Could Ozempic Before Bariatric Surgery Help People with Extreme Obesity?

The Role of GLP-1 Drugs in Preparing for Bariatric Surgery

Recent research emphasizes the benefits of using GLP-1 (glucagon-like peptide-1) drugs, such as Ozempic, Wegovy, and Mounjaro, before undergoing bariatric surgery for individuals grappling with extreme obesity. This pivotal study was presented at the American Society for Metabolic and Bariatric Surgery (ASMBS) 2024 Annual Scientific Meeting, shedding light on a new approach to managing extreme obesity 

Understanding Extreme Obesity

Extreme obesity is defined as having a body mass index (BMI) of 70 or more. According to the World Health Organization (WHO), New Zealand has one of the highest adult obesity rates in the OECD, with approximately 34% of adults classified as obese. Australia follows closely, with an obesity rate of 31%. This rising trend is concerning, as obesity significantly increases the risk of various health complications, including diabetes, heart disease, and certain cancers. In 2022, nearly 280,000 metabolic and bariatric surgeries were performed in the United States alone, underlining the growing need for effective weight management solutions.

Study Insights

The research included 113 patients with a BMI greater than 70 who attempted weight loss before surgery using three distinct methods: medically supervised diet and exercise, single GLP-1 medication (primarily semaglutide), or multimodal therapy that involved multiple GLP-1 drugs. Patients were treated for an average of 72.9 days, with the study focusing on their weight loss outcomes.

Weight Loss Results

The findings revealed that patients utilizing combination drug therapy experienced the most significant total body weight loss of 13.1%, compared to 8.14% for those on single GLP-1 therapy and 5.95% for those relying solely on diet and exercise. Notably, the most substantial reductions in BMI were observed in patients who engaged in combination therapy for durations of six to twelve months.

Common GLP-1 Medications

1. Ozempic (Semaglutide): Originally developed for type 2 diabetes management, Ozempic helps regulate blood sugar levels while also promoting weight loss. It works by enhancing insulin secretion, reducing appetite, and slowing gastric emptying.
2. Wegovy (Semaglutide): This is a higher-dose version of semaglutide specifically approved for chronic weight management. It helps patients achieve significant weight loss when combined with a reduced-calorie diet and increased physical activity.
3. Mounjaro (Tirzepatide): This novel medication targets both GLP-1 and GIP (glucose-dependent insulinotropic polypeptide) receptors, making it effective for weight loss as well as blood sugar control. Research shows it may provide enhanced weight loss results compared to traditional GLP-1 agonists.
4. Other Options: Additional weight loss medications include Liraglutide (Victoza), Phentermine/Topiramate (Qsymia), and Setmelanotide (Imcivree). Each of these medications works through different mechanisms to assist with appetite control and weight management.