New Generation Anti-Obesity Pharmacotherapy: Companion or Competitor to Metabolic bariatric Surgery?

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1RAs), which were originally developed and approved for the management of type 2 diabetes, have recently been demonstrated to yield significant weight loss accompanied by improvements in cardiometabolic risks and quality of life among adults with obesity. (p1) Dual and triple agonists targeting glucose-dependent insulinotropic polypeptide (GIP) and glucagon receptors have led to weight loss approaching reported results after bariatric surgery in clinical trials over one year. (p2) Whereas bariatric surgical procedures primarily restrict stomach size and/or absorption of food, the GLP-1RAs seem to induce weight loss via suppression of appetite, enhancement of satiety, and by delaying gastric emptying. (p3) The substantial weight loss outcomes with these new-generation incretin mimetics have prompted discussions about their potential to replace bariatric surgery. Nevertheless, before considering these drugs as a viable alternative to bariatric surgery, there are several factors to consider.