Use of Anti-Obesity Medications in Post-Operative Metabolic and Bariatric Surgery Patients

Here is the slide deck.

About 1 in 4 patients experience insufficient weight loss or weight recurrence after bariatric surgery. Roughly 240,000 bariatric surgeries are done per year. This translates to about 60,000 patients in the US each year who are weight recurrent post-MBS, a sizeable population.

This slide deck looks primarily at GLP-1 drugs in post-bariatric surgery patients who experience weight recurrence or struggle to lose weight. . The first RCT in this space published late 2023 showed that liraglutide results in 8% weight loss over 6 months compared to 0.5% loss on placebo. Retrospective studies with semaglutide in weight recurrent post-MBS patients support this finding with possibly larger weight loss percentages (up to 12% over 6 months).

5% weight loss in patients with obesity demonstrably lowers cardiovascular risk. Given that GLP-1 drugs in post-MBS weight recurrent patients hit this benchmark and more, it may be a useful therapeutic strategy in this patient population. We have 1 RCT with liraglutide which goes off patent in June 2024 which will make it more accessible for patients especially since cost is often a primary reason patients do not take a GLP-1 drug. We are still waiting for an RCT looking at semaglutide in this group of patients but expect that the findings will be similar to the retrospective and liraglutide RCT.

This was presented to the minimally invasive and bariatric surgery group at Yale while rotating there in medical school.