Combining Weight Loss Medications Outperforms GLP-1s or Diet for Pre-Surgical High BMI Patients

Patients preparing for metabolic surgery with a body mass index (BMI) of 70 or higher often face challenges in losing sufficient weight preoperatively, which is crucial for enhancing surgical safety and outcomes. Traditionally, diet and exercise have been recommended for weight reduction before surgery; however, recent research highlights the superior effectiveness of multi-modal anti-obesity medications (mmAOMs) in this context.

A study conducted by researchers at Pennington Biomedical Research Center's Metamor Institute, published in the International Journal of Obesity, compared the efficacy of various preoperative treatments, including GLP-1 receptor agonists (GLP-1s), structured diet and exercise plans, and multi-modal anti-obesity medications. The results indicated that patients using mmAOMs experienced significantly greater weight loss—more than 13% of their total body weight—compared to 8.1% with GLP-1 therapy alone and about 6% with diet and exercise.

The findings suggest that utilizing multiple anti-obesity medications accelerates and amplifies weight loss, potentially leading to improved surgical outcomes. The study also found that optimal weight loss with mmAOMs typically occurs around 51 weeks, with some slowing after approximately 88 weeks, likely due to physiological adaptation or side effects. Nevertheless, the consistent weight reduction provided by mmAOMs offers a predictable window to better prepare patients for surgery.

Experts emphasize that even modest preoperative weight loss can significantly improve postoperative safety, reduce liver size, and diminish abdominal fat, thereby reducing complications. Dr. Michael Kachmar from the Metamor Institute highlights that current strategies often fall short, and the integration of multi-modal medication regimens could be a game-changer in managing extreme obesity.

Furthermore, research underscores the public health urgency, especially as obesity rates escalate among those with BMI exceeding 60 kg/m². The latest studies advocate for personalized treatment approaches and underscore the importance of further research to optimize medication combinations and duration, ultimately aiding in addressing the rising prevalence of extreme obesity.

Source: Medical Xpress