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Updated: Sep 11, 2025
Roux-en-Y Gastric Bypass Operation in Rats
Published on: June 11, 2012
Surgical Outcomes in Patients with Preoperative GLP-1 Therapy: A Retrospective Analysis
Adisa Poljo1, Jakob J Reichl2, Simon Bürgi3
1Department of Visceral Surgery, Clarunis, University Digestive Health Care Center Basel, St. Clara Hospital and University Hospital Basel, Basel, Switzerland.
Background:
Obesity, a chronic disease with serious associated medical problems, remains a global health challenge. While metabolic bariatric surgery (MBS) is the most effective treatment for weight loss, GLP-1 receptor agonists (RAs) are emerging as promising alternatives or adjuncts. This study evaluates the impact of preoperative GLP-1 therapy on weight loss and obesity-related complications over three years and explores reasons for transitioning to surgery.
Methods:
Patients who underwent RYGB or SG from 2015-2021 were retrospectively analyzed, excluding those with revision and conversion surgeries, postoperative GLP-1 use, or pregnancy during follow-up. Propensity score matching (1:1) was used to adjust for confounders. The primary outcome was a combined endpoint of the SF-Bari Score, incorporating weight loss, improvement of obesity-related conditions, and surgical complications until 36 months post-surgery.
Results:
A total of 215 patients were analyzed, including 54 who received GLP-1 RAs prior to surgery, with a preoperative total body weight loss (%TWL) of 3.7 ± 4.3%. %TWL did not differ significantly between groups: at 12 months, 29.8 ± 7.7% (non-GLP-1) vs. 28.1 ± 7.6% (GLP-1); at 24 months, 28.9 ± 8.2% vs. 27.2 ± 8.4%; and at 36 months, 26.9 ± 9.1% vs. 25.4 ± 9.1%. SF-Bari Scores were similar between groups at all timepoints: 96.0 ± 24.2 vs. 93.5 ± 26.3 at 12 months, 93.8 ± 24.4 vs. 91.0 ± 25.6 at 24 months, and 89.1 ± 24.7 vs. 85.5 ± 25.8 at 36 months (non-GLP-1 vs. GLP-1). Propensity score matching confirmed comparable outcomes between groups. Patients transitioned to surgery for definitive treatment, side effects, or medication unavailability.
Conclusion:
Among patients who proceeded to surgery after GLP-1 therapy, prior GLP-1 use was not associated with different surgical outcomes.
Insights
Preoperative use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) did not significantly alter weight loss or obesity-related complication outcomes three years after metabolic bariatric surgery. Patients transitioned to surgery for various reasons, including definitive treatment needs.
Area of Science:
- Endocrinology
- Bariatric Surgery
- Obesity Medicine
Background:
- Obesity is a global health challenge requiring effective treatments.
- Metabolic bariatric surgery (MBS) is highly effective for weight loss.
- Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are emerging as alternatives or adjuncts to MBS.
Purpose of the Study:
- To evaluate the impact of preoperative GLP-1 RA therapy on weight loss and obesity-related complications.
- To explore reasons for patients transitioning from GLP-1 RA therapy to bariatric surgery.
- To assess long-term outcomes up to three years post-surgery.
Main Methods:
- Retrospective analysis of patients undergoing Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG).
- Propensity score matching (1:1) to control for confounders.
- Primary outcome: SF-Bari Score assessing weight loss, comorbidity improvement, and surgical complications at 36 months.
Main Results:
- No significant difference in % total body weight loss (%TWL) at 12, 24, or 36 months between GLP-1 RA users and non-users.
- SF-Bari Scores were comparable between groups at all time points up to 36 months.
- Reasons for surgery transition included definitive treatment, side effects, or medication unavailability.
Conclusions:
- Preoperative GLP-1 RA use was not associated with altered surgical outcomes in patients undergoing MBS.
- GLP-1 RAs may serve as a viable option prior to bariatric surgery without compromising results.
- Further research can explore optimal sequencing of therapies.
