P3331 - Weight Loss Outcomes of Glucagon-Like Peptide 1 Receptor Agonists in Patients With Sleeve Gastrectomy vs Patients With Intact Stomach

Hellen Jumo, BSc¹, Lavender Micalo, BS¹, Sagar Shah, MD¹, Ruvimbo Dzvurumi, BS¹, Norman Spivak, BS¹, Vahagn Aldzhyan, MS¹, Elizza E. Villarruel, BS², Anna Lee, MD¹, Firas Bahdi, MD¹, Venkataraman R. Muthusamy, MD³, Danny Issa, MD^1
1David Geffen School of Medicine at UCLA, Los Angeles, CA; ²David Geffen School of Medicine at UCLA, La Puente, CA; ³David Geffen School of Medicine at UCLA, Sherman Oaks, CA

Introduction: Glucagon-like peptide 1 receptor agonists (GLP1-RA) are widely prescribed anti-obesity medications with remarkable efficacy. While GLP1-RA offer significant weight loss in patients with intact stomach, their performance in patients with weight regain following sleeve gastrectomy (SG) has not been well-established. We here compare the weight loss outcomes of GLP1-RA in patients with prior SG vs intact stomach controls.

Methods: A retrospective study of all patients ≥18 years with prior SG who were treated with semaglutide or tirzepatide injections for weight regain between Jan 2018 and Oct 2023 at a large tertiary-care health system. We identified a matched group of obese patients with intact stomach who were treated with GLP1-RA around the same interval. The primary outcome was the percentage total body weight loss (%TBWL) at 3,6, and 12 months. Secondary outcome was determining factors associated with weight loss following GLP1-RA initiation through multivariate linear regression analysis.

Results: The study included 151 patients (68 post SG and 83 with intact stomach). Mean age was 52 ± 11 years old and 77% of patients were female [Table 1]. The two groups had similar baseline characteristics, including age, ethnicity, comorbidity, BMI, and hemoglobin A1c. Compared to SG patients, GLP1-RA offered more %TBWL in patients with intact stomach at three months (5.9% vs 4.3%, P=0.01), six months (9.2% vs 6.8%, P=0.03), and 12 months (12.2% vs 9.2%, P=0.07), [Figure 1]. On multivariate linear regression analysis, baseline BMI was significantly associated with %TBWL at three months as each 1 kg/m2 increase in BMI was associated with a 0.18 decrease in %TBWL at three months (P= 0.01 and 95% CI -0.29 to -0.08). This association did not persist at 6 or 12 months following GLP1-RA initiation.

Discussion: GLP1-RA injections offered significantly less weight loss in patients with prior sleeve gastrectomy than those with intact stomachs. Higher baseline BMI predicted early but not long-term weight loss. Future studies are encouraged to explore the pathophysiological causes behind the observed lower GLP1-RA efficacy in SG patients.



Disclosures:


Hellen Jumo, BSc¹, Lavender Micalo, BS¹, Sagar Shah, MD¹, Ruvimbo Dzvurumi, BS¹, Norman Spivak, BS¹, Vahagn Aldzhyan, MS¹, Elizza E. Villarruel, BS², Anna Lee, MD¹, Firas Bahdi, MD¹, Venkataraman R. Muthusamy, MD³, Danny Issa, MD¹. P3331 - Weight Loss Outcomes of Glucagon-Like Peptide 1 Receptor Agonists in Patients With Sleeve Gastrectomy vs Patients With Intact Stomach, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.