Preoperative Weight Loss With GLP-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

Abstract

We examined the relationship between weight changes following preoperative glucagon-like peptide-1 receptor agonist (GLP-1 RA) and weight changes from the start of medical weight management (MWM) till 12 months after bariatric surgery in patients with Type 2 diabetes in a retrospective cohort study. Forty-five patients (64.4% women, median age 49 (IQR 45-60) years) were included. The median weight loss from start of MWM until 12 months post-surgery was 17.9% (13.0%-29.3%). GLP-1 RA during MWM resulted in 5.0% (1.9%-7.7%) weight loss. Weight loss during GLP-1 RA treatment predicted weight loss from the start of MWM till 12 months post-surgery; but not post-operative weight loss following adjustment. The proportion of weight loss from start of MWM to 12 months post-surgery attributed to GLP-1 RA was negatively associated with that attributed to surgery following adjustment. In conclusion, weight change following GLP-1 RA 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 following GLP-1 RA should not be considered a barrier to having bariatric surgery.