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Review
. 2025 Aug 28;30(1):70.
doi: 10.1007/s40519-025-01770-z.

The role of glucagon-like peptide-1 receptor agonists in weight regain treatment or prevention after bariatric surgery: a systematic review and meta-analysis

Asma Mousavi #  1   2 , Shayan Shojaei #  1   2 , Alireza Azarboo  1   2 , Razman Arabzadeh Bahri #  3 , Sara Mohammadi  1 , Sanam Alilou  4 , Shaygan Yousefifar  1 , Saba Maleki  5 , Hanieh Radkhah #  6
Affiliations
Review

The role of glucagon-like peptide-1 receptor agonists in weight regain treatment or prevention after bariatric surgery: a systematic review and meta-analysis

Asma Mousavi et al. Eat Weight Disord. .

Abstract

Background: Weight regain (WR) and insufficient weight loss (WL) occur in 20-25% of patients after bariatric surgery due to various factors. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have shown promise in promoting WL; however, evidence regarding their effectiveness in managing WL and preventing WR post-bariatric surgery remains limited.

Objective: This study aims to evaluate the role of GLP-1RAs in treating and preventing WR following bariatric surgery.

Methods: A systematic search was conducted across PubMed, Scopus, and Web of Science for studies assessing the impact of GLP-1RAs on WR after bariatric surgery.

Results: Our search identified 27 original studies, with 10 included in the meta-analysis involving 769 participants (392 treated with GLP-1RAs). The mean age was 44.05 years, with 30.47% male. The time interval from surgery to the initiation of GLP-1RAs treatment ranged from 1.5 to 86.7 months, with treatment durations between 4 and 12 months. The analysis showed significantly greater WL in the GLP-1RAs group compared to placebo (SMD = 0.82, 95% CI 0.23 to 1.42). Subgroup analysis for treatment durations ≤ 6 months indicated a higher WL in the GLP-1RAs group (SMD = 0.79, 95% CI 0.25 to 1.34). Adverse events were primarily gastrointestinal, with nausea significantly more frequently in the GLP-1RAs group (OR = 2.01, 95% CI 1.24 to 3.27).

Conclusion: GLP-1RAs effectively promote WL among participants experiencing WR after bariatric surgery. Initiating GLP-1RAs therapy shortly after surgery may help prevent WR. Further research is warranted to explore long-term outcomes and optimize treatment protocols for this patient population.

Keywords: Bariatric surgery; GLP-1RAs; Meta-analysis; Systematic review; Weight regain.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart. Summary of study selection
Fig. 2
Fig. 2
Comparison of weight loss after therapy between groups treated with GLP-1RAs and placebo based on SMD. A Overall analysis, B subgroup analysis of studies with treatment duration of ≤ 6 months, C subgroup analysis of studies with treatment duration of > 6 months
Fig. 3
Fig. 3
Sensitivity analysis was conducted by omitting each study for comparison of weight loss after therapy between GLP-1RAs and placebo-treated groups. A Overall analysis, B subgroup analysis of studies with treatment duration of ≤ 6 months, C subgroup analysis of studies with treatment duration of > 6 months
Fig. 4
Fig. 4
Comparison of weight loss after therapy between groups treated with GLP-1Ras and placebo based on absolute weight change (kg). A Overall analysis, B subgroup analysis of studies with treatment duration of ≤ 6 months, C subgroup analysis of studies with treatment duration of > 6 months
Fig. 5
Fig. 5
Comparison of adverse events between GLP-1RAs and placebo-treated groups: A nausea, B vomiting, C diarrhea
See this image and copyright information in PMC

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