Background: About 20-25% of patients experience weight regain (WR) or insufficient weight loss (IWL) after bariatric surgery (BS) associated with relapse of obesity-related comorbidities. Therefore, we aimed to assess the effectiveness of Semaglutide once-weekly as synthetic analogue of the hormone GLP-1 in patients without type 2 diabetes (T2D) with WR or IWL after BS.

Methods: Post-bariatric surgery patients without T2D with WR or IWL (n=48) were included in the analysis. The primary endpoint was weight loss 3 and 6 months after initiation of add-on treatment with Semaglutide. Secondary endpoints included change in BMI, HbA1c, lipid profile, hs-CRP, pancreatic lipase and liver enzymes.

Results: Patients initiated Semaglutide approximately 64.4 months [interquartile range (IQR) 27-97 months] after BS. Mean postoperative weight regain after reaching weight nadir following surgery to initiation of Semaglutide was 11.5kg and 12.9%, respectively. Over 3.2 (IQR 3.0-3.5 months) (n=36) and 5.8 months (IQR 5.8-6.4 months) (n=14) taking Semaglutide, mean total weight loss was 6.2% (IQR 3.5-8.6%) and 9.8% (IQR 5.8-13.3%) , respectively. Categorical weight loss data indicate that 64% of patients reached more than 5% weight loss, 17% more than 10% weight loss and 6% more than 15% weight loss at visit 2. With regard to type of surgery, there were no significant differences in drug-induced total weight loss (p=0.8) .

Discussion and Conclusion: Weight loss options for excess weight management in post-bariatric surgery patients are limited. Our results suggest that post-bariatric patients with WR or IWL may benefit from add-on treatment with Semaglutide once-weekly. Our results might be the basis for a prospective randomized-controlled trial to evaluate larger cohorts of patients to determine if Semaglutide once-weekly may close the gap between lifestyle intervention and revision surgery to treat weight recidivism or IWL after BS.


A.Lautenbach: Advisory Panel; Novo Nordisk, Speaker's Bureau; Boehringer Ingelheim International GmbH, Novo Nordisk. M.Wernecke: None. F.D.Stoll: None. S.M.Meyhöfer: None. S.Meyhöfer: None. J.Aberel: Advisory Panel; Novo Nordisk, Speaker's Bureau; Novo Nordisk.

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