Introduction: Bariatric surgeries have shown to be the most effective weight loss intervention. However, some patients may experience weight recurrence which requires further management. Recent randomized trials demonstrated the effectiveness of semaglutide, a GLP-1 agonist, in achieving weight loss. Little is known about real-world outcomes of semaglutide use in patients with overweight and obesity who underwent bariatric surgeries.
Methods: We performed a retrospective data collection on the use of semaglutide in adults who underwent bariatric surgery (i.e., Roux-en-Y gastric bypass [RYGB] or sleeve gastrectomy [SG]). We included patients with a body mass index ≥27 kg/m2 who used any dose of weekly semaglutide subcutaneous injections for ≥3 months after their surgery. We excluded patients taking other anti-obesity medications or with an active malignancy. The primary end point was the total body weight loss percentage (TBWL%), and secondary end points were TBWL% of each of RYGB and SG and the proportion of patients achieving ≥5% and ≥10% TBWL at 3 and 6 months of taking semaglutide. Continuous end points were analyzed using matched paired t test. Data are presented as mean ± standard deviation.
Results: A total of 24 patients who underwent bariatric surgery were included in the analysis (96% female, mean age 48.9± 9.5 years, body-mass index 44.3± 15.4 kg/m2). The median number of years between the bariatric surgery and semaglutide initiation was 8 years. There was a statistical difference in weight loss of 6.3 kg equivalent to a TBWL% of 5.7% (n= 24; p<0.001) at 3 months and a weight loss of 15.0 kg equivalent to 13.0% (n=13; p< 0.001) at 6 months. Patients with RYGB had a TBWL% of 5.5% (n=16) and 13.7% (n=8) while those with SG had 6.1% (n=8) and 11.9% (n=5) at 3 (p=0.69) and 6 months (p=0.58), respectively. In our cohort, 15/24 patients (63%) achieved ≥5% TBWL while 3/24 (13%) achieved ≥10% TBWL% in 3 months. In addition, 13/13 patients (100%) achieved ≥5% TBWL while 7/13 (54%) achieved ≥10% TBWL in 6 months. In our cohort, 10/24 (42%) patients reported experiencing side effects with nausea/vomiting (25%) being the most common.
Discussion: This study demonstrates significant weight loss outcomes of semaglutide in patients after undergoing bariatric surgery. More studies with larger sample size are needed to further evaluate the effectiveness of this medication to counteract the weight recurrence after bariatric surgeries.
