Background

Bariatric surgery remains the gold standard treatment for severe obesity. Recently, several Anti-Obesity Medications (AOM) demonstrate significant weight-loss. Here, we investigate the synergistic effect of AOMs in patients undergoing bariatric surgery.

Methods

This is a single-surgeon retrospective study from a large academic center. Analyzed variables included age, race/ethnicity, diabetes status, insurance, type of medication, operation, revision status, length of stay, weight loss and adverse events.

Results

281 patients were included, of which 95 (34%) received adjunct anti-obesity medication therapy (“With”), and 186 (66%) did not (“Without”). There was no significant difference in the age, race/ethnicity, diabetes status, or insurance status between the two groups (Table 1). Patients who received medication had a higher average preoperative weight (Without: 115.5±1.4kg, With: 125.0±2.5kg p<0.001), and were more likely to have a bypass procedure (Without: 11%, With: 21%, p<0.05). Patients who received medication lost more weight in the preoperative period (Without: 5±0.3, With: 7.6±0.6, p<0.0001; Figure 1A), as well as by 1-month after surgery (Without: 10.6±0.3kg, With: 12.3±0.5kg, p<0.05; Figure 1B). The average duration of medication use was 41.7±4.3 weeks (range 1-250 weeks). Semaglutide use was associated with the greatest 1-month weight loss (13.4±0.8kg; Figure 1B).

Conclusions

Enhanced outcomes through combined therapies represented here is the largest reported case series for combined AOMs preoperatively with surgery. There are large variations in the duration of adjuvant anti-obesity medication use, but overall, there does appear to be an added weight-loss benefit. Semaglutide use is associated with the greatest improvement in early weight-loss after bariatric surgery.