Adjunctive use of glucagon-like peptide-1 receptor agonists after bariatric surgery: updated systematic review and meta-analysis of randomized controlled trials.

In 30 seconds

This systematic review and meta-analysis pooled seven randomized controlled trials (460 participants) comparing GLP-1 receptor agonists with placebo after bariatric surgery; all trials evaluated liraglutide. At 6 months, treatment was associated with greater weight loss (mean difference −5.33 kg; 95% CI −9.42 to −1.23; p = 0.02) and greater total body weight loss. Neither weight outcome showed a statistically significant between-group difference at 12 months. HbA1c did not differ at 6 or 12 months, and gastrointestinal adverse events were similar. The authors note that initiation timing may influence response.

Key findings

• At 6 months, weight loss was greater with GLP-1 receptor agonists (MD −5.33 kg; 95% CI −9.42 to −1.23; p = 0.02).
• Total body weight loss was higher at 6 months (MD 5.13%; 95% CI 2.14 to 8.11; p = 0.007), but not significantly different at 12 months.
• HbA1c did not differ between groups at 6 or 12 months; gastrointestinal adverse events were similar.
• Quality of life improved at 6 months in trials reporting this outcome; subgroup analyses suggested response may vary by initiation timing.

Why it matters

Weight regain or insufficient weight loss after bariatric surgery can prompt consideration of adjunctive therapy. This synthesis suggests liraglutide may improve weight outcomes over the short term, while the absence of statistically significant differences at 12 months and in HbA1c limits conclusions about durability and glycaemic benefit. The findings also identify treatment timing as an unresolved question for future trials.

What to keep in mind

Only seven trials with 460 participants were included, and all evaluated liraglutide. Twelve-month estimates were not statistically significant; the abstract does not provide longer-term follow-up.