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Weight regain is influenced by hormonal adaptations, including ghrelin rebound and leptin resistance.

Understanding hormonal influences can help in developing targeted interventions for weight management post-surgery.

Glycerol concentration increased by GIP (+13%) and GLP-1/GIP/glucagon receptor triagonist (+28%) in human adipose tissue.

GIP may be a potential target for enhancing fat loss in overweight individuals.

Direct lipolytic effects of GIP exist in human subcutaneous adipose tissue.

GIP could be targeted in therapies aimed at enhancing fat loss.

The proportion of GLP-1 RA users without T2DM or obesity rose from approximately 2% in 2020 to over 5% in May 2022.

There is a growing concern regarding the use of GLP-1 RAs in individuals without the approved indications.

Potential misuse of GLP-1 RAs was identified in 2.2% of users.

Monitoring for misuse of GLP-1 RAs is necessary due to the identified percentage of potential misuse.

GLP-1RAs may lead to treatment discontinuation due to gastrointestinal side effects.

Clinicians should prepare patients for the possibility of discontinuation due to side effects.

Solid gastric contents were significantly more frequent in patients receiving semaglutide treatment (42%) compared to controls (7%).

Healthcare providers should consider the higher likelihood of solid gastric contents in patients on semaglutide when planning surgeries.

There has been a shift in the therapeutic approach to coronary artery disease (CAD) in patients with Type 2 Diabetes Mellitus (T2DM).

Healthcare providers should stay updated on evolving treatment strategies for CAD in T2DM patients.

Both semaglutide and tirzepatide show gastrointestinal side effects including nausea, vomiting, pancreatitis, and diarrhea.

Clinicians should be aware of these common gastrointestinal side effects when prescribing these medications.

GLP-1 receptor agonists reduced systolic blood pressure (SBP) by 3.4 mmHg and diastolic blood pressure (DBP) by 0.9 mmHg.

GLP-1 receptor agonists can be considered for managing blood pressure in overweight or obese patients.

Incretin-based therapy did not increase the risk of hypoglycaemia or pancreatitis.

Clinicians can consider incretin-based therapies as safe options for managing obesity and hypertension without increasing hypoglycaemia or pancreatitis risk.

Semaglutide reduced frailty burden after 52 weeks of treatment.

Semaglutide may be beneficial in reducing frailty in patients with obesity-related HFpEF over a year.

Erectile dysfunction (ED) affects up to three out of four individuals with diabetes.

Healthcare providers should be aware of the high prevalence of ED in diabetic patients.

Preliminary reports have raised concerns about a possible association between GLP-1 RA use and erectile dysfunction.

Clinicians should monitor erectile function in patients using GLP-1 RAs.

GLP-1 RA users had higher rates of type 2 diabetes (55.6% versus 29.5%) compared to nonusers.

Understanding the diabetes status of patients may inform perioperative management strategies.

Gastrointestinal adverse events (AEs) are common with incretin-based therapies (IBTs), with placebo-subtracted incidences of 5–39% for nausea, −7–39% for diarrhea, 2–31% for constipation, 0–26% for vomiting, and 2–20% for abdominal pain.

Clinicians should be aware of the high incidence of GI AEs when prescribing IBTs.

GLP-1RA use was associated with increased fracture risk in nondiabetic patients who were overweight or obese (3.05% vs. 2.61%, OR 1.19, CI [1.09 to 1.31]).

Practitioners should consider the increased fracture risk when prescribing GLP-1RAs to overweight or obese nondiabetic patients.

In patients with a BMI ≥40, fracture risk was significantly increased with GLP-1RA use (3.15% vs. 1.91%, OR 1.26, CI [1.04 to 1.52]).

Higher BMI patients may require closer monitoring for fracture risk when prescribed GLP-1RAs.

Patients older than 67 years showed a significant increase in fracture risk with GLP-1RA use, particularly those aged 68 to 77 years (5.61% vs. 3.65%, OR 2.25, CI [1.62 to 3.13]) and 78 to 88 years (9.28% vs. 5.10%, OR 4.99, CI [2.68 to 9.26]).

Older patients may be at higher risk for fractures when prescribed GLP-1RAs and should be monitored accordingly.

If access to GLP-1RAs was restricted to people with severe obesity and 50% moved into a lower BMI category, there would be a simulated reduction in cumulative cancer cases of 7476.

Restricting GLP-1RA access to those with severe obesity can still lead to significant cancer case reductions.

Patients receiving semaglutide within 10 days of surgery have a significantly increased risk of residual gastric content compared to a control sample (40% vs. 3%).

Clinicians should be cautious when managing patients on semaglutide in the peri-operative setting due to increased aspiration risk.

Increased residual gastric content was observed regardless of whether patients held semaglutide for 1–7 or 8–10 days pre-operatively.

The duration of holding semaglutide before surgery may not mitigate the risk of residual gastric content.

Increased residual gastric content can persist up to 10 days after stopping subcutaneous semaglutide.

Clinicians may need to consider longer pre-operative interruption intervals for patients on semaglutide to reduce aspiration risk.

Transient reductions in fasting glucose were observed in participants with T2D, but these were not sustained and not significantly different from placebo at day 29.

While LY3537021 may reduce fasting glucose, the effects may not be long-lasting.