GLP-1 Therapies Most Effective for Preoperative Weight Loss in High-BMI Patients: Study
A new study published in the journal of Surgical Endoscopy that GLP-1 therapies lead to greatest preoperative weight and BMI reduction when compared to other strategies, making them effective for high-risk, high-BMI patients before surgery. However further research is needed to determine the optimal use and cost-effectiveness of anti-obesity medications before and after metabolic procedures.
From April 2018 to February 2023, a total of 206 patients underwent bariatric procedures at the Tulsa center. Of these, 79 individuals had an initial body mass index equal to or over 49.5 kg/m², making them part of a high-risk surgical group. The average age of the participants was 44 years, with females representing roughly 76% of the sample. Also, 43% of the patients were found to have obesity-associated genetic markers.
The patients in the program were offered a comprehensive weight loss approach, including lifestyle interventions, anti-obesity medications (AOMs), or a combination thereof. The medications included oral AOMs, GLP-1 receptor agonists, GLP-1/GIP co-agonists, and combination medical therapies. The individuals who followed lifestyle modification alone lost a median of 3.1 kg before surgery. Oral AOMs improved that figure to 8.5 kg. However, the most substantial weight loss occurred among the patients treated with GLP-1 or GLP-1/GIP agents, who lost a median of 10.3 kg.
The patients using combination therapy, which included GLP-1s alongside other treatments, showed a similar median loss of 10.4 kg. The statistical difference between these groups was significant (P = 0.01), demonstrating the added value of pharmacologic support. The benefits of these medications extended beyond the operating table. At the one-year postoperative mark, the average total weight loss among all patients was approximately 62 kg, amounting to 65.6% excess weight loss.
This study emphasized the importance of GLP-1 therapies as part of a multimodal prehabilitation plan for high-BMI individuals. These results confirm that GLP-1 receptor agonists not only improve surgical readiness but may also enhance long-term outcomes in metabolic surgery. Overall, these results suggest that introducing GLP-1-based medications into preoperative protocols can help optimize weight loss and potentially reduce surgical risks in patients with severe obesity.
Source:
Obermark, A. D., Seo, D. Y., Bernazard, A., Richards, J. R., Phillippe, S., Khorgami, Z., & Chow, G. S. (2025). Bariatric outcomes of high BMI patients with preoperative anti-obesity medications. Surgical Endoscopy. https://doi.org/10.1007/s00464-025-11851-w
