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Patterns of Weight Loss Medication Utilization and Outcomes Following Bariatric Surgery
Colston Edgerton1, Meetal Mehta2, Danny Mou2
1Center for Metabolic and Bariatric Surgery, Division of Gastrointestinal Surgery, Medical University of South Carolina, Charleston, SC, USA.
Summary
Weight loss medications (WLM) can aid bariatric surgery patients. Roux-en-Y gastric bypass patients show better results than sleeve gastrectomy patients, and early WLM use is most effective.
Area of Science:
- Bariatric Surgery
- Obesity Medicine
- Pharmacotherapy
Background:
- Bariatric surgery is effective for obesity but weight regain occurs.
- Weight loss medications (WLM) are increasingly used post-surgery with limited evidence.
- This study examines WLM effectiveness in bariatric surgery patients.
Purpose of the Study:
- To evaluate weight loss outcomes in patients using WLM after bariatric surgery.
- To compare WLM effectiveness between different bariatric surgery types (SG and RYGB).
- To identify the most effective WLM for post-bariatric surgery patients.
Main Methods:
- Retrospective analysis of 197 bariatric surgery patients (2016-2019).
- Patients categorized into Weight Regainers (WR), Adequate Weight Loss (AWL), and Non-Responders (NR) based on post-surgery outcomes.
- Analysis of weight loss and WLM use patterns.
Main Results:
- Roux-en-Y gastric bypass (RYGB) patients achieved greater weight loss than sleeve gastrectomy (SG) patients using WLM.
- Phentermine + topiramate showed the highest likelihood of achieving significant weight loss (5%, 10%, 15%).
- The AWL group, initiating WLM earlier, experienced more weight loss compared to their pre-operative or nadir weights.
Conclusions:
- RYGB patients respond better to WLM compared to SG patients.
- Proactive WLM use during weight plateau (AWL group) leads to greater overall weight loss.
- Phentermine + topiramate is the most effective WLM for post-bariatric surgery patients.
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