Preoperative weight loss with glucagon‐like peptide‐1 receptor agonist treatment predicts greater weight loss achieved by the combination of medical weight management and bariatric surgery in patients with type 2 diabetes: <scp>A</scp> longitudinal analysis

Tang, Tien T.; Abbott, Sally; Roux, Carel W. le; Wilson, Violet; Singhal, Rishi; Bellary, Srikanth; Tahrani, Abd A

doi:10.1111/dom.13131

Cited by 16 publications

(12 citation statements)

References 17 publications

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“…receptor agonists both provide effective mechanisms for weight loss in persons living with obesity and may even provide additional benefit when used in combination [55,56].…”

Section: Discussionmentioning

confidence: 99%

“…It is also postulated that GLP‐1 receptor expression may mediate the anorexigenic response to exogenous GLP‐1 receptor agonists in the hypothalamus [54]. Therefore, GLP‐1 agonism with bariatric surgery and exogenous GLP‐1 receptor agonists both provide effective mechanisms for weight loss in persons living with obesity and may even provide additional benefit when used in combination [55,56].…”

Section: Discussionmentioning

confidence: 99%

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Weight loss between glucagon‐like peptide‐1 receptor agonists and bariatric surgery in adults with obesity: A systematic review and meta‐analysis

Sarma

Palcu

2022

Obesity

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Objective Glucagon‐like peptide‐1 (GLP‐1) receptor agonists recently demonstrated 15% to 20% weight loss in adults with obesity, a range which has previously been achieved only with bariatric surgery. This systematic review and meta‐analysis compares weight loss between GLP‐1 receptor agonists and bariatric surgery. Methods The databases MEDLINE, MEDLINE In‐Process, MEDLINE Epubs Ahead of Print, Embase Classic + Embase (OvidSP), and Cochrane (Wiley) were searched from inception to April 21, 2021, for randomized controlled trials and observational studies. Two independent reviewers extracted data, reported risk of bias, and graded certainty of evidence. Random‐effects models were used to pool change in weight, BMI, and glycated hemoglobin. Results Six studies, encompassing 332 patients, were included. Among randomized controlled trials, mean difference in weight between all bariatric surgery types and GLP‐1 receptor agonists was −22.68 kg (95% CI: −31.41 to −13.96), mean difference in BMI was −8.18 kg/m2 (95% CI: −11.59 to −4.77), and mean difference in glycated hemoglobin was −1.28% (95% CI: −1.94% to −0.61%). Among observational studies, mean difference in weight was −25.11 kg (95% CI: −40.61 to −9.60), and mean difference in BMI was −10.60 kg/m2 (95% CI: −17.22 to −3.98). Only one observational study reported glycemic outcomes. Conclusion In adults with obesity, bariatric surgery still confers the highest reductions in weight and BMI but confers similar effects in glycemic control when compared with GLP‐1 receptor agonists.

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“…receptor agonists both provide effective mechanisms for weight loss in persons living with obesity and may even provide additional benefit when used in combination [55,56].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Weight loss between glucagon‐like peptide‐1 receptor agonists and bariatric surgery in adults with obesity: A systematic review and meta‐analysis

Sarma

Palcu

2022

Obesity

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“…Weight loss in tier 3 did not predict weight loss at 12 or 24 months despite adjustment for age, gender, ethnicity, baseline weight (kg), time in tier 3 and type 2 diabetes. In another study from Birmingham that included 45 patients with type 2 diabetes, there was no significant relationship between the % weight loss induced by glucagon-like peptide 1 (GLP-1) receptor agonists during tier 3 services and 12 months post-surgical (band, sleeve, bypass) % weight loss [60]. Interestingly, the correlation coefficients were negative (especially in the gastric bypass and sleeve gastrectomy group) suggesting higher post-operative weight loss in those with less weight loss following GLP-1 agonist treatment [60].…”

Section: Selecting the Right Patient: Achieving 5-10% Weight Loss Befmentioning

confidence: 99%

Developing Integrated Clinical Pathways for the Management of Clinically Severe Adult Obesity: a Critique of NHS England Policy

et al. 2020

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Purpose of the Review Pathways for obesity prevention and treatment are well documented, yet the prevalence of obesity is rising, and access to treatment (including bariatric surgery) is limited. This review seeks to assess the current integrated clinical pathway for obesity management in England and determine the major challenges. Recent Findings Evidence for tier 2 (community-based lifestyle intervention) and tier 3 (specialist weight management services) is limited, and how it facilitates care and improve outcomes in tier 4 remains uncertain. Treatment access, rigidity in pathways, uncertain treatment outcomes and weight stigma seems to be major barriers to improved care. Summary More emphasis must be placed on access to effective treatments, treatment flexibility, addressing stigma and ensuring treatment efficacy including long-term health outcomes. Prevention and treatment should both receive significant focus though should be considered to be largely separate pathways. A simplified system for weight management is needed to allow flexibility and the delivery of personalized care including post-bariatric surgery care for those who need it.

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“…Increased endogenous GLP-1 signaling has been regarded as a primary pathway resulting in postsurgical weight loss and improvement in glucose metabolism [52]. GLP-1 analogs are considered the effective obesity therapeutics [53].…”

Section: Glucagon-like Peptide-1mentioning

confidence: 99%

Potential mechanisms of sleeve gastrectomy for reducing weight and improving metabolism in patients with obesity

Huang

Ding

et al. 2019

Surgery for Obesity and Related Diseases

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Obesity is a severe medical problem endangering the health of individuals worldwide. Sleeve gastrectomy (SG), one of the most commonly performed bariatric procedures, has been widely applied to the treatment of such patients. Currently, the potential mechanisms underlying the significant weight loss and metabolic improvement after SG have been well studied. First, and most importantly, by removing a large volume of stomach, the SG directly or indirectly restricts food intake. Then, there are alterations in the absorption and metabolism of both macro-and micronutrients, which may benefit or worsen the patients' well-being. Another profound change is enhanced secretion of the satiety gut hormone and reduced secretion of the hunger hormone as a consequence of the operation. Additionally, adjustment of gastrointestinal motility, alteration in the gut microbial community, and an inflammatory response were found after surgery. Therefore, the purpose of the present review was focused on such hypotheses and to compile the accumulated facts on the physiologic mechanism of bariatric surgery so that these results can help improve the understanding of how SG produces substantial weight loss and a significant improvement in the metabolism of patients with metabolic syndrome.

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Preoperative weight loss with glucagon‐like peptide‐1 receptor agonist treatment predicts greater weight loss achieved by the combination of medical weight management and bariatric surgery in patients with type 2 diabetes: A longitudinal analysis

Cited by 16 publications

References 17 publications

Weight loss between glucagon‐like peptide‐1 receptor agonists and bariatric surgery in adults with obesity: A systematic review and meta‐analysis

Weight loss between glucagon‐like peptide‐1 receptor agonists and bariatric surgery in adults with obesity: A systematic review and meta‐analysis

Developing Integrated Clinical Pathways for the Management of Clinically Severe Adult Obesity: a Critique of NHS England Policy

Potential mechanisms of sleeve gastrectomy for reducing weight and improving metabolism in patients with obesity

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