- A new study finds that people who take GLP-1 drugs after bariatric surgery lose more weight than people on placebos.
- GLP-1 drugs suppress appetite and improve glucose, cholesterol, and blood pressure levels, which help contribute to weight loss.
- About 1 in 4 people who have bariatric surgery do not see major weight loss.
- Taking the GLP-1 drug liraglutide may help induce weight loss in these people.
New research has found that glucagon-like peptide-1 (GLP-1) receptor antagonist drugs may improve outcomes in individuals who underwent bariatric surgery but didn’t achieve their metabolic and weight loss goals within a year after the procedure.
Prior research has found that liraglutide, in varying doses,
This trial is the first randomized clinical trial to evaluate the efficacy and safety of 3 mg of liraglutide compared to a placebo — combined with lifestyle changes — in people with suboptimal weight loss outcomes after metabolic surgery.
GLP-1 drugs have a similar effect on the body’s gastrointestinal signals as bariatric surgery.
These effects suppress appetite and improve glucose, cholesterol, and blood pressure levels, which help contribute to weight loss.
“The study reaffirms what we have seen in our own bariatric surgery practice; we have seen patients who have less than optimal results after surgery or weight regain, and weight loss medications have been helpful,” Dr. Mir Ali, MD, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, told Healthline.
The researchers recruited 70 people in the United Kingdom who had a poor weight loss response after receiving bariatric surgery.
Of the group, 35 took 3.0 mg of liraglutide for 24 weeks and 35 took a placebo.
The participants also adhered to lifestyle changes — a 500-kcal daily energy deficit — over the course of the study period.
A handful of the patients dropped out of the study or discontinued the treatment. Fifty seven individuals completed the trial.
Researchers found that people who took liraglutide dropped 8% more body weight compared to people who took a placebo.
The group that took liraglutide also experienced positive changes in fasted glucose, hemoglobin A1c, systolic blood pressure, total cholesterol, and high-density lipoprotein cholesterol compared to those who took the placebo.
There were no serious adverse events or deaths related to the treatments.
Dr. Dan Azagury, MD, FACS, an associate professor of surgery at Stanford Healthcare, says these findings are also in line with what he’s observed in his clinical experience.
“We have been using these medications routinely in our clinic for years in this same patient population and the positive results reported in the study are in line with our experience,” Azagury, who was not involved in the study, said.
Metabolic surgery is one of the most effective treatments for people with severe obesity. However, the outcomes differ from person to person.
While many individuals lose a signification percentage of their body weight, approximately 1 in 4 people who undergo metabolic surgery experience poor weight loss, defined as losing less than 20% of one’s body weight, or weight regain.
In most cases, metabolic surgery alters gastrointestinal signals.
For example, post-surgery, many patients have higher levels of the gut hormone GLP-1, which contributes to satiety, reducing their appetite.
Other individuals, however, experience changes in their gut hormones that are associated with increased appetite.
Ali says there are many factors that can impact people’s outcomes.
“The patient’s age, sex, genetics, lifestyle, underlying medical conditions, even socioeconomic status can affect how successful someone is after surgery,” Ali said.
Even though surgery is a highly effective treatment option for obesity, it requires long-term follow-up, says Azagury.
“Response rates vary and recurrences can happen over time,” he said.
As the report states, there’s a strong need for therapeutic interventions for people who don’t respond well to metabolic surgery.
Liraglutide, and other GLP-1 drugs, act on the same overall mechanisms as surgery.
“As the effect of the surgery decreases over time, these drugs allow us to ‘boost’ that effect back up,” says Azagury.
GLP-1 drugs can be used to optimize surgery outcomes in numerous ways, according to Ali.
They can be given to patients starting at a very high weight to reduce risk of complications during surgery, after surgery when weight loss plateaus, or even years later if the patient experiences weight regain, says Ali.
“The goal of any weight loss program is to provide a patient with tools to make sustainable lifestyle changes. Medications are another tool that we as clinicians can use,” Ali said.
Glucagon-like peptide-1 (GLP-1) drugs may improve outcomes in individuals who underwent bariatric surgery but didn’t achieve their metabolic and weight loss goals within a year after the procedure, according to new research. Liraglutide, and other GLP-1 drugs, act on the same overall mechanisms as surgery and can optimize surgery outcomes in numerous ways.