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The Role of Glucagon-Like Peptide-1 Receptor Agonists in Weight Regain Treatment or Prevention After Bariatric Surgery: A Systematic Review and Meta-Analysis Publisher



A Mousavi ASMA ; S Shojaei SHAYAN ; A Azarboo ALIREZA ; Ra Bahri Razman ARABZADEH ; S Mohammadi SARA ; S Alilou SANAM ; S Yousefifar SHAYGAN ; S Maleki SABA ; H Radkhah HANIEH
Authors

Source: Eating and Weight Disorders Published:2025


Abstract

Background: Weight regain (WR) and insufficient weight loss (WL) occur in 20–25% of patients after bariatric surgery due to various factors. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have shown promise in promoting WL; however, evidence regarding their effectiveness in managing WL and preventing WR post-bariatric surgery remains limited. Objective: This study aims to evaluate the role of GLP-1RAs in treating and preventing WR following bariatric surgery. Methods: A systematic search was conducted across PubMed, Scopus, and Web of Science for studies assessing the impact of GLP-1RAs on WR after bariatric surgery. Results: Our search identified 27 original studies, with 10 included in the meta-analysis involving 769 participants (392 treated with GLP-1RAs). The mean age was 44.05 years, with 30.47% male. The time interval from surgery to the initiation of GLP-1RAs treatment ranged from 1.5 to 86.7 months, with treatment durations between 4 and 12 months. The analysis showed significantly greater WL in the GLP-1RAs group compared to placebo (SMD = 0.82, 95% CI 0.23 to 1.42). Subgroup analysis for treatment durations ≤ 6 months indicated a higher WL in the GLP-1RAs group (SMD = 0.79, 95% CI 0.25 to 1.34). Adverse events were primarily gastrointestinal, with nausea significantly more frequently in the GLP-1RAs group (OR = 2.01, 95% CI 1.24 to 3.27). Conclusion: GLP-1RAs effectively promote WL among participants experiencing WR after bariatric surgery. Initiating GLP-1RAs therapy shortly after surgery may help prevent WR. Further research is warranted to explore long-term outcomes and optimize treatment protocols for this patient population. © 2025 Elsevier B.V., All rights reserved.
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