A new retrospective study has found that multi-modal anti-obesity medication (mmAOM) offers the most effective preoperative weight loss strategy for patients with a body mass index (BMI) of 70 kg/m² or higher who are preparing for metabolic surgery. This group of patients faces increased surgical risks, and optimizing their weight before surgery is a critical step in improving safety and outcomes.
The study analyzed data from 113 patients treated at a single metabolic disease center. Researchers divided participants into three treatment groups: non-pharmacologic medically supervised weight loss (NP-MSWL), glucagon-like peptide-1 receptor agonist monotherapy (Mono-GLP-1), and mmAOM. The primary focus was to compare the mean percentage of total body weight loss (%TBWL) among the groups, with additional analysis of weight loss at specific time intervals throughout treatment.
Patients in the mmAOM group showed the greatest weight loss, achieving an average of 13.07% total body weight loss. The median weight loss in this group was 9.93%, significantly higher than the 5.58% median seen in the Mono-GLP-1 group and the 5% median recorded in the NP-MSWL group. Statistical analysis using the Kruskal-Wallis test confirmed significant differences among the three approaches (p = 0.0047).
The most notable weight loss occurred between weeks 51 and 88 of the preoperative period, with a median loss of 10.25% (p = 0.0093). These results underline the importance of early and sustained intervention using a combination of anti-obesity medications for patients with extremely high BMI levels.
The study concludes that mmAOM is a more effective strategy than either GLP-1 monotherapy or non-pharmacologic methods alone. It highlights the potential benefits of incorporating this approach into preoperative care protocols to enhance weight loss and improve surgical outcomes in patients with severe obesity.
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