Peter Rye1, Renuca Modi2,3, Sarah Cawsey3,4, Arya M Sharma3,4. 1. Richmond Road Diagnostic Treatment Centre, University of Calgary, Room 18126, 1820 Richmond Road SW, Calgary, AB, T2T 5C7, Canada. peter.L.rye@gmail.com. 2. Department of Family Medicine, University of Alberta, Edmonton, AB, Canada. 3. Edmonton Adult Bariatric Specialty Clinic, Royal Alexandra Hospital, Royal Alexandra Hospital CSC 472, 10240 Kingsway Avenue, Edmonton, AB, T5H 3V9, Canada. 4. Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, Canada.
Abstract
BACKGROUND: Bariatric surgery is the most effective long-term treatment of severe obesity. Unfortunately, many patients experience inadequate weight loss, weight plateau, or weight recidivism. We sought to determine the efficacy of high-dose liraglutide (3.0 mg once daily) in patients with prior bariatric surgery. METHODS: We performed a retrospective chart review of 33 consecutive patients, aged 18-65, who received liraglutide for weight loss in the setting of any previous bariatric surgery. Indications were weight recidivism (> 10% weight regain from lowest post-surgical weight), inadequate weight loss (< 20% weight loss from initial clinic assessment, or pre-surgical weight if unavailable), and plateau (patient desires further weight loss but does not fit into either other category). Our primary outcomes were median percentage weight loss and median BMI change at 16 and 28 weeks, inclusive of time taken to titrate the medication to target dose. Secondary outcomes were the presence of adverse effects and the need to discontinue the medication. RESULTS: Of a total of 33 patients identified, 20 met inclusion criteria and had adequate data to be included in our analysis. At 16 weeks median percentage weight loss was 7.1% (IQR 5.1-12.2%), and at 28 weeks 9.7% (IQR 7.8-13.9%). Median BMI change was 3.5 kg/m2 (16 weeks, IQR 2.2-4.6 kg/m2) and 4.7 kg/m2 (28 weeks, IQR 3.7-5.6 kg/m2). There were no major adverse events. CONCLUSIONS: High-dose liraglutide is an effective adjunct treatment for weight loss in patients with prior bariatric surgery.
BACKGROUND: Bariatric surgery is the most effective long-term treatment of severe obesity. Unfortunately, many patients experience inadequate weight loss, weight plateau, or weight recidivism. We sought to determine the efficacy of high-dose liraglutide (3.0 mg once daily) in patients with prior bariatric surgery. METHODS: We performed a retrospective chart review of 33 consecutive patients, aged 18-65, who received liraglutide for weight loss in the setting of any previous bariatric surgery. Indications were weight recidivism (> 10% weight regain from lowest post-surgical weight), inadequate weight loss (< 20% weight loss from initial clinic assessment, or pre-surgical weight if unavailable), and plateau (patient desires further weight loss but does not fit into either other category). Our primary outcomes were median percentage weight loss and median BMI change at 16 and 28 weeks, inclusive of time taken to titrate the medication to target dose. Secondary outcomes were the presence of adverse effects and the need to discontinue the medication. RESULTS: Of a total of 33 patients identified, 20 met inclusion criteria and had adequate data to be included in our analysis. At 16 weeks median percentage weight loss was 7.1% (IQR 5.1-12.2%), and at 28 weeks 9.7% (IQR 7.8-13.9%). Median BMI change was 3.5 kg/m2 (16 weeks, IQR 2.2-4.6 kg/m2) and 4.7 kg/m2 (28 weeks, IQR 3.7-5.6 kg/m2). There were no major adverse events. CONCLUSIONS: High-dose liraglutide is an effective adjunct treatment for weight loss in patients with prior bariatric surgery.
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