Golzarand Mahdieh, Toolabi Karamollah, Mirmiran Parvin
Nutrition and Endocrine Research Center, Research Institute for Endocrine Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Int J Obes (Lond). 2025 May 17. doi: 10.1038/s41366-025-01807-4.
Postoperative recurrent weight gain or suboptimal clinical response are important concerns; however, there is no consensus regarding the use of pharmacotherapy to manage weight after bariatric surgery. Hence, it is reasonable to combine the available data to provide a practical guideline for clinicians about the administration of obesity medications for patients with recurrent weight gain or suboptimal clinical response after bariatric surgery.
We conducted a search of electronic databases, including Scopus, PubMed/Medline, and the Web of Science, up to December 2024. The eligible studies included randomized controlled trials or retrospective studies that assessed the effects of obesity medications on weight, body mass index (BMI), or percentage total weight loss (%TWL) in patients experiencing recurrent weight gain or a suboptimal clinical response following bariatric surgery.
This meta-analysis reviewed 26 relevant studies and demonstrated that glucagon-like peptide-1 (GLP-1) receptor agonists reduced weight by 8.38 kg (95% CI: -9.68 to -7.08) and BMI by 3.76 kg/m² (95% CI: -4.50 to -3.01). The overall %TWL was 9.94% (95% CI: 8.34 to 11.53). After subgroup analysis, we found that the effect of semaglutide on %TWL was significantly greater than that of liraglutide. In terms of non-GLP-1 receptor agonists, patients achieved a weight loss of 2.97 kg (95% CI: -4.00 to -1.95), a BMI loss of 1.41 kg/m² (95% CI: -2.28 to -0.53), and a % TWL of 4.50% (95% CI: 2.86 to 6.15). The subgroup analysis suggested that combination therapy had more pronounced effects on outcomes than monotherapy.
Our results indicated that obesity medications may be an effective adjunctive therapy to maintain weight loss post-bariatric surgery.
术后体重反复增加或临床反应欠佳是重要问题；然而，关于减肥手术后使用药物疗法控制体重尚无共识。因此，综合现有数据为临床医生提供一份关于肥胖症药物用于减肥手术后体重反复增加或临床反应欠佳患者给药的实用指南是合理的。
我们检索了截至2024年12月的电子数据库，包括Scopus、PubMed/Medline和科学网。符合条件的研究包括随机对照试验或回顾性研究，这些研究评估了肥胖症药物对减肥手术后体重反复增加或临床反应欠佳患者的体重、体重指数（BMI）或总体重减轻百分比（%TWL）的影响。
这项荟萃分析回顾了26项相关研究，结果表明胰高血糖素样肽-1（GLP-1）受体激动剂使体重减轻8.38千克（95%CI：-9.68至-7.08），BMI降低3.76千克/平方米（95%CI：-4.50至-3.01）。总体%TWL为9.94%（95%CI：8.34至11.53）。亚组分析后，我们发现司美格鲁肽对%TWL的影响显著大于利拉鲁肽。就非GLP-1受体激动剂而言，患者体重减轻2.97千克（95%CI：-4.00至-1.95），BMI降低1.41千克/平方米（95%CI：-
