Using glucagon-Like Peptide-1 Agonists for Post-Bariatric Surgery: A Narrative Review
Novelty in Biomedicine,
Vol. 14 No. 1 (2026),
8 February 2026
,
Page 54-59
https://doi.org/10.22037/nbm.v14i1.49143
Abstract
Background: Post-bariatric surgery weight regain, or lack of optimal weight loss, are two common problems after bariatric surgery. Some studies recommend the administration of glucagon-like peptide-1 (GLP-1) agonists for weight loss in these conditions. In this study, we aimed to review prior studies evaluating the effects of GLP-1 after bariatric surgery.
Materials and Methods: In this narrative review, we reviewed studies from 2015 to 2025 using the keywords “bariatric surgery,” “GLP1,” “Glucagon-like peptide-1,” “sleeve gastrectomy,” “Roux-en-Y,” and “Gastric Bypass.” Keywords were searched in PubMed/MEDLINE, Web of Science, EMBASE/Elsevier, Scopus, and CENTRAL. After considering the exclusion criteria, ten studies were enrolled in the review.
Results: GLP1 agonists significantly reduced weight in patients who did not experience weight loss as expected and in patients who experienced weight regain. Different types of GLP1 agonists had different effectiveness; in this respect, semaglutide had better effects than Liraglutide. Side effects of GLP1 agonists were tolerable and primarily gastrointestinal.
Conclusion: GLP1 agonists are safe and effective therapies for weight regain or suboptimal weight loss after bariatric surgery.
- Bariatric surgery
- Glucagon-like peptide-1 agonists
- Liraglutide
- Semaglutide
How to Cite
References
1. Syn NL, Cummings DE, Wang LZ, Lin DJ, Zhao JJ, Loh M, et al. Association of metabolic–bariatric surgery with long-term survival in adults with and without diabetes: a one-stage meta-analysis of matched cohort and prospective controlled studies with 174 772 participants. The Lancet. 2021;397(10287):1830-41.
2. Voorwinde V, Steenhuis IH, Janssen IM, Monpellier VM, van Stralen MM. Definitions of long-term weight regain and their associations with clinical outcomes. Obesity surgery. 2020;30:527-36.
3. Arterburn DE, Telem DA, Kushner RF, Courcoulas AP. Benefits and risks of bariatric surgery in adults: a review. Jama. 2020;324(9):879-87.
4. Cambi MPC, Baretta GAP, Magro DDO, Boguszewski CL, Ribeiro IB, Jirapinyo P, et al. Multidisciplinary approach for weight regain—how to manage this challenging condition: an expert review. Obesity surgery. 2021;31:1290-303.
5. Shukla AP, He D, Saunders KH, Andrew C, Aronne LJ. Current concepts in management of weight regain following bariatric surgery. Expert review of endocrinology & metabolism. 2018;13(2):67-76.
6. Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JF, Nauck MA, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. New England Journal of Medicine. 2016;375(4):311-22.
7. Kristensen SL, Rørth R, Jhund PS, Docherty KF, Sattar N, Preiss D, et al. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. The lancet Diabetes & endocrinology. 2019;7(10):776-85.
8. Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jódar E, Leiter LA, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. New England Journal of Medicine. 2016;375(19):1834-44.
9. Jensen AB, Renström F, Aczél S, Folie P, Biraima-Steinemann M, Beuschlein F, et al. Efficacy of the glucagon-like peptide-1 receptor agonists liraglutide and semaglutide for the treatment of weight regain after bariatric surgery: a retrospective observational study. Obesity surgery. 2023;33(4):1017-25.
10. Mok J, Adeleke MO, Brown A, Magee CG, Firman C, Makahamadze C, et al. Safety and efficacy of Liraglutide, 3.0 mg, once daily vs placebo in patients with poor weight loss following metabolic surgery: the BARI-OPTIMISE randomized clinical trial. Jama Surgery. 2023;158(10):1003-11.
11. Hany M, Torensma B, Ibrahim M, Zidan A, Agayby AS, Abdelkhalek MH, et al. Boosting weight loss after conversional Roux-en-Y Gastric Bypass with Liraglutide and placebo use. A double-blind-randomized controlled trial. International Journal of Surgery. 2024;110(3):1546-55.
12. Wharton S, Kuk JL, Luszczynski M, Kamran E, Christensen RA. Liraglutide 3.0 mg for the management of insufficient weight loss or excessive weight regain post‐bariatric surgery. Clinical obesity. 2019;9(4):e12323.
