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Liraglutide for the Treatment of Weight Regain After Bariatric Surgery: A Systematic Review and Meta-analysis

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Abstract

Introduction

The efficacy of liraglutide for treating type 2 diabetes mellitus and obesity is well established, but their role in the treatment of weight regain after bariatric surgery remains unclear.

Methods

We searched PubMed, Embase, and Cochrane Library databases in January 2024. A random-effects model was employed to compute mean differences (MD) and events per 100 observations with 95% confidence intervals (CI) for continuous and binary endpoints. Statistical analysis was performed using R software.

Results

A total of 16 studies were included and 881 individuals. Patients were mostly female (50%), aged 36 to 55 years, with a mean body mass index (BMI) of 39.4 kg/m2, and had BS surgery 5 years prior. Over a mean follow-up time ranging from 3 months to 4 years, it was observed a statistically significant reduction in BMI (MD − 8.56 kg/m2; 95% CI 3.34 to 13.79; p < 0.01) and a mean reduction in total weight (MD − 16.03 kg; 95% CI 0.03 to 32.02; p = 0.05) after liraglutide use. Additionally, 65% of patients undertaking liraglutide showed total body weight loss (BWL) above 5% (65.8 events per 100 observations; 95% CI 54.96 to 75.20; p < 0.01), while 26% lost more than 10% of total BWL (26.77 events per 100 observations; 95% CI 19.17 to 36.02; p < 0.01). A limitation is a variability between the studies.

Conclusions

Our findings support the use of liraglutide for weight management in patients who experience weight regain after BS. Liraglutide is well tolerated and promotes significant weight loss, providing clinicians with a therapeutic option for this clinical challenge.

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Data Availability

The datasets generated during and/or analysed during the current study are available and are included in this published article [and its supplementary information files]. Requests for materials should be addressed to F.C.A.d.M. (francisco.cezar2205@gmail.com).

Abbreviations

AEs:

Adverse events

BMI:

Body mass index

BS:

Bariatric surgeries

BWL:

Body weight loss

C:

Control group

CI:

Confidence intervals

GLMM:

Events per 100 observations

GLP-1:

Glucagon-like peptide-1

GLP-1Ras:

GLP-1 receptor agonists

HbA1c:

Hemoglobin A1c

I:

Intervention group

LAGB:

Laparoscopic adjustable gastric banding

MD:

Mean differences

NA:

Not reported

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analysis

PROSPERO:

International Prospective Register of Systematic Reviews

RYGB:

Roux-en-Y gastric bypass

RoB2:

Cochrane Collaboration’s tool for assessing risk of bias in randomized trials

ROBINS-I:

Risk Of Bias In Non-randomized Studies of Interventions

Sleeve:

Longitudinal gastrectomy

T2DM:

Type 2 diabetes mellitus

WR:

Weight regain

RCTs:

Randomized controlled trials

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Authors and Affiliations

  1. Department of Medicine, Federal University of Pará, R. Augusto Corrêa, nº01 Guamá, Belém, Pará, 66073-005, Brazil

    Francisco Cezar Aquino de Moraes

  2. Feevale University, Novo Hamburgo, Rio Grande Do Sul, 93510-235, Brazil

    Victoria Morbach

  3. Department of Medicine, Federal University of Acre, Rio Branco, Acre, 69920-900, Brazil

    Vitor Kendi Tsuchiya Sano

  4. Afya Abaetetuba, Abaetetuba, Pará, 68440-000, Brazil

    Lilianne Rodrigues Fernandes

  5. Lutheran University of Brazil, Canoas, Rio Grande Do Sul, 92425-020, Brazil

    Michele Kreuz

  6. Dante Pazzanese Institute of Cardiology, São Paulo, São Paulo, 04012-909, Brazil

    Francinny Alves Kelly

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Key Points

• Patients post-bariatric surgery benefits from liraglutide in weight management

• Liraglutide is well tolerated and promotes significant weight loss

• Potential of liraglutide as a valuable tool for sustaining long-term weight loss

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de Moraes, F.C.A., Morbach, V., Sano, V.K.T. et al. Liraglutide for the Treatment of Weight Regain After Bariatric Surgery: A Systematic Review and Meta-analysis. OBES SURG (2024). https://doi.org/10.1007/s11695-024-07384-1

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