It is known that people with extreme obesity, where the body mass index (BMI) exceeds 70, face a higher risk of complications after surgical intervention compared to patients with lower BMI. Reducing this risk can be achieved through preoperative weight loss, but lifestyle changes and first-generation anti-obesity medications are insufficient to produce enough weight loss to significantly change the situation.
Recent studies have shown that a combination of GLP-1 agonists taken before surgery can help patients with extreme obesity minimize the risk of postoperative complications.
Study Overview The study involved 113 patients with a BMI >70 who were under medical supervision attempting to lose weight before bariatric surgery using diet and exercise, a single GLP-1 medication (primarily semaglutide), or multimodal therapy (taking two or more GLP-1 drugs). The therapy lasted on average 72.9 days.
Results The highest percentage of total body weight loss (13.1%) was achieved by patients taking multiple medications. With a single GLP-1 therapy, weight loss was 8.14%, while diet and exercise alone resulted in only 5.95% weight loss. The greatest reduction in BMI was observed in patients receiving combined pharmacological therapy for 6–12 months.
Dr. Phil Schauer, MD, noted that combining multiple anti-obesity medications can achieve significantly greater preoperative weight loss for people with extreme obesity than other methods. He added, “Many patients who would otherwise have been considered too ill for surgery can now meet the criteria.”
Dr. Marina Kurian, MD, president of ASMBS, who did not participate in the study, stated: “Further research is needed to determine the optimal role of GLP-1 before and after metabolic and bariatric surgery across different patient groups. Obesity should be approached like other chronic diseases, where more than one therapy is often required.”