13. Farías MM. Use of Liraglutide after bariatric surgery: a 36-month follow-up in a real-world setting in Chile. Archives of Endocrinology and Metabolism. 2024;68:e230234.
14. Rye P, Modi R, Cawsey S, Sharma AM. Efficacy of high-dose Liraglutide as an adjunct for weight loss in patients with prior bariatric surgery. Obesity surgery. 2018;28:3553-8.
15. Murvelashvili N, Xie L, Schellinger JN, Mathew MS, Marroquin EM, Lingvay I, et al. Effectiveness of semaglutide versus Liraglutide for treating post‐metabolic and bariatric surgery weight recurrence. Obesity. 2023;31(5):1280-9.
16. Elhag W, El Ansari W. Effectiveness and safety of Liraglutide in managing inadequate weight loss and weight regain after primary and revisional bariatric surgery: anthropometric and cardiometabolic outcomes. Obesity Surgery. 2022;32(4):1005-15.
17. Lautenbach A, Wernecke M, Huber TB, Stoll F, Wagner J, Meyhöfer SM, et al. The potential of semaglutide once-weekly in patients without type 2 diabetes with weight regain or insufficient weight loss after bariatric surgery—a retrospective analysis. Obesity surgery. 2022;32(10):3280-8.
18. Zenno A, Nwosu EE, Fatima SZ, Nadler EP, Mirza NM, Brady SM, et al. An open‐label 16‐week study of Liraglutide in adolescents with obesity post‐sleeve gastrectomy. Pediatric Obesity. 2024;19(11):e13154.
19. Adams TD, Davidson LE, Litwin SE, Kim J, Kolotkin RL, Nanjee MN, et al. Weight and metabolic outcomes 12 years after gastric bypass. New England Journal of Medicine. 2017;377(12):1143-55.
20. Maciejewski ML, Arterburn DE, Van Scoyoc L, Smith VA, Yancy WS, Weidenbacher HJ, et al. Bariatric surgery and long-term durability of weight loss. JAMA surgery. 2016;151(11):1046-55.
21. Sheng B, Truong K, Spitler H, Zhang L, Tong X, Chen L. The long-term effects of bariatric surgery on type 2 diabetes remission, microvascular and macrovascular complications, and mortality: a systematic review and meta-analysis. Obesity surgery. 2017;27:2724-32.
22. Mingrone G, Panunzi S, De Gaetano A, Guidone C, Iaconelli A, Capristo E, et al. Metabolic surgery versus conventional medical therapy in patients with type 2 diabetes: 10-year follow-up of an open-label, single-centre, randomised controlled trial. The Lancet. 2021;397(10271):293-304.
23. Jakobsen GS, Småstuen MC, Sandbu R, Nordstrand N, Hofsø D, Lindberg M, et al. Association of bariatric surgery vs medical obesity treatment with long-term medical complications and obesity-related comorbidities. Jama. 2018;319(3):291-301.
24. Schiavon CA, Bersch-Ferreira AC, Santucci EV, Oliveira JD, Torreglosa CR, Bueno PT, et al. Effects of bariatric surgery in obese patients with hypertension: the GATEWAY randomized trial (gastric bypass to treat obese patients with steady hypertension). Circulation. 2018;137(11):1132-42.
25. Heffron SP, Parikh A, Volodarskiy A, Ren-Fielding C, Schwartzbard A, Nicholson J, et al. Changes in lipid profile of obese patients following contemporary bariatric surgery: a meta-analysis. The American journal of medicine. 2016;129(9):952-9.
26. Aminian A, Zajichek A, Arterburn DE, Wolski KE, Brethauer SA, Schauer PR, et al. Association of metabolic surgery with major adverse cardiovascular outcomes in patients with type 2 diabetes and obesity. Jama. 2019;322(13):1271-82.
27. Moussa O, Ardissino M, Heaton T, Tang A, Khan O, Ziprin P, et al. Effect of bariatric surgery on long-term cardiovascular outcomes: a nationwide nested cohort study. European Heart Journal. 2020;41(28):2660-7.
28. Näslund E, Stenberg E, Hofmann R, Ottosson J, Sundbom M, Marsk R, et al. Association of metabolic surgery with major adverse cardiovascular outcomes in patients with previous myocardial infarction and severe obesity: a nationwide cohort study. Circulation. 2021;143(15):1458-67.
29. Reges O, Greenland P, Dicker D, Leibowitz M, Hoshen M, Gofer I, et al. Association of bariatric surgery using laparoscopic banding, Roux-en-Y gastric bypass, or laparoscopic sleeve gastrectomy vs usual care obesity management with all-cause mortality. Jama. 2018;319(3):279-90.
