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Background <p>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.</p> Methods <p>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&#xa0;months post-surgery.</p> Results <p>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&#xa0;months, 29.8 ± 7.7% (non-GLP-1) vs. 28.1 ± 7.6% (GLP-1); at 24&#xa0;months, 28.9 ± 8.2% vs. 27.2 ± 8.4%; and at 36&#xa0;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&#xa0;months, 93.8 ± 24.4 vs. 91.0 ± 25.6 at 24&#xa0;months, and 89.1 ± 24.7 vs. 85.5 ± 25.8 at 36&#xa0;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.</p> Conclusion <p>Among patients who proceeded to surgery after GLP-1 therapy, prior GLP-1 use was not associated with different surgical outcomes.</p>

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Surgical Outcomes in Patients with Preoperative GLP-1 Therapy: A Retrospective Analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月12日

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  • Adisa Poljo,
  • Jakob J. Reichl,
  • Simon Bürgi,
  • Amanda S. Dirnberger,
  • Romano Schneider,
  • Jennifer M. Klasen,
  • Adrian T. Billeter,
  • Beat P. Müller,
  • Ralph Peterli,
  • Marko Kraljević

摘要

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.