Is Bariatric Surgery at Risk Due to Semaglutide?

Purpose: Obesity remains a significant public health issue in the Western world, affecting millions of Americans and contributing to chronic conditions such as diabetes and hypertension. In June 2021, the Food and Drug Administration approved semaglutide for long-term weight management. While its effectiveness in promoting weight loss has been well-documented, its impact on the field of bariatric surgery remains uncertain. Materials and Methods: A retrospective analysis was conducted on 515 bariatric patients from January 2022 to November 2023. Patients on semaglutide in the preoperative period were compared to those not using the medication, with outcomes including time to surgery, cancellation rates, weight loss at different time points, and secondary outcomes such as side effects. Results: Thirteen percent of patients were on semaglutide. Semaglutide users had higher rates of diabetes (P<0.001). Starting and preoperative weights were comparable between both groups. Patients on semaglutide were less likely to proceed with surgery (P=0.001). For patients who had surgery, those on semaglutide experienced longer times from evaluation to surgery, compared to patients not taking this medication (8.8 months vs. 7.4 months, P=0.152). Weight loss outcomes at 2- and 6-month post-surgery were similar between groups. Notably, 22% of semaglutide patients no longer qualified for surgery due to successful weight loss. Conclusion: The use of semaglutide has the potential to reduce the number of bariatric surgeries and delay surgical intervention for some patients. However, the long-term effects of semaglutide on weight maintenance and its broader implications for clinical practice require further investigation.