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TOPLINE:

In patients with class II-III obesity, adding semaglutide 1 month after laparoscopic sleeve gastrectomy led to significantly greater total and excess weight loss at 12 months than surgery alone.

METHODOLOGY:

• Although metabolic and bariatric surgery is the most effective treatment for class II-III obesity and yields substantial and sustained benefits, long-term weight maintenance remains challenging, prompting increased interest in GLP-1s.
• Researchers conducted a prospective, single-center, nonrandomized controlled study in patients with class II-III obesity (BMI ≥ 35) scheduled to undergo laparoscopic sleeve gastrectomy to investigate whether early, short-term adjunctive semaglutide improved postoperative weight-loss outcomes.
• Patients received semaglutide beginning 1 month postoperatively at 0.25 mg weekly, with dose titration based on individual response through month 6, whereas the control group underwent surgery alone. Both groups received identical standardized postoperative nutrition and dietary care protocols.
• The primary outcome was percentage total weight loss (%TWL) at 12 months after surgery; secondary outcomes included percentage excess weight loss (%EWL) at 12 months, %TWL and %EWL at 6 months, distributions of %TWL and %EWL, and changes in metabolic parameters.

TAKEAWAY:

• Of 103 patients included, 48 (median age, 32 years; 54.2% female) received semaglutide and 55 (median age, 35 years; 43.6% female) underwent surgery alone.
• At 12 months, mean %TWL was significantly greater in the semaglutide group than in the control group (-35.14% vs -30.73%; P = .002). At 6 months, mean %TWL was -29.74% vs -26.32%, respectively (P < .001).
• Mean %EWL at 12 months was significantly higher in the semaglutide group than in the control group (86.42% vs 76.87%; P = .026), although no significant difference was observed at 6 months.
• Both groups experienced comparable improvements in metabolic measures, including A1c, fasting blood glucose, total cholesterol, triglycerides, low-density lipoprotein, alanine aminotransferase levels, and urinary albumin-to-creatinine ratio at 1 year.
• Although adverse events were more common in the semaglutide group than in the control group (P = .040), no serious adverse events occurred in either group.

IN PRACTICE:

“These findings provide preliminary, hypothesis-generating evidence for the potential role of early, short-term adjunctive semaglutide therapy after [metabolic bariatric surgery] in this population,” the authors of the study wrote.

SOURCE:

The study was led by Yi Shan Huang and Jingyuan Wen, Department of General Surgery & Obesity and Metabolic Disease Center, China-Japan Friendship Hospital, Beijing, China. It was published online in Obesity Surgery.

LIMITATIONS:

As a nonrandomized, single-center study, the findings were susceptible to selection bias and residual confounding. Treatment initiation was based on shared decision-making rather than random allocation. Patients who chose semaglutide may have differed from controls in socioeconomic status, treatment motivation, adherence to postoperative dietary recommendations, or other unmeasured characteristics. The 12-month follow-up period may not have been sufficient to assess long-term weight maintenance or the risk for weight regain.

DISCLOSURES:

The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.