Why Taking GLP-1s Like Ozempic Before Bariatric Surgery May Not Lead to More Weight Loss

Recent research indicates that the use of GLP-1 medications, such as Ozempic and Wegovy, prior to bariatric surgery does not result in greater weight loss one year after the operation. This finding could reshape how healthcare providers approach weight management before surgical interventions.

The study, published in *JAMA Surgery*, analyzed data from 383 individuals who underwent bariatric surgery at a single medical center between 2022 and 2024. Of these participants, 92, or about 24%, were using GLP-1 medications before their surgery. Researchers tracked their progress for a full year after the procedure, measuring total body weight loss, complications, and levels of hemoglobin A1C, which indicates diabetes control.

Results showed that those who took GLP-1s before surgery experienced an average weight loss of 24% of their body weight, compared to 25% for those who did not use these medications. The differences in weight loss were not statistically significant, suggesting that pre-surgical use of GLP-1s does not confer additional benefits in terms of weight reduction.

Furthermore, the study revealed no notable differences in postoperative complications, length of hospital stay, or emergency department visits between the two groups. Researchers noted that while those using GLP-1 medications had a higher prevalence of diabetes, it did not translate into improved outcomes post-surgery.

Experts suggest that, despite the lack of significant weight loss benefits, GLP-1 medications may still play a role in the broader context of obesity management. They can assist patients in losing weight prior to surgery and managing any weight regain that may occur afterward. Dr. Mir Ali, a bariatric surgeon, emphasized that pre-surgical weight loss can reduce surgical risks and lead to better long-term outcomes.

One limitation of the study is that it did not account for any weight loss participants may have achieved while on GLP-1 medications before surgery. Additionally, the follow-up period was only 12 months, which may not provide a complete picture of the long-term effectiveness of combining GLP-1s with bariatric surgery.

Dr. Paunel Vukasinov, an obesity medicine specialist, pointed out that the study’s findings should encourage a rethinking of obesity treatment as a chronic condition that can benefit from a variety of therapeutic approaches, rather than strictly a choice between medication and surgery.

In clinical practice, GLP-1 medications are often used to help patients with high BMIs lose weight before surgery, thereby reducing risks and improving surgical outcomes. They are also considered for patients who reach a weight loss plateau after surgery or experience weight regain years later.

Ultimately, the study sheds light on the complex relationship between GLP-1 medications and bariatric surgery, suggesting that while they may not enhance immediate weight loss outcomes, they could still be a valuable part of a comprehensive weight management strategy.