Background

Background: Anti-obesity medications (AOMs) are becoming a viable therapy for patients with obesity. Poor weight loss trajectory or weight regain are complications of bariatric surgery that can often be treated with surgical conversion or revision. The effect of AOMs on patients with obesity who have a history of bariatric surgery remains unclear. We sought to evaluate 1-year outcomes for our newly established Obesity Medicine Clinic. Objectives: Evaluate weight loss outcomes of AOMs in patients with prior bariatric surgery. Setting: Academic center Obesity Medicine Clinic.

Methods

Retrospective chart and database review.

Results

From October 2021 – October 2022, 61 patients established care and had at least 2 follow-up visits. The majority had prior bariatric surgery (n=36, 59.0%) of which 20 (55.6%) suffered weight regain and 14 (38.9%) poor weight loss trajectory. Prior surgery patients were more likely African American (63.9% vs 36.1%, p<0.05). Comorbidity was similar between groups. Initial visit BMI was similar for those without surgery compared to those with prior surgery (43.5 ± 9.3 vs 41.6 ± 8.7 kg/m2, p=0.427). Patients were treated with a variety of medications, similar between groups. BMI changes were similar at 1st follow-up (-1.0 ± 1.0 vs -1.2 ± 1.9 kg/m2, p=0.677) and 2nd follow-up (-2.1 ± 1.6 vs -2.4 ± 2.8 kg/m2, p=0.624).

Conclusions

It appears patients with prior bariatric surgery can achieve similar weight loss with AOMs compared to patients with no bariatric surgery. Further study, including multi-center randomized trials, is warranted to identify optimal treatment regimen and timing.