GLP-1 drugs help patients lose regained weight after bariatric surgery

People who regain weight after bariatric surgery may benefit from glucagon-like peptide-1 receptor agonists (GLP-1s), according to a study involving Regenstrief Institute, Indiana University, Purdue University and University of Florida researchers. The study found that patients prescribed these medications lost more of their regained weight over six and 12 months than comparable patients who did not use them.

Bariatric surgery can produce substantial weight loss, but some patients later regain weight, potentially reducing the procedure's long-term health benefits. Evidence about how medications can help manage that recurrence remains limited. This study adds evidence about the effectiveness and safety of medications, increasingly used to address weight regain after surgery.

"Weight regain after bariatric surgery presents an important challenge for patients and clinicians," said Dr Tarik Yuce, Regenstrief Institute research scientist and a co-first author of the study. "By studying outcomes in routine care, we can build evidence about treatment options for patients whose needs continue long after surgery."

The research team analysed electronic health records from the OneFlorida+ Data Trust spanning 2015 through 2024. The study included adults with at least 10% weight recurrence after metabolic and bariatric surgery.

Researchers compared patients who began GLP-1 therapy with patients who did not use these medications, matching the groups on body mass index and the timing of clinical encounters. Additional statistical adjustments accounted for measured differences in patient characteristics. The analyses included 68 medication users and 131 nonusers at six months, and 72 users and 139 nonusers at 12 months.

At six months, patients using GLP-1 medications lost an average of 9.6% of their regained weight, compared with 4.3% among nonusers. At 12 months, the corresponding figures were 14.8% and 8.1%. These percentages describe the portion of regained weight lost, rather than a percentage of total body weight. The researchers found no evidence of an increased risk of gastrointestinal or postsurgical complications they evaluated among patients taking the medications.

"Real-world evidence helps us examine how treatments perform in everyday clinical settings," Yuce added. "These findings provide a foundation for further research into which patients may benefit, when treatment should begin, and how long benefits last."

Because the study was observational, it cannot establish that the medications caused the differences in weight loss. Although researchers adjusted for measured differences between groups, other factors may have influenced the results. Further research is needed to confirm the findings and better understand longer-term benefits and risks.

The findings were featured in the paper, ‘Real‐World Effectiveness and Safety of GLP ‐1 Receptor Agonists Among Patients With Weight Recurrence After Bariatric Surgery’, published in Obesity.