Weight loss before bariatric surgery can significantly reduce the risk of complications, according to research presented at the American Society for Metabolic and Bariatric Surgery’s 2024 annual scientific meeting. Participants in the study who lost weight prior to surgery had a lower risk of complications, with those having a BMI over 70 being at the greatest risk. Researchers found that using GLP-1 agonist medications, such as Ozempic, before surgery could help jump start weight loss in individuals with extreme obesity.
The study included 113 participants, with over 70 attempting to lose weight before bariatric surgery through various methods such as medically supervised diet and exercise, single GLP-1 medication, or multimodal therapy using multiple medications. Participants using multiple medications had the most significant weight loss, with an average of 13% of body weight lost. Those on single GLP-1 had an 8% weight loss, while those relying on diet and exercise had the least at 6%.
Dr. Mir Ali, a bariatric surgeon, and medical director at MemorialCare Surgical Weight Loss Center in California, emphasized the importance of lowering BMI before surgery, preferably to the 50s. However, he also mentioned that GLP-1 medications may not always be an option due to insurance coverage and cost. In such cases, working with a diet counselor or following a liquid diet may be recommended as alternative weight loss strategies.
Body mass index (BMI) is a key indicator used to assess obesity, with a BMI of 30 and above considered as having obesity. However, BMI does not account for factors such as age, gender, ethnicity, or muscle mass. Medical professionals should consider these factors and other risk measurements when using BMI as an indicator for overweight or obesity.
Although bariatric surgery is considered safe, there were nearly 280,000 procedures conducted in the United States in 2022, comprising only about 1% of those eligible based on BMI. Obesity affects about 42% of adults in the U.S. and can increase the risk of developing chronic diseases such as cardiovascular disease, type 2 diabetes, and certain cancers. Further research is needed to determine the optimal role of GLP-1 medications before and after bariatric surgery in different patient groups.
In conclusion, weight loss before bariatric surgery can reduce the risk of complications, particularly for individuals with extreme obesity. Using GLP-1 agonist medications as part of a weight loss strategy before surgery may help achieve significant weight loss and improve outcomes. Medical professionals should consider a holistic approach to obesity management, taking into account factors beyond BMI, to optimize patient care and achieve long-term success.
