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. 2023 Dec;37(12):9509-9513.
doi: 10.1007/s00464-023-10387-1. Epub 2023 Sep 12.

Use of GLP-1 agonists in high risk patients prior to bariatric surgery: a cohort study

Malynn Ilanga  1 , Jessica C Heard  2 , James McClintic  1 , Danielle Lewis  3 , Gregory Martin  4 , Carah Horn  1 , Zhamak Khorgami  1 , Jesse Richards  3 , Geoffrey S Chow  1 , Robert B Lim  5
Affiliations

Use of GLP-1 agonists in high risk patients prior to bariatric surgery: a cohort study

Malynn Ilanga et al. Surg Endosc. 2023 Dec.

Abstract

Introduction: Body mass index (BMI) > 50 kg/m2 is associated with relatively increased morbidity and mortality with bariatric surgery (BS). There is reluctance to consider these patients operative candidates without preoperative weight loss. Glucagon-like peptide-1 (GLP-1) agonists have demonstrated effective weight loss in the post-BS setting. This study aims to determine the safety and efficacy of GLP-1 agonists in the pre-habilitation of patients with BMI > 50 kg/m2.

Methods: This is a retrospective review of bariatric surgery patients with BMI > 50 kg/m2 from a single bariatric center. Patients were compared by preoperative GLP-1 therapy status. All patients received medical, surgical, psychiatric, and nutritional evaluation and counseling. Preoperative BMI, change in weight from program intake until surgery, time to surgery, and perioperative complications were evaluated.

Results: 31 patients were included in the analysis. 18 (58%) received a GLP-1 agonist preoperatively. GLP-1 agonist use was associated with a 5.5 ± 3.2-point reduction in BMI compared to 2.9 ± 2.4 amongst controls (p = 0.026). There was no difference in the mean length of time in the bariatric program prior to surgery between groups (p = 0.332). There were no reported complications related to GLP-1 use in the preoperative setting and no difference in perioperative complications between groups (p = 0.245).

Discussion: GLP-1 agonist use in patients with a BMI > 50 kg/m2 results in significantly more weight loss prior to bariatric surgery, without increased time to surgery or complication rate. Further study is required to evaluate the long-term impact of preoperative GLP-1 agonist use prior to bariatric surgery. This therapy may improve perioperative and long-term outcomes in the very high-risk BMI population.

Keywords: Bariatric; GLP-1 agonist; Pre-habilitation; Surgery.

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References

    1. National Institutes of Health (1998) Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—the evidence report. Obes Res 6 Suppl 2:51S–209S. Erratum in: Obes Res 1998;6(6):464
    1. World Health Organization (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 894(i–xii):1–253
    1. Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L, NEDCOM, the Netherlands Epidemiology and Demography Compression of Morbidity Research Group (2003) Obesity in adulthood and its consequences for life expectancy: a life-table analysis. Ann Intern Med 138(1):24–32. https://doi.org/10.7326/0003-4819-138-1-200301070-00008 - DOI - PubMed
    1. Eisenberg D, Shikora SA, Aarts E, Aminian A, Angrisani L, Cohen RV, De Luca M, Faria SL, Goodpaster KPS, Haddad A, Himpens JM, Kow L, Kurian M, Loi K, Mahawar K, Nimeri A, O’Kane M, Papasavas PK, Ponce J, Pratt JSA, Rogers AM, Steele KE, Suter M, Kothari SN (2022) 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): indications for metabolic and bariatric surgery. Surg Obes Relat Dis 18(12):1345–1356. https://doi.org/10.1016/j.soard.2022.08.013 - DOI - PubMed
    1. Carter J, Chang J, Birriel TJ, Moustarah F, Sogg S, Goodpaster K, Benson-Davies S, Chapmon K, Eisenberg D (2021) ASMBS position statement on preoperative patient optimization before metabolic and bariatric surgery. Surg Obes Relat Dis 17(12):1956–1976. https://doi.org/10.1016/j.soard.2021.08.024 - DOI - PubMed

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