Effectiveness and Safety of Liraglutide in Managing Inadequate Weight Loss and Weight Regain after Primary and Revisional Bariatric Surgery: Anthropometric and Cardiometabolic Outcomes

Abstract

Background: No study appraised the effectiveness and safety of liraglutide in managing inadequate weight loss or weight regain (IWL/ WR) after primary versus revisional bariatric surgery (BS).

Methods: Retrospective study of all eligible adults who completed liraglutide 3 mg therapy for IWL/WR after primary or revisional BS at our institution between May 2016 and June 2019 (N = 145; 119 primary, 82%; 26 revisional, 18%). Changes in anthropometric and cardiometabolic parameters were assessed before the start of liraglutide and at 6 and 12 months after treatment.

Results: The mean age was 43.32 ± 10.49 years, and 83% were females. Patients received liraglutide at a mean of 54.10 ± 31.75 months after their BS, for WR (74.3%) or IWL (25.6%). Liraglutide significantly reduced weight and BMI among primary and revisional patients (P < 0.0001 for all) and was equally effective in these reductions for both groups. Primary patients achieved total weight loss percentage (TWL%) of 5.97% and 6.93% at 6 and 12 months. Additionally, 52.3% and 60% of the patients lost ≥ 5% of their total weight (TW) at 6 and 12 months after primary BS. Revisional patients achieved TWL% of 6.41% and 4.99% at 6 and 12 months, and 60% and 48% of patients lost ≥ 5% TW at the two time points. Liraglutide did not improve cardiometabolic outcome for primary patients; for revisional patients, only the systolic blood pressure decreased after treatment. Liraglutide was well tolerated, and the most common side effect was nausea.

Conclusions: Liraglutide is useful as an adjunct weight loss medication for patients achieving unsatisfactory outcomes with BS.

Keywords: Bariatric surgery; Dyslipidemia; Hypertension; Insufficient weight loss; Liraglutide; Type 2 diabetes; Weigh regain; Weight loss medication.