Glucagon-like peptide-1 (GLP-1) receptor agonist liraglutide (Saxenda, Novo Nordisk) was safe և effective for Roux-en-Y gastric bypass (RYGB) weight recovery in a randomized controlled trial.
That is, 132 patients who lost at least 25% of their original weight after RYGB and then returned at least 10% were randomly selected at a 2: 1 ratio, receiving liraglutide և frequent lifestyle advice from a registered dietitian or lifestyle counselor alone.
One year later, 69%, 48% և 24% of patients receiving liraglutide lost at least 5%, 10% և 15% of their study intake weight, respectively. In contrast, only 5% of patients in the control group lost at least 5% of their weight, and none lost at least 10% of their weight.
“Liraglutide 3.0 mg / day, with a lifestyle change, was significantly more effective than a placebo for regaining weight after RYGB without increasing the risk of serious adverse events,” Dr. Holly F.®: 2021 meeting.
Lofton, Clinical Associate Professor of Surgery, Director of Weight Management, NYU, Langone Health, New York City, explained: Medscape Medical News He initiated the study by attending a “packaged” session on weight loss after post-bariatric surgery at a previous conference of the American Society for Metabolism and Bariatric Surgery.
“The lecturers recommended conservative measures (for example, repetition of dietary recommendations, exercises, [and] “Review surgeries,” he said in an e-mail, but at the time “there was no literature on which medication would be best for this population.”
It was known that the decrease in endogenous GLP-1 levels coincided with weight loss, և liraglutide (Saxenda) was the only GLP-1 agonist approved for chronic weight management at the time, so he developed the protocol for the current study.
The findings are especially useful for patients who are not candidates for bariatric surgery, he said. Further research is needed to study the effects of newer GLP-1 agonists, such as semaglutide (Wegovy), on weight loss after various bariatric surgeries.
With the request to comment, Dr. Wendy S. King, who was not involved in the study, said that in the current study, more than two-thirds of patients treated with 3 mg / day subcutaneous liraglutide injections lost at least 5% of their original weight. years later,% 20% of them gained minimal or lower weight after bariatric surgery (Nadir weight).
“The fact that both groups received lifestyle advice from registered nutritionists for a little over a year, but only patients in the liraglutid group lost weight on average, speaks of the difficulty of losing weight after post-bariatric surgery,” King added. Associate Professor of Epidemiology, University of Pittsburgh, Pennsylvania.
This study “provides data that may help clinicians understand the potential impact of 3.0 mg / day liraglutide on their weight loss efforts,” he said. Medscape Medical News in the letter.
However, “Considering that 42% of liraglutide users reported gastrointestinal side effects, patients should also be advised of this potential outcome and given suggestions on how to minimize such side effects,” King suggested. :
Weight loss will be followed by fatigue and constant tiredness
Weight recovery is common even years after bariatric surgery. “Recurrent surgery carries some risk. Only lifestyle approaches rarely succeed in regaining weight,” Lofton told the audience.
The researchers included 132 adults who weighed 134 kg (295 pounds) when they underwent RYGB, who lost at least 25% of their original weight (average weight loss 38%) after surgery, but who also were restored. at least 10% of their initial weight.
At the time of the current (baseline) enrollment, patients had an RYGB of 18 months to 10 years ago (mean 5.7 years ago), an average weight of 99 kg (218 lbs), and an average BMI of 35.6 kg / m.2:. None of the patients had diabetes.
Patients were randomly selected to receive liraglutide (n = 89.84% of women) or placebo (n = 43.88% of women) at 56 weeks.
Their average age was 48 years, about 59% were white and 25% were white.
All patients visited the clinic every 3 months, where they received lifestyle advice from a registered dietitian.
At 12 months, patients in the liraglutide group lost an average of 8.8% of their original body weight, while patients in the placebo group gained an average of 1.48% of their original body weight.
There were no significant differences between the groups of cardiometabolic variables.
None of the patients in the control group reached a weight that was as low as their average weight after RYGB.
Levels of nausea (25%), constipation (16%) և abdominal pain (10%) were higher in the liraglutide group than in the placebo group (7%, 14% և 5%, respectively), but were similar. Gastrointestinal side effects in other experiments with this agent.
Lofton revealed that he had received consulting fees գտնվելու being at the Novo Nordisk Speakers’ Bureau ացման receiving research funding from Boehringer Ingelheim, Eli Lilly և Novo Nordisk. King did not comment on the financial situation.
Obesity week®: 2021. Submitted November 2, 2021.
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