Effect of Glucagon-like Peptide-1 Receptor Agonists (GLP-1RA) on Weight Loss Following Bariatric Treatment

Mar 15, 2024The Journal of clinical endocrinology and metabolism

Weight Loss After Bariatric Surgery and the Role of GLP-1 Receptor Agonists

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Abstract

Patients who previously underwent metabolic bariatric surgery lost an average of 7.83 kg when treated with glucagon-like peptide-1 receptor agonists.

A total of 17 studies involving 1164 participants were included in the analysis.
Observational studies indicated an average weight reduction of 7.83 kg after treatment with glucagon-like peptide-1 receptor agonists.
Randomized controlled trials showed a weight reduction of 4.36 kg compared to placebo.
Approximately 23% of participants reported adverse events, but only 7% discontinued treatment.
The findings support a significant weight loss effect associated with the use of liraglutide and semaglutide in this patient population.

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CONTEXT: There has been growing recognition of the need for considering weight-loss strategies following metabolic bariatric surgery (MBS) to limit the magnitude of potential weight regain. The use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in this setting remains uncertain.

OBJECTIVE: We conducted a systematic review and meta-analysis to evaluate the effect of GLP-1RAs on weight changes in patients who previously underwent MBS.

METHODS: We examined the effect of GLP-1RAs on weight changes by calculating pooled estimates (random-effects model) of the absolute differences in body weight (kg) compared to baseline for observational studies and compared to a control group for randomized controlled trials (RCTs). A total of 17 studies (1164 participants) met our inclusion criteria. Pooling the data from the 14 observational studies evaluating the effect of GLP-1RAs post bariatric treatment demonstrated a reduction of 7.83 kg compared to pre treatment (before the use of GLP-1RA) (weight-7.83 kg [95% CI, -9.27 to -6.38]). With respect to tolerability, 23% (95% CI, 10%-36%) of participants reported any adverse event but only 7% discontinued treatment. Data from RCTs showed that the use of GLP-1RAs induced weight reduction of 4.36 kg (95% CI, -0.42 to -8.30) compared to placebo with a similar safety profile.

CONCLUSION: Our findings suggest that the use of liraglutide and semaglutide in patients who previously underwent MBS can promote significant weight reduction with an acceptable safety profile.

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Effect of Glucagon-like Peptide-1 Receptor Agonists (GLP-1RA) on Weight Loss Following Bariatric Treatment

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