Background

Modified long-acting analogues of native glucagon-like peptide 1 receptor agonists (GLP-1 RA) have recently been approved for the treatment of obesity. This study is a review of a cohort of VA patients who required adjunct treatment for obesity with GLP-1 RAs (semaglutide or liraglutide) after bariatric surgery. Patients included in this study have either weight recurrence or less than expected weight loss following bariatric surgery (defined as either loss of <2 body mass index (BMI) points after 3 months post-op, loss of <8-12 BMI points for sleeve gastrectomy 9 months post-op, or loss of <10-15 BMI points for gastric bypass 9 months post-op). The cohort currently includes 57 patients who met inclusion criteria for GLP-1 RA treatment, 44 (75.9%) of whom underwent sleeve gastrectomy and 13 (24.1%) of whom underwent Roux-en-Y gastric bypass, with a mean of 33 months between surgery and initiation of GLP-1 RA. Median time since initiating GLP1-RA treatment is currently 4 months, with mean BMI decrease at 2 and 6 months following GLP-1 RA initiation of 1.54 and 3.67 points, respectively. Given the relatively recent introduction of GLP-1 RAs for the treatment of obesity, as well as the current lack of data regarding the use of GLP-1RAs in the post-operative bariatric population, this study provides valuable insight into the efficacy of a new therapy in this specific population. Our early results demonstrate that this therapy is well-tolerated and effective in patients who have difficult to manage weight recurrence or plateau following bariatric surgery.