GLP-1 Medication Before Bariatric Surgery
Bariatric surgery, despite the prevalence and results afforded by GLP-1 medications, remains the best, longest-term option for effectively addressing significant obesity. With that said, GLP–1 medication is often a valuable complement to the bariatric surgery process – it can be an exceptional tool to reduce surgical risk before surgery even takes place.
Why not just stay on GLP-1 Medications instead of having surgery?
GLP-1 meds are very effective in helping patients significantly reduce their weight. Clinical trials have shown that upwards of one-third of all patients may lose between 20 and 25% of their body weight, depending on the drug they take. While this is exceptional weight loss by any non-surgical standard, it does remain inadequate for most patients with a BMI above 40 or so. Ultimately, even if these patients achieve the maximum weight loss afforded by a GLP-1 drug, they will likely plateau at a level that is still above that which would significantly improve or eliminate metabolic diseases, and also above the amount of weight they could lose with a bariatric procedure.
How do GLP-1 medications complement surgery?
Severe obesity increases surgical risk dramatically, and GLP-1 drugs play a role in reducing that risk by allowing patients to lose a moderate amount of weight and shrink their liver before the procedure. Combined with a pre-operative liver-shrinking diet, patients who use GLP-1 meds before their surgery may reduce the risk of surgical complications significantly.
Note: GLP-1 medication works by slowing the movement of food from the stomach into the small intestine. Essentially, it induces gastroparesis. As such, patients must stop their GLP–1 medication at least two weeks before surgery to reduce the risk of aspiration under anesthesia.
When is a GLP-1 not indicated before surgery?
As with any medication, there are side effects, and some patients will not be ideal candidates for GLP-1 use before their primary bariatric procedure. This may be because they have already tried the medication and experienced side effects, or because it failed to produce meaningful weight reduction.
It can also be the case if they have persistent gastroparesis, which may complicate a surgery that requires anesthesia. Whatever the reason, whether or not patients can take GLP-1 medications before bariatric surgery, the procedure itself remains a very safe and effective option that markedly reduces the risks associated with excess weight.
Speak to your SAMPA surgeon, Nurse Practitioner Claudia, or your prescribing physician to understand more about whether GLP-1 drugs are appropriate before your surgery.