Document Type

Article

Publication Date

1-1-2025

Publication Title

International Journal of Obesity

Abstract

Background/objectives: Optimizing patients with a body mass index (BMI) ≥ 70 kg/m² for metabolic surgery (MS) is challenging. However, pre-operative weight loss may be important for improving the safety of MS for these high-risk patients. Multi-modal anti-obesity medications (mmAOM) may enhance preoperative weight loss compared to non-pharmacologic medically supervised weight loss (NP-MSWL) or glucagon-like peptide-1 receptor agonist monotherapy (Mono-GLP-1) alone. Subjects/methods: This retrospective study analyzed 113 patients with BMI ≥ 70 kg/m² at a single metabolic disease treatment institute. Interventions/methods: Patients were categorized into NP-MSWL (n = 13), Mono-GLP-1 (n = 54), and mmAOM (n = 46) groups. The primary outcome was mean percent total body weight loss (%TBWL). Secondary outcomes included %TBWL across time intervals (0–23, 23–51, 51–88, and 88+ weeks). Results: The mmAOM group achieved the highest average - 13.07% - and median (9.93% [5.57–14.29]) %TBWL; followed by Mono-GLP-1 (5.58% [0.98–10.19]); and NP-MSWL (5% [2.97–7.02]). Significant differences among groups were confirmed by Kruskal-Wallis test (p = 0.0047). The highest median %TBWL was at 51–88 weeks (10.25 [6.49–16.45]) (p = 0.0093). Conclusions: mmAOM treatment yields the highest %TBWL, especially within the first 51 weeks of preoperative preparation, demonstrating superior efficacy over Mono-GLP-1 and NP-MSWL in patients with BMI ≥ 70 kg/m². These findings suggest that incorporating mmAOM in preoperative protocols could optimize weight loss and improve surgical outcomes for high BMI patients.

PubMed ID

40456879

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Featured in Faculty Publications Display; July 2025.

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Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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