Pharmacotherapy in Conjunction with a Diet and Exercise Program for the Treatment of Weight Recidivism or Weight Loss Plateau Post-bariatric Surgery: a Retrospective Review

Abstract

Phentermine and phentermine-topirimate in addition to diet and exercise appear to be viable options for weight loss in post-RYGB and LAGB patients who experience WR or WLP.

The utility of weight loss medications after bariatric surgery for weight regain or inadequate weight loss: A multi-center study

“…The mean of this added weight loss was −7.6% (17.8 lbs) of total postsurgical weight. After further stratification, we found that patients who were prescribed medication at weight plateau lost a similar amount of weight compared to those who were prescribed medication after weight regain, (− 6.9% or 16.1 lbs and − 7.7% or 18.2 lbs) consistent with findings reported in previous literature [27,28,32,33]. Consequently, total weight loss percentage from preoperative status was higher in patients who were prescribed medications at their plateau than in those patients who were prescribed medication after weight regain had occurred (32.3% versus 26.8%; P = .486).…”

“…To date, there is a paucity of published literature on utilizing weight loss medication as an adjunct to bariatric surgery for individuals who have had inadequate weight loss or for individuals who have regained weight after undergoing bariatric surgery. We are aware of only a few studies that have examined this issue [27,28,32,33]. …”

“…Another retrospective study by Schwartz et al examined the use of phentermine and combination phentermine/topiramate in individuals who underwent RYGB or laparoscopic gastric banding (LAGB) who desired additional weight loss one year after their surgical procedure [33]. In their study, the group reported that at 90 days weight loss was 6.35 kg (12.8% EWL) and 3.81 kg (12.9% EWL) in the phentermine and phentermine/topiramate groups respectively [33].…”

“…In their study, the group reported that at 90 days weight loss was 6.35 kg (12.8% EWL) and 3.81 kg (12.9% EWL) in the phentermine and phentermine/topiramate groups respectively [33]. Furthermore, in a retrospective study, Pajecki et al examined the use of glucagon-like peptide-1 agonist liraglutide over a period of 12.5 ± 4 weeks in 15 individuals who had >15 % of weight regain 2 years after bariatric surgery.…”

Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management

“…Prescribing weight loss pharmacotherapy before weight regain occurs (at weight plateau) may result in greater amount of total weight loss from the pre-operative period [159] and may prevent weight regain. A recent retrospective review demonstrated that phentermine alone and a phentermine-topiramate combination, in addition to diet and exercise, appear to be viable options for weight loss in RYGB and adjustable gastric banding patients who experienced weight recidivism or weight loss plateau [160]. Another study showed that medical treatment directed to the control of satiety using liraglutide may be an alternative treatment of patients with poor weight loss or weight regain after surgery [161].…”