Primary Care Providers Perspectives of GLP-1 Receptor Agonists to Manage Recurrent Weight Gain after Metabolic Bariatric Surgery - a Qualitative Study

Recurrent weight gain after metabolic bariatric surgery (MBS) affects 20-25% of patients, with research indicating that up to 87% of patients experience some post-MBS weight gain. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly being used to manage obesity in primary care. However, there remains a gap in understanding primary care providers (PCPs) perspectives on GLP-1RAs in the context of MBS.

For this qualitative study, we recruited primary care providers (PCPs) (n = 38) from the United States and Sweden who had experience providing healthcare services in primary care after MBS. Individual semi-structured interviews were conducted between September 2024 and March 2025. We analyzed the transcribed interviews with reflexive thematic analysis.

The primary theme "GLP-1RAs - Navigating Between Breakthrough and Uncertainty" captures PCPs' perception of the advent of GLP-1RAs as beneficial, while characterizing their uncertainty regarding GLP-1RA use in post-MBS care. PCPs welcomed the emergence of a new tool to address recurrent weight gain. However, patient requests for GLP-1RAs raised concerns about primary care prescription resources and access due to systematic barriers. PCPs identified a need for more knowledge and experience with GLP-1RA use post-MBS. They also recognized the changing role of MBS in treating obesity.

PCPs perceived GLP-1RAs as a promising and effective tool for addressing recurrent weight gain after MBS, and that care options for patients had improved. Systematic barriers were perceived to have a negative impact on the effectiveness of treatment. More expert guidance and support to effectively treat patients with GLP-1RAs after MBS is needed.