Preoperative weight loss with glucagon-like peptide-1 receptor agonist treatment predicts greater weight loss achieved by the combination of medical weight management and bariatric surgery in patients with type 2 diabetes: A longitudinal analysis

Diabetes Obes Metab. 2018 Mar;20(3):745-748. doi: 10.1111/dom.13131. Epub 2017 Nov 22.

Abstract

We examined the relationship between weight changes after preoperative glucagon-like peptide-1 receptor agonist (GLP-1RA) treatment and weight changes from the start of medical weight management (MWM) until 12 months after bariatric surgery in patients with type 2 diabetes in a retrospective cohort study. A total of 45 patients (64.4% women, median [interquartile range] age 49 [45-60] years) were included. The median (interquartile range) weight loss from start of MWM until 12 months post-surgery was 17.9% (13.0%-29.3%). GLP-1RA treatment during MWM resulted in 5.0% (1.9%-7.7%) weight loss. Weight loss during GLP-1RA treatment predicted weight loss from the start of MWM until 12 months post-surgery, but not postoperative weight loss after adjustment. The proportion of weight loss from start of MWM to 12 months post-surgery attributed to GLP-1RA treatment was negatively associated with that attributed to surgery, after adjustment. In conclusion, weight change after GLP-1RA treatment predicted the weight loss achieved by a combination of MWM and bariatric surgery, but not weight loss induced by surgery only. Failure to lose weight after GLP-1RA treatment should not be considered a barrier to undergoing bariatric surgery.

Keywords: Roux-en-Y gastric bypass; bariatric surgery; glucagon-like peptide-1 receptor agonist; laparoscopic adjustable gastric band; laparoscopic sleeve gastrectomy; obesity; type 2 diabetes mellitus; weight loss.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Bariatric Surgery*
  • Combined Modality Therapy
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Female
  • Glucagon-Like Peptide-1 Receptor / agonists*
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Preoperative Care
  • Weight Loss / physiology*
  • Weight Reduction Programs / methods

Substances

  • Glucagon-Like Peptide-1 Receptor
  • Hypoglycemic Agents