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.

Creative Commons License

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

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