Impact of Treatment with GLP1 Receptor Agonists, Liraglutide 3.0 mg and Semaglutide 1.0 mg, While on a Waiting List for Bariatric Surgery

Abstract

Background: Weight loss before undergoing metabolic and bariatric surgery (MBS) has been suggested to reduce perioperative complications, although with controversial results. The objective of this study is to evaluate the impact of treatment with GLP1-R agonists (liraglutide 3.0 mg and semaglutide 1.0 mg) on preoperative weight loss and patients’ decisions regarding MBS while on a surgical waiting list. Materials and methods: One hundred and two patients on a waiting list for MBS started treatment with GLP1-RA for at least 6 months. Changes in weight at 26 and 52 weeks, the number of patients achieving >5% weight loss, and patients’ decisions regarding MBS were evaluated. Results: After 52 weeks, patients lost 16.9 ± 7.2% of weight with semaglutide 1.0 mg and 16.1 ± 5.8% of weight with liraglutide 3.0 mg. All patients lost ≥5% of initial weight, 84.7% lost ≥10%, 54.6% lost ≥15%, and 27.5% reached ≥20%. A total of 68.6% of participants were satisfied with the achieved weight loss and withdrew from the waiting list for MBS. A threshold of >15.1% weight loss had the greatest sensitivity and specificity for the final decision regarding undergoing MBS. Conclusions: Losing >15% of initial weight after 52 weeks of treatment with liraglutide 3.0 mg or semaglutide 1.0 mg during the waiting list for MBS impacts patients’ decisions regarding the final acceptance or rejection of the procedure.

Tackling the dual burden of malnutrition in pregnancy – pregnancy after weight loss surgery

“…However, since then, the onset of the COVID-19 pandemic has further limited the number of surgeries being conducted, with demand and eligibility far outstripping supply (41) . Simultaneously, new pharmaceutical weight loss therapies, Glucagon Like Peptide-1 Receptor Agonists (GLP-1RA), have been licenced for use in the UK (79,80) , which have been evaluated for use both prior (81) to and after bariatric surgery (82) . Although GLP-1RAs are contraindicated during pregnancy (83,84) and there are concerns about inhibition of absorption of oral contraceptives (85) , there is evidence for their use in improving fertility in those with PCOS (27) .…”