TOPLINE:

A small real-world observational cohort study found that tirzepatide, a dual glucose-dependent insulinotropic polypeptide and GLP-1 agonist, was associated with substantial weight loss in patients with weight regain after bariatric surgery or endoscopic bariatric therapy.

METHODOLOGY:

• Researchers conducted a prospective observational study to assess the efficacy and safety of tirzepatide in patients who had undergone bariatric surgery or endoscopic bariatric therapy and subsequently experienced weight regain (≥ 15% of previously lost weight).
• The study involved 34 patients (mean age, 49.1 years; 76% women; mean BMI, 33.2) who had undergone one-anastomosis gastric bypass (n = 18), sleeve gastrectomy (n = 13), adjustable gastric banding (n = 1), or endoscopic sleeve gastroplasty (n = 2). The mean time since surgery was 6 years.
• Tirzepatide was initiated at 2.5 mg subcutaneously once weekly and titrated in 2.5 mg increments to reach the minimum effective dose, with maintenance doses ranging from 2.5 to 10 mg/wk (mean maintenance dose, 6 mg/wk). All patients also received nutritional counseling for a Mediterranean diet and were instructed to perform at least 150 minutes of moderate-intensity physical activity per week.
• The primary endpoint was percentage total body weight loss (%TBWL) at 24 weeks, and clinically meaningful weight loss was defined as %TBWL ≥ 5%.

TAKEAWAY:

• At 24 weeks, mean %TBWL was 18.1%, and mean waist circumference decreased by 10.1 cm (P < .0001 for both).
• All patients achieved clinically meaningful weight loss; 94% of the patients lost ≥ 10% of the baseline body weight, 68% lost ≥ 15%, and 32% lost ≥ 20%.
• After treatment, a notable shift in BMI categories was observed, with 29% of the patients achieving BMIs classified as normal weight, 53% with overweight, and 18% with class I obesity. No patient continued to have class II or III obesity.
• Multivariate analysis showed that a higher maintenance dose of tirzepatide was independently associated with a higher %TBWL (P = .0077). Adverse events were limited to mild-to-moderate gastrointestinal complaints (constipation, 50%; diarrhea, 8%; and nausea, 3%). No serious adverse events or treatment discontinuations occurred.

IN PRACTICE:

“The observed weight loss exceeds that reported with other pharmacological interventions in this challenging population, and the favorable safety profile supports further evaluation of tirzepatide as part of multimodal management strategies for postbariatric weight recurrence,” the authors wrote.

SOURCE:

This study, led by Federica Vinciguerra, University of Catania, Catania, Italy, was published online in Obesity Surgery.

LIMITATIONS:

The study lacked a comparator arm. The sample size was relatively small and drawn from a single tertiary center in Italy. The follow-up period was only 24 weeks, which was insufficient to evaluate long-term outcomes.

DISCLOSURES:

The study received funding for open access from Università degli Studi di Catania within the CRUI-CARE Agreement. The authors declared 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.