Tratamiento de la obesidad después de la cirugía bariátrica con análogos del receptor de GLP-1: evidencia en vida real

📖 Top 50% JournalAug 27, 2025Medicina clinica

Using GLP-1 receptor drugs to treat obesity after weight-loss surgery: real-world evidence

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GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗

Abstract

A total of 122 patients treated with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) experienced a 25.6% total weight loss with semaglutide compared to 21.6% with liraglutide.

Approximately 25-30% of patients after bariatric surgery experience weight regain or suboptimal weight loss.
At the start of treatment, patients had lost an average of 18.6% of their initial weight, with 52% losing less than 20% and 82% regaining more than 20% of lost weight.
Semaglutide treatment resulted in a maximum weight loss of 8.3%, while liraglutide resulted in 4.7%.
The proportion of patients with a suboptimal weight response decreased from 52% to 31% after receiving GLP-1 RAs.
The average treatment duration for patients was 19.3 months.

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INTRODUCTION: Approximately 25-30% of patients undergoing bariatric surgery (BS) experience weight regain or suboptimal weight loss. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as a therapeutic option in these cases.

AIM: To evaluate the effectiveness of GLP-1 RAs in managing weight regain and suboptimal weight response after BS in a real-world setting.

MATERIALS AND METHODS: Retrospective study of BS patients treated with GLP-1 RAs due to weight regain or suboptimal weight response.

RESULTS: A total of 953 patients underwent BS between 2015 and 2020; 122 initiated treatment with GLP-1 RAs. The cohort was composed 78% women, with a mean age of 50.4±10.6 years and a baseline BMI of 44.7±6.3kg/m. At the start of treatment, 41.9±20.5 months post-BS, the mean weight loss was 18.6±10%; 52% had lost <20% of their initial weight and 82% had regained >20% of the weight lost. 35% received liraglutide (LIRA) (1.8±0.5mg/day) and 65% semaglutide (SEMA) (1.0±0.8mg/week), with a mean treatment duration of 19.3±17.3 months. Maximum weight loss was 4.7±4.8% with LIRA vs. 8.3±5.9% with SEMA (p=0.01). Total weight loss (BS+GLP-1 RA) was 21.6±9.2% with LIRA vs. 25.6±10.5% with SEMA. The proportion of patients with a suboptimal weight response after BS+pharmacotherapy (<20%) significantly decreased (from 52% to 31%). 2

CONCLUSIONS: SEMA led to greater weight reduction than LIRA, positioning it as a more effective option for managing post-BS weight regain.

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