(Press-News.org) SAN DIEGO – June 13, 2024 – A combination of GLP-1 agonists taken before metabolic and bariatric surgery may help patients with extreme obesity lower the risk of post-operative complications, according to a new study* presented today at the American Society for Metabolic and Bariatric Surgery (ASMBS) 2024 Annual Scientific Meeting
Patients with extreme obesity, a body mass index (BMI) of 70 or more, face a higher risk of complications from surgery compared to patients with lower BMIs. Studies have shown weight loss before surgery can mitigate risk but lifestyle intervention or first generation anti-obesity medications have not led to enough weight loss to make a difference.
In the study, 113 patients with BMI >70 attempted to lose weight prior to metabolic and bariatric surgery with either medically supervised diet and exercise, a single GLP-1 medication (mostly semaglutide) or multimodal therapy of more than one GLP-1. Patients were treated for an average of 72.9 days.
Individuals on multiple medications had the greatest percentage total body weight loss (13.1%), followed by single GLP-1 therapy (8.14%) and diet and exercise (5.95%). BMI reductions were highest for those treated for six to 12 months with combination drug therapy.
“Combining anti-obesity medications may achieve much greater pre-surgery weight loss than other methods for those with extreme obesity,” said Phil Schauer, MD, Director of the Metamor Metabolic Institute at Pennington Biomedical in Baton Rouge. “Many patients who would otherwise be considered ‘too sick for surgery’ may now qualify.”
The ASMBS reports that in 2022 nearly 280,000 metabolic and bariatric procedures were performed in the U.S., which represents only about 1% of those who meet eligibility requirements based on BMI. According to the U.S. Centers for Disease Control and Prevention (CDC), obesity effects 42.4% of Americans. Studies show the disease can weaken or impair the body’s immune system and cause chronic inflammation and increase the risk of many other diseases and conditions including cardiovascular disease, stroke, type 2 diabetes, and certain cancers.
“More studies are needed to determine the optimal role of GLP-1s before and after metabolic and bariatric surgery among different patient groups,” said Marina S. Kurian, MD, ASMBS President and Clinical Professor, Dept. of Surgery, Division of Bariatric Surgery, who was not involved in the study. “Obesity must be viewed like other chronic diseases where sometimes more than one therapy is necessary over time and for different reasons.”
About Weight-Loss Surgery
Metabolic, bariatric, or weight-loss surgery such as gastric bypass and sleeve gastrectomy has been shown to be the most effective and long-lasting treatment for severe obesity. The operations improve or resolve diseases including type 2 diabetes, heart disease and high blood pressure and leads to significant and durable weight loss. Its safety profile is comparable to some of the safest and most commonly performed surgeries in the U.S. including gallbladder surgery, appendectomy and knee replacement.
About ASMBS
The ASMBS is the largest organization for bariatric surgeons in the United States. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of severe obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for patients with severe obesity. For more information, visit www.asmbs.org.
A050 -- Multi-Modal Anti-Obesity Medication May Yield Superior Preoperative Weight Loss in High Risk Patients with BMI ≥70
Michael Kachmar Baton Rouge LA1, Florina Corpodean New Orleans LA1, Iryna Popiv Baton Rouge LA1, Kyle LaPenna New Orleans LA2, Devan Lenhart New Orleans LA1, Michael Cook New Orleans LA2, Vance Albaugh Baton Rouge LA1, Philip Schauer Baton Rouge LA1 Pennington / LSU-HSC1 LSU-HSC2
END
Pre-operative use of GLP-1s may reduce complications after metabolic and bariatric surgery in patients with extreme obesity
2024-06-13
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