Pre-surgery GLP-1 use does not boost weight loss

A new study has examined the use of the GLP-1 drug semaglutide in patients undergoing bariatric surgery. Researchers found that taking semaglutide before surgery did not significantly improve total weight loss compared to surgery alone. This raises questions about whether antiobesity medications are beneficial before surgery. The study was led by Dr. Eric G. Sheu at Brigham and Women’s Hospital in Boston. He pointed out that there are no set guidelines on when to use GLP-1 drugs with bariatric surgery. Interest in combining these treatments has increased as more effective antiobesity medications have become available, even as bariatric surgery rates have declined. In the study, patients were divided into two groups. One group received semaglutide for about 24 weeks before surgery, while the other group had surgery without the medication. Although those taking semaglutide showed initial weight loss before surgery, the surgery-only group had greater total weight loss six months after the operation. Researchers found no significant differences in diabetes remission between the groups one year after surgery. Overall, the findings suggest that surgery remains more effective for long-term weight loss than GLP-1 medications. Dr. Sheu expressed concerns over current practices where patients with high body mass indexes frequently begin GLP-1 treatment before considering surgery. He believes patients with high BMIs should focus on surgery first for better results. The study did have limitations. Semaglutide was used at a lower dose than what is generally given for weight loss. Additionally, the patient group mainly included those undergoing sleeve gastrectomy, which may not reflect other types of bariatric surgery. Experts in the field are hopeful that GLP-1 medications can enhance outcomes for patients who have bariatric surgery, but clarity on their use is still needed. Some surgeons recommend a structured approach based on BMI when deciding whether to use GLP-1s, with a tendency to use them before surgery in patients with severe obesity. Despite the mixed results, research continues into how GLP-1s might better support weight loss after bariatric surgery.