30. Carlsson LM, Sjöholm K, Jacobson P, Andersson-Assarsson JC, Svensson P-A, Taube M, et al. Life expectancy after bariatric surgery in the Swedish obese subjects study. New England Journal of Medicine. 2020;383(16):1535-43.
31. Wiggins T, Guidozzi N, Welbourn R, Ahmed AR, Markar SR. Association of bariatric surgery with all-cause mortality and incidence of obesity-related disease at a population level: a systematic review and meta-analysis. PLoS medicine. 2020;17(7):e1003206.
32. Trujillo JM, Nuffer W, Ellis SL. GLP-1 receptor agonists: a review of head-to-head clinical studies. Therapeutic advances in endocrinology and metabolism. 2015;6(1):19-28.
33. Hamed K, Alosaimi MN, Ali BA, Alghamdi A, Alkhashi T, Alkhaldi SS, et al. Glucagon-like peptide-1 (GLP-1) receptor agonists: exploring their impact on diabetes, obesity, and cardiovascular health through a comprehensive literature review. Cureus. 2024;16(9).
34. Vilsbøll T, Christensen M, Junker AE, Knop FK, Gluud LL. Effects of glucagon-like peptide-1 receptor agonists on weight loss: systematic review and meta-analyses of randomised controlled trials. Bmj. 2012;344.
35. Davidson MH. Cardiovascular effects of glucagonlike peptide–1 agonists. The American journal of cardiology. 2011;108(3):33B-41B.
36. Garber AJ. Long-acting glucagon-like peptide 1 receptor agonists: a review of their efficacy and tolerability. Diabetes care. 2011;34(Suppl 2):S279.
37. Gallwitz B. GLP-1 agonists and dipeptidyl-peptidase IV inhibitors. Diabetes-Perspectives in Drug Therapy. 2011:53-74.
38. Okerson T, Chilton RJ. The cardiovascular effects of GLP‐1 receptor agonists. Cardiovascular therapeutics. 2012;30(3):e146-e55.
39. Smits MM, Tonneijck L, Muskiet MH, Kramer M, Cahen D, van Raalte DH. Gastrointestinal actions of glucagon‐like peptide‐1‐based therapies: glycaemic control beyond the pancreas. Diabetes, Obesity and Metabolism. 2016;18(3):224-35.
40. Hare KJ, Vilsbøll T, Asmar M, Deacon CF, Knop FK, Holst JJ. The glucagonostatic and insulinotropic effects of glucagon-like peptide 1 contribute equally to its glucose-lowering action. Diabetes. 2010;59(7):1765-70.
41. Campbell JE, Drucker DJ. Pharmacology, physiology, and mechanisms of incretin hormone action. Cell metabolism. 2013;17(6):819-37.
42. Zheng SL, Roddick AJ, Aghar-Jaffar R, Shun-Shin MJ, Francis D, Oliver N, et al. Association between use of sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide 1 agonists, and dipeptidyl peptidase 4 inhibitors with all-cause mortality in patients with type 2 diabetes: a systematic review and meta-analysis. Jama. 2018;319(15):1580-91.
43. Seufert J, Gallwitz B. The extra‐pancreatic effects of GLP‐1 receptor agonists: a focus on the cardiovascular, gastrointestinal and central nervous systems. Diabetes, Obesity and Metabolism. 2014;16(8):673-88.
44. ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 9. Pharmacologic approaches to glycemic treatment: standards of care in diabetes—2023. Diabetes care. 2022;46(Suppl 1):S140.
45. Hinnen D. Glucagon-like peptide 1 receptor agonists for type 2 diabetes. Diabetes spectrum. 2017;30(3):202-10.
46. Knudsen LB, Lau J. The discovery and development of Liraglutide and semaglutide. Frontiers in endocrinology. 2019;10:155.
47. Lau J, Bloch P, Schäffer L, Pettersson I, Spetzler J, Kofoed J, et al. Discovery of the once-weekly glucagon-like peptide-1 (GLP-1) analogue semaglutide. Journal of medicinal chemistry. 2015;58(18):7370-80.
48. O'Neil PM, Birkenfeld AL, McGowan B, Mosenzon O, Pedersen SD, Wharton S, et al. Efficacy and safety of semaglutide compared with Liraglutide and placebo for weight loss in patients with obesity: a randomised, double-blind, placebo and active controlled, dose-ranging, phase 2 trial. The Lancet. 2018;392(10148):637-49.
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