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Can you use Semaglutide after bariatric surgery?
Medically Reviewed by Felix Gussone, MD, Ro; Written by Amelia Willson
Last updated: May 9, 2023
6 min read
Weight loss surgery is growing in popularity. Over 250,000 people undergo bariatric surgery each year in the United States. Around 20% to 30% of those people may experience insufficient weight loss or regain weight after bariatric surgery. While lifestyle changes like diet and exercise are helpful, treatment options to manage post-bariatric weight regain have been scarce. Health researchers are looking into the most effective ways people can keep the weight off post-bariatric surgery. One treatment that may hold promise is semaglutide, manufactured under the brand names Ozempic and Wegovy.
If you recently got bariatric surgery, are worried about weight regain down the road, and wonder if you can use semaglutide after bariatric surgery, here’s the good news: Recent research suggests that using semaglutide after bariatric surgery can effectively reduce weight regain and support long-term weight loss.
What is Semaglutide?
Semaglutide is the active ingredient in drugs like Ozempic and Wegovy. It was originally released under the brand name Ozempic for the treatment of type 2 diabetes, in combination with diet and exercise. The medication comes in a prescription pen which you inject on a weekly basis into the skin of your upper arm, thigh, or abdomen. As a GLP-1 drug, semaglutide mimics glucagon-like peptