# Efficacy and Safety of Glucagon‐Like Peptide‐1 Receptor Agonists Following Bariatric Surgery: A Systematic Review and Meta‐Analysis

## TL;DR

GLP-1 receptor agonists help reduce weight and improve metabolic markers in patients after bariatric surgery, but may cause more side effects.

## Contribution

This study is the first systematic review and meta-analysis evaluating the efficacy and safety of GLP-1RAs specifically in post-bariatric surgery patients.

## Key findings

- GLP-1RAs significantly reduced weight, BMI, HbA1c, and total cholesterol in post-bariatric surgery patients.
- Adverse events and nausea were more common with GLP-1RA use compared to placebo.
- No significant changes were observed in blood pressure, triglycerides, or fasting blood glucose.

## Abstract

Glucagon‐like peptide‐1 receptor agonists (GLP‐1RA) have demonstrated promising effects in promoting weight loss and improving metabolic markers. However, their effectiveness post‐bariatric surgery remains uncertain.

PubMed, Cochrane CENTRAL, and Scopus were queried through March 2025 for randomised controlled trials comparing GLP‐1RA to placebo in post‐bariatric surgery patients. Outcomes included weight loss, BMI, total cholesterol, triglycerides, fasting blood glucose, blood pressure, HbA1c, and adverse events. Random‐effects models were used to calculate standardised mean differences (SMDs), weighted mean differences (WMDs), and risk ratios (RRs).

Six trials (n = 401) were included. GLP‐1RA significantly reduced weight (SMD: −5.96 kg [95% CI: −9.40, −2.53]; p = 0.0007), BMI (WMD: −3.08 kg/m2 [95% CI: −4.16, −2.00]; p < 0.00001), total cholesterol (WMD: −0.30 mmol/L / −11.60 mg/dL [95% CI: −0.50, −0.09 / −19.34, −3.48]; p = 0.005), and HbA1c (WMD: −0.39% [95% CI: −0.62, −0.17]; p = 0.0007). Total adverse events (RR: 1.49 [95% CI: 1.14, 1.94]; p = 0.003) and nausea (RR: 2.23 [95% CI: 1.21, 4.09]; p = 0.010) were more common with GLP‐1RA compared to placebo. No significant changes were found in blood pressure, triglycerides, or fasting blood glucose.

GLP‐1RAs significantly reduce weight, BMI, HbA1c, and total cholesterol in patients following bariatric surgery. These findings highlight the potential of GLP‐1RA therapy post‐bariatric surgery. Future research is warranted to assess the long‐term effects of GLP‐1RA on the post‐operative metabolic profile.

GLP‐1 receptor agonists significantly improved weight loss, BMI, HbA1c, and cholesterol in patients after bariatric surgery, supporting their role in enhancing postoperative metabolic outcomes.