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AOMs help patients manage postsurgical weight recurrence

Anti-obesity medications, including semaglutide (Ozempic and Wegovy), can effectively help patients manage weight regained after bariatric surgery, according to a study led by UT Southwestern Medical Center (UTSW) researchers.

"There was very little published data on how to treat post-bariatric surgery weight gain. Our research found that newer anti-obesity medications are effective for treating weight regain and optimising body weight after bariatric surgery," said Dr Jaime Almandoz, Associate Professor of Internal Medicine in the Division of Endocrinology at UTSW and the study's senior author. ". Our study also found that weight management medication regimens containing semaglutide worked better than those containing liraglutide, even when the dose of semaglutide was lower than what is currently approved to treat obesity."

In recent years, two anti-obesity medications have been approved by the Food and Drug Administration: semaglutide (Wegovy), which is given as a weekly injection, and liraglutide (Saxenda), a daily injection. Both belong to the same drug class - glucagon-like peptide-1 (GLP-1) receptor agonists - and work by controlling appetite and satiety. Previous work by Almandoz and colleagues suggested that this class of drugs could be more effective than other drugs, or even lifestyle modification, in treating post-bariatric surgery weight regain. However, the two drugs had not been directly compared in this context.

The new study analysed health records for 207 adults who previously had bariatric surgery and were then treated for obesity at UTSW's Weight Wellness Program between 2015 and 2021. Nearly 90% of the patients were women, and the average age was 55. About 46% were non-Hispanic white, nearly 35% were non-Hispanic Black, and about 11% were Hispanic. These patients were, on average, eight years out from surgery and had regained more than 40% of the weight they lost after their bariatric procedures. Data were analysed from patients who were prescribed weight management regimens containing either semaglutide or liraglutide for at least three months.

Patients were treated with semaglutide 1.0mg weekly (n=115) or liraglutide 3.0mg daily (n=92). The primary end point was percentage body weight change at 12 months of treatment with regimens containing semaglutide or liraglutide. The mean sample age was 55.2 years; mean BMI was 40.4 kg/m2; and 50% completed sleeve gastrectomy, 29% completed Roux-en-Y gastric bypass and 21% completed adjustable gastric banding.

Twelve months later, those taking semaglutide had lost an average of 12.9% of their body weight, while those taking liraglutide had lost an average of 8.8%, the study showed. People in the semaglutide group were more than twice as likely to have lost at least 10% of their body weight. The results with semaglutide remained unchanged when factoring in age, sex or the type of bariatric surgery, according to the study.

"Our results support the real-world effectiveness of GLP-1 receptor agonists for treating post-bariatric weight recurrence and suggest that semaglutide is superior to liraglutide," added Almandoz. He noted that the results could help inform the use of these drugs in optimising body weight after bariatric surgery.

The findings were reported in the paper, ‘Effectiveness of semaglutide versus liraglutide for treating post‐metabolic and bariatric surgery weight recurrence’, published in the journal Obesity.

To access this paper, please click here


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