Hormonal
Post-bariatric pharmacotherapy with GLP-1 receptor agonists (specifically liraglutide) effectively augments weight loss and prevents weight regain in patients who have undergone Roux-en-Y gastric bypass or sleeve gastrectomy.
If you have had bariatric surgery and are regaining weight, talk to your doctor about adding a GLP-1 medication like liraglutide. It is taken as a daily injection, starting at a low dose to minimize side effects like nausea, and can help you lose additional weight or stop regaining it. This is a standard, evidence-based next step when surgery alone is not enough.
A randomized, double-blind, placebo-controlled, multicentric trial (GRAVITAS; n = 71, 2:1, liraglutide:placebo) studied the effect of liraglutide 1.8 mg in patients with recurrent or persistent type 2 diabetes mellitus 1 year after RYGB. The GRAVITAS trial showed a 4.23 kg (6.81 kg vs. 1.64 kg; p = 0.0017) weight loss difference between the liraglutide 1.8 mg and placebo groups after 26 weeks of treatment.
Why this rating
Supported by multiple randomized controlled trials (GRAVITAS, etc.) and retrospective studies, though sample sizes for specific post-surgical subgroups are often small.
Source
Pharmacotherapy as an Augmentation to Bariatric Surgery for Obesity
L Horvath et al. · Drugs · 2024
DOI 10.1007/s40265-024-02029-0
More from this paper
- Phentermine/Topiramate combination therapy significantly reduces the rate of weight regain in patients who have undergone Roux-en-Y gastric bypass (RYGB).Moderate
- Orlistat is effective in promoting weight loss in patients who have undergone Laparoscopic Adjustable Gastric Banding (LAGB) and have plateaued, but its use is not recommended after malabsorptive surgeries.Moderate
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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