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Cohort studyObesity surgery · 2026

Optimal Timing of GLP-1 Receptor Agonist Initiation in Patients with Obesity Eligible for Metabolic Bariatric Surgery.

Guy Loic Nguefang, Sarpong Boateng, Yussif Issaka … Basile Njei

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SurgeryCohort study

GLP-1 receptor agonist use after bariatric surgery is associated with lower death risk.

Optimal Timing of GLP-1 Receptor Agonist Initiation in Patients with Obesity Eligible for Metabolic Bariatric Surgery.

Guy Loic Nguefang et al. · Obesity surgery · 2026

Background

GLP-1-RAs and metabolic bariatric surgery (MBS) both improve outcomes in obesity.

Purpose

This study compares the effectiveness and safety of early GLP-1 initiation (≥ 3 months before) versus delayed initiation (≥ 1 month after) in adults undergoing MBS.

Methods

Retrospective cohort study using TriNetX.

Results

GLP-1 medicine after weight-loss surgery lowered the risk of death

HR by subgroup · 95% CI

More results

In contrast, initiating GLP-1 RA before MBS reduced mortality by 80% (HR 0.20, 95% CI 0.14-0.30) only.

GLP-1 after MBS also lowered the risk of micronutrient deficiency by 10% (HR 0.90, 95% CI 0.83-0.97), whereas GLP-1 RA before MBS increased this risk by 18% (HR 1.18, 95% CI 1.08-1.28).

More results

GLP-1 RA after MBS reduced the risk of SBO by 65% (HR 0.35, 95% CI 0.28-0.44), compared with a 39% reduction for GLP-1 RA before MBS (HR 0.61, 95% CI 0.49-0.76).

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Conclusion · 1 of 2

Initiating GLP-1 RA therapy after MBS appears to provide the most favorable balance of survival, cardiometabolic outcomes, and postoperative complications.

Conclusion · 2 of 2

These findings, particularly those related to mortality, should be interpreted with caution given the observational design and immortal time bias.

Post

Optimal Timing of GLP-1 Receptor Agonist Initiation in Patients with Obesity Eligible for Metabolic Bariatric Surgery.

GLP-1 receptor agonist use after bariatric surgery is associated with lower death risk.

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