Research led by Monash University and Alfred Health has revealed that the weight loss medication liraglutide can significantly enhance weight loss outcomes for individuals who do not achieve optimal results after bariatric surgery. The findings indicate that combining this medication with surgical procedures may reduce the necessity for additional surgeries, which carry considerable risks.
Around 31 percent of adults in Australia are classified as obese, prompting many to seek metabolic bariatric surgery (MBS) as an effective treatment option. While most patients lose between 20-30 percent of their total body weight following surgery, approximately 10-15 percent experience sub-optimal weight loss or regain weight post-operation. Prior to this study, options for these patients were limited, often leading to further surgeries that pose a four to five times higher risk of serious complications.
The study, published in JAMA Network Open, aimed to explore the potential of liraglutide, initially developed for managing type 2 diabetes, as a complementary treatment for patients struggling with weight loss after surgery. A double-blinded randomized controlled trial involving 48 adults, aged between 20-65 years and 12-36 months post-bariatric procedures such as Adjustable Gastric Band (AGB) and Roux-en-Y Gastric Bypass, was conducted. Participants were randomly assigned to receive either daily liraglutide or a placebo for twelve months.
Results showed that the liraglutide group achieved a mean total body weight loss (TBWL) of 4.4 percent compared to an increase of 1.4 percent in the placebo group, demonstrating a significant difference without adverse impacts on health or quality of life.
Professor Wendy Brown, the first author and head of the Monash University Department of Surgery, expressed optimism about the findings. “We have shown that for people who regain weight or don’t have an optimal weight loss effect from bariatric surgery, adding a weight loss drug will help them lose weight, often at a lower dose than is needed in people who have not had surgery,” she stated.
This research marks a pivotal step in addressing the challenges faced by patients who do not achieve desired outcomes from bariatric surgery. The findings suggest that liraglutide may allow for effective weight loss without the need for repeat surgeries, which are often both risky and complex.
Joint senior author Professor John Wentworth, an adult endocrinologist at the Royal Melbourne Hospital, highlighted the implications of the study. “Our demonstration that incretin drugs enhance weight loss following bariatric surgery provides great hope. Newer, more effective drugs have become available and should help our patients achieve even better weight and health outcomes,” he noted.
Co-author Dr. Paul Burton from the Monash University School of Translational Medicine reiterated the importance of a multi-faceted approach to obesity management. He emphasized that while MBS facilitates durable weight loss and improves various obesity-related health conditions, up to 15 percent of patients still experience sub-optimal results.
“A multimodal approach has long been the guiding principle in care following weight loss surgery, but until now it rested on a limited evidence base,” Dr. Burton explained. “The results reinforce that personalized treatment, careful patient selection, sustained lifestyle change, and ongoing adherence are essential to managing obesity as a lifelong disease.”
Liraglutide, classified as a glucagon-like peptide-1 (GLP-1) receptor agonist, has been part of previous studies exploring combined medication and surgery, all of which have shown varying degrees of weight loss success. This research further supports the idea that combining therapies could allow for safer and reversible procedures, such as AGB, to be considered viable options for patients who do not achieve their weight loss goals after surgery.
The study’s promising results could lead to significant shifts in how post-bariatric care is approached, ultimately enhancing long-term health outcomes for patients struggling with obesity. As the medical community continues to explore effective strategies, the integration of medications like liraglutide into weight management protocols could represent a transformative advance in the field.
For those interested in the full study, it can be accessed through the DOI link: 10.1001/jamanetworkopen.2025.39848.
