diabetes. These findings suggest preoperative GLP-1 therapy is unlikely to compromise MBS weight loss outcomes.

Full Text

Full text is available at the source.

View full text ↗

Preoperative GLP-1 Receptor Agonist Use and Weight Loss Outcomes Following Bariatric Surgery

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief