Liraglutide Boosts Weight Loss After Bariatric Surgery in Patients With Poor Initial Results: Study

Suboptimal weight loss or weight regain is a well-recognized problem after MBS and continues to be one of the major indications for revision or conversion surgery. The traditional approaches usually include lifestyle modifications or reoperation, which are associated with enhanced surgical risks. Pharmacologic interventions like GLP-1 receptor agonists, including liraglutide, have shown weight reduction in nonsurgical populations and have thus raised interest in postbariatric subjects. This was a prospective, double-blinded, single-center randomized clinical trial conducted to determine if liraglutide could enhance weight loss and improve health outcomes among adults who, despite having undergone anatomically correct bariatric procedures like adjustable gastric band, sleeve gastrectomy, one-anastomosis gastric bypass, or Roux-en-Y gastric bypass, had achieved limited weight loss with stable postoperative status.

The study took place at an academic surgical department and involved 48 adult participants randomized in equal numbers to two arms: 24 into the liraglutide group and 24 into the placebo group. The participants' ages ranged from 20 to 65 years, with a BMI above 35, and they were assessed post-surgery after 12 to 36 months. These participants had stable weight for at least three months and showed suboptimal excess body weight loss: between 25% and 40% for adjustable gastric banding and between 25% and 60% for other procedures. Participants self-administered daily injections of liraglutide or placebo for 12 months, titrating their doses as tolerated. The primary endpoint was weight loss at 12 months, while secondary measures included changes in health status and quality of life. Randomization began on January 18, 2019, and concluded on June 9, 2023, with data analysis performed on July 15, 2024.

Results

• The mean (SD) age was 48.7 (10.5) years, and 92% were female in the liraglutide arm, while in the placebo arm, the mean (SD) age was 43.6 (11.4) years, and 83% were female.

• Among liraglutide recipients, 4 patients withdrew and 1 was lost to follow-up, while in the placebo group, 6 withdrew and 6 were lost to follow-up.

• At 12 months, patients in the liraglutide group had a mean (SE) weight loss of 5.7 (1.1) kg, whereas patients in the placebo group had a mean (SD) weight gain of 1.4 (1.2) kg.

• The between-group difference in weight change was 7.1 kg (95% CI, 3.9–10.3 kg; P < 0.001), showing a statistically significant advantage for liraglutide.

• No adverse effects on health or quality of life were noted during the course of the study.

In the present randomized clinical trial, liraglutide resulted in a mean weight loss of 5.7 kg, which was statistically significant compared with a mean weight gain of 1.4 kg in the placebo group. This study confirms that liraglutide enhances weight loss and supports weight maintenance in patients with a suboptimal response to metabolic bariatric surgery without impairing safety or quality of life.

Reference:

Brown WA, Burton PR, Laurie C, et al. Liraglutide and Weight Loss Among Suboptimal Responders to Metabolic Bariatric Surgery: A Randomized Clinical Trial. JAMA Netw Open. 2025;8(10):e2539848. doi:10.1001/jamanetworkopen.2025.39848