942-P: Treatment of Weight Regain after Bariatric Surgery: Real-World Comparative Outcomes

Abstract

After bariatric surgery, people frequently do not achieve a healthy weight and/or regain weight. There is limited outcomes data on anti-obesity medications in patients with prior bariatric surgery. GLP-1RAs promote weight loss by decreasing gastric motility and appetite, yet post-prandial levels of GLP-1 are elevated after bariatric surgery. We evaluated weight outcomes in patients with prior bariatric surgery seen in an academic medical center’s weight management program. We compared the following groups: intensive lifestyle modification (ILM) vs. any GLP-1 RA (GLP-1) vs. any non-GLP-1 RA weight loss agents (non-GLP-1) vs. combination of weight loss agents including GLP-1 RA (GLP-1 combination). We included patients with a history of bariatric surgery, at least two clinic visits, and no anti-obesity medications at the initial visit. Data was extracted from the Electronic Medical Record and confirmed by manual chart review. All patients were counseled on lifestyle modification for weight loss. The two GLP-1-based treatment groups had significantly greater % weight loss at 3- and 6-months compared to the ILM group (Figure). In multivariable regression model, adjusting for baseline age and sex, surgery type did not (p=0.2 and p=0.97 for 3- and 6-mo analyses) influence outcome. GLP-1 RA therapies (alone or in combination) are effective for weight loss in patients with prior bariatric surgery, regardless of surgery type. Disclosure C. Gazda: None. J. Almandoz: None. I. Lingvay: Consultant; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Intarcia Therapeutics, Janssen Pharmaceuticals, Inc., MannKind Corporation, Novo Nordisk A/S, Sanofi, TARGET PharmaSolutions, Valeritas, Inc. Other Relationship; Self; Novo Nordisk A/S. J. Clark: None.