Glucagon-like peptide-1 receptor agonists for post-bariatric surgery weight regain and insufficient weight loss: A systematic review

Abstract

Aim

The rising prevalence of obesity has elevated it to a significant public health concern. Bariatric surgery (BS) has emerged as a promising solution for severe obesity and associated complications, surpassing traditional approaches. Nonetheless, the escalating utilization of BS has given rise to novel challenges, namely weight regain (WR) and insufficient weight loss (IWL). Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have surfaced as a promising therapeutic avenue. Recognizing the potential of GLP-1 RAs in addressing relapse among individuals who have undergone BS is imperative for enhancing patient outcomes.

Materials and methods

A comprehensive systematic review was undertaken by searching through databases including PUBMED, EBSCO, ProQuest, and manual exploration, following the PRISMA 2020 guideline. Included were studies that examined the application of GLP-1RAs in individuals who had undergone BS and encountered WR and IWL.

Results

This review encompassed 10 studies, all of which demonstrated consistent findings. Irrespective of the diversity in surgical methods, a range of total weight loss (TWL) outcomes were observed. Both primary and revisional surgeries exhibited reductions in body mass index (BMI); emphasizing the overall efficacy of GLP-1 RAs. The collective evidence consistently highlighted the effectiveness and safety of GLP-1RAs in managing post-bariatric weight concerns.

Conclusions

Based on current evidence, GLP-1 RA is a safe and effective treatment for post-BS WR and IWL. However, comparison studies using cohort or randomized controlled trials are needed to confirm its effect.