Impact of glucagon-like peptide-1 receptor agonist or glucagon-like peptide-1 receptor agonist/glucose-dependent insulinotropic polypeptide receptor agonists After bariatric surgery in the veteran population

JAPhA Pharmacotherapy Pub Date : 2025-07-30 DOI:10.1016/j.japhar.2025.100020

Sara Corum, Timothy Morgan, Ashley Thomas

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Abstract

Background

Obesity is a progressive chronic disease that increases the risk of metabolic complications. Bariatric surgery is recommended alongside comprehensive lifestyle interventions for patients with a body mass index (BMI) of > 40 kg/m², BMI of > 35 kg/m² with obesity-related comorbidities, or BMI of > 30 kg/m² with a history of type 2 diabetes mellitus (T2DM). Bariatric procedures result in weight loss and improved metabolic outcomes, although weight regain can occur after surgery. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and GLP-1 RA/glucose-dependent insulinotropic polypeptide receptor agonists (GIP RAs) have emerged as effective injectable therapies for weight loss and management of obesity-related comorbidities.

Objective

This project evaluated the efficacy and tolerability of GLP-1 RA and GLP-1 RA/GIP RA therapy after bariatric surgery.

Methods

This single-center, retrospective project included patients who underwent bariatric surgery, were initiated on GLP-1 RA or GLP-1/GIP RA at least 1 year after surgery, and were on therapy for at least 6 months. The primary outcome was the percentage change in body weight from initiation of therapy to 6 months after. Secondary outcomes included the percentage of patients achieving ≥ 5%, ≥ 10%, or ≥ 15% reduction in weight; time from bariatric surgery to therapy initiation; discontinuation or dose reduction of therapy; and weight change comparison between patients with a history of T2DM and not enrolled in a weight loss clinic compared with those enrolled in a weight loss clinic.

Results

Fifty patients met the inclusion criteria. The mean percentage weight change at 6 months was −8.4%. For percentage weight reduction, 16 patients achieved ≥ 5%, 13 achieved ≥ 10%, and 7 achieved ≥ 15%. Median time from surgery to initiation of therapy was 111 months. Adverse events occurred in 3 patients (6%).

Conclusion

Overall, in patients receiving GLP-1 RA at least 1 year after bariatric surgery, additional weight loss was observed with minimal reported adverse events.

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胰高血糖素样肽-1受体激动剂或胰高血糖素样肽-1受体激动剂/葡萄糖依赖性胰岛素多肽受体激动剂对退伍军人减肥手术后的影响

背景：肥胖是一种进行性慢性疾病，可增加代谢并发症的风险。对于体重指数（BMI）为40 kg/m2、BMI为35 kg/m2并伴有肥胖相关合并症或BMI为30 kg/m2并有2型糖尿病（T2DM）病史的患者，建议在进行综合生活方式干预的同时进行减肥手术。减肥手术可以减轻体重并改善代谢结果，尽管手术后可能会出现体重反弹。胰高血糖素样肽-1受体激动剂（GLP-1 RAs）和GLP-1 RA/葡萄糖依赖性胰岛素性多肽受体激动剂（GIP RAs）已成为减肥和肥胖相关合并症管理的有效注射疗法。目的评价减肥手术后GLP-1 RA及GLP-1 RA/GIP RA治疗的疗效和耐受性。方法：本单中心回顾性研究纳入了接受减肥手术的患者，术后至少1年开始使用GLP-1 RA或GLP-1/GIP RA，治疗至少6个月。主要结局是从治疗开始到治疗后6个月体重的百分比变化。次要结局包括患者体重减轻≥5%、≥10%或≥15%的百分比；从减肥手术到治疗开始的时间；停止或减少治疗剂量；有2型糖尿病病史但未参加减肥诊所的患者与参加减肥诊所的患者之间的体重变化比较。结果50例患者符合纳入标准。6个月时体重变化的平均百分比为- 8.4%。体重减轻百分比方面，16例达到≥5%，13例达到≥10%，7例达到≥15%。从手术到开始治疗的中位时间为111个月。不良事件发生3例（6%）。总体而言，在减肥手术后至少1年接受GLP-1 RA的患者中，观察到额外的体重减轻，报告的不良事件最少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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JAPhA Pharmacotherapy

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