Efficacy of the Glucagon-Like Peptide-1 Receptor Agonists Liraglutide and Semaglutide for the Treatment of Weight Regain After Bariatric surgery: a Retrospective Observational Study

Anders Boisen Jensen, Frida Renström, Stefan Aczél, Patrick Folie, Magdalena Biraima-Steinemann, Felix Beuschlein, Stefan Bilz, Anders Boisen Jensen, Frida Renström, Stefan Aczél, Patrick Folie, Magdalena Biraima-Steinemann, Felix Beuschlein, Stefan Bilz

Abstract

Purpose: Weight regain after bariatric surgery occurs in up to a third of patients and reduces treatment-associated health benefits. The efficacy of glucagon-like peptide-1 receptor agonists (GLP1-RA) for treatment of type 2 diabetes mellitus and obesity is well established, but their role in the treatment of weight regain after bariatric surgery remains to be defined.

Materials and methods: This was a single centre retrospective observational study conducted at a Swiss bariatric reference centre. Patients with 6 months of treatment with GLP1-RA, up until November 2021, due to weight regain after bariatric surgery were identified. Data on body weight and relevant clinical parameters were collected before and after 6 months of treatment with GLP1-RA. Data are presented as median (interquartile range).

Results: Fifty patients (82% female) were included. Before GLP1-RA treatment (liraglutide, n=29; semaglutide, n=21), weight and BMI were 90.5 kg (83.4, 107.9) and 34.0 kg/m2 (31.7, 38.7), respectively, with a post-bariatric weight regain of 15.1% (10.6, 22.8) of total body weight and 4.6 kg/m2 (3.3, 6.2). After 6 months of GLP1-RA treatment, a reduction in weight and BMI of 8.8% (5.2, 11.4) of total body weight and 2.9 kg/m2 (1.8, 4.0) was observed (P value <0.0001), corresponding to 67.4% (40.4, 92.2) of the weight regain. No serious adverse events were reported.

Conclusion: For patients experiencing weight regain after bariatric surgery, two-thirds of the weight regain can be safely lost with GLP1-RA, providing clinicians with a therapeutic option for this clinical challenge, and highlights the need for a large-scale randomized clinical trial.

Keywords: Bariatric surgery; GLP-1 receptor agonist; Liraglutide; Obesity; Semaglutide; Weight regain.

Conflict of interest statement

Anders Boisen Jensen is a previous employee of Novo Nordisk (2008–2010) and has received speaker honoraria and financial support for attending congresses from Novo Nordisk.

Frida Renström has no conflict of interest to declare.

Stefan Aczél has received speaker honoraria and financial support for attending congresses from Novo Nordisk.

Patrick Folie and Magdalena Biraima-Steinemann have received speaker honoraria from Novo Nordisk.

Felix Beuschlein has received financial support for attending symposia and for educational programmes by Novo Nordisk.

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Figures

Fig. 1
Fig. 1
Strobe flow chart
Fig. 2
Fig. 2
Box plot showing BMI before bariatric surgery, at weight nadir, at baseline and 6 months of GLP1-RA therapy (n=50)
Fig. 3
Fig. 3
Histogram of percentage of patients with ≥5%, ≥10%, and ≥15% weight loss following 6 months of GLP1-RA treatment (N=50)
Fig. 4
Fig. 4
Box plot showing the change in BMI following 6 months of GLP1-RA therapy (N=50), further stratified by liraglutide (3.0 mg [n=28] and 1.8 mg [n=1], daily subcutaneous injection) and semaglutide (1.0 mg, weekly subcutaneous injection [n=20] or 14 mg, daily oral intake [n=1])

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Source: PubMed

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