Healthcare (Commonwealth Union) – A study led by Monash University and Alfred Health has revealed that combining bariatric surgery with weight loss medication can support individuals who struggle to shed enough weight after surgery.
Obesity is a serious health concern across the globe. Researchers of the study pointed out that Bariatric Surgery (MBS) remains the most reliable and effective treatment, typically resulting in a 20–30 per cent reduction in total body weight.
However, around 10–15 per cent of patients either fail to achieve the expected weight loss or regain weight following the procedure.
Currently, there is no way to identify in advance who might experience these challenges, and until now, the only available option for additional weight loss has been repeat surgery — a procedure associated with a four- to fivefold higher risk of serious complications.
Taking into account that some medications can also promote weight loss, researchers designed the study to test whether combining surgery with obesity management medications (OMM) could be done safely.
Appearing in JAMA Network Open, the research used the OMM drug liraglutide—originally created to treat type 2 diabetes—on patients who had experienced limited success after metabolic bariatric surgery. The double-blind, randomised controlled trial involved 48 adults, with half receiving daily liraglutide and the other half a placebo.
After 12 months, participants taking liraglutide achieved an average total body weight loss (TBWL) of 4.4 per cent, while the control group gained 1.4 per cent—showing a clear and significant contrast.
No negative effects on health or quality of life were observed.
Lead author Professor Wendy Brown, Head of the Monash University Department of Surgery and Director of The Alfred’s Oesophago-Gastric-Bariatric Unit, said the findings were highly encouraging.
Professor Brown indicated that they have demonstrated that for individuals who regain weight or do not have an optimal weight loss impact from bariatric surgery, getting additional weight loss drug will assist them in losing weight, often at a lesser dose than is required for individuals who have not had surgery.
“We are the first to show that the full dose of obesity management medication may not be needed in the post-bariatric surgery setting, and importantly, quality of life is not affected by introducing the obesity management medication.
Professor Brown further pointed out that this brings up the possibility of preventing a risky repeat surgery which is presently the main option when individuals need further weight loss following a bariatric surgery.
Participants in the study were between 20 and 65 years old and had undergone procedures such as Adjustable Gastric Banding (AGB), Sleeve Gastrectomy, Roux-en-Y Gastric Bypass, or One Anastomosis Gastric Bypass between 12 and 36 months earlier.
Of the 48 patients whose surgical outcomes were less than ideal, half were randomly assigned to take a daily dose of liraglutide for 12 months, while the other half received a placebo.
The researchers reported that liraglutide resulted in significantly greater weight loss over 12 months compared to placebo among patients who had an inadequate response to MBS.
Professor John Wentworth, joint senior author and adult endocrinologist at the Royal Melbourne Hospital, described the findings as highly encouraging.
“Our demonstration that incretin drugs enhance weight loss following bariatric surgery provides great hope,” explained Professor Wentworth. “Excitingly, newer, more effective drugs have become available and should help our patients achieve even better weight and health outcomes.”
Co-author Adjunct Associate Professor Dr Paul Burton, from Monash University’s Department of Surgery within the School of Translational Medicine and The Alfred’s Oesophago-Gastric and Bariatric Unit, said that MBS offers lasting weight reduction, improves numerous obesity-related conditions, and extends life expectancy.
However, he noted that as many as 15 per cent of patients achieve less-than-expected weight loss, resulting in reduced health benefits.
Dr Burton indicated that for a long time, the standard of care after weight loss surgery has been a multimodal approach, though this has previously relied on limited supporting evidence.
