Background

GLP-1 agonists (GLP1s) are an effective tool for weight loss both by themselves and in combination with bariatric surgery. Recent research supports their use in combination with metabolic surgery to maximize weight loss, particularly when used in the post-operative setting (1). Some insurance companies require a trial of GLP1s before approving bariatric surgery as studies suggest certain patients decide to forego surgery when desired weight loss is achieved with pre-operative medication alone (2). We hypothesized preoperative and/or postoperative use of GLP1s would show improved weight loss in our patients. A retrospective analysis of 1335 patients from Gundersen Health System who underwent bariatric surgery between 2013 and 2022 was performed to evaluate the effect preoperative and postoperative use of GLP1s had on post-operative weight loss. Patient demographics and surgery type were compared between those who received GLP1s and those who did not. 8.1% of patients received GLP1s before surgery and 6.6% of patients received GLP1s after surgery. Patients who received pre-operative GLP1s had no significant difference in post-operative weight loss when compared with those that did not receive preoperative GLP1s. Patients who received post-op GLP1s following surgery showed significantly less %EWL than those that did not receive this treatment. Preoperative use of GLP1s was not associated with any difference in weight loss following bariatric surgery. Use of GLP1s after surgery was associated with poorer weight loss. Further research is needed to optimize the use of these medications in combination with bariatric surgery. Insurance mandated use prior to bariatric surgery is inappropriate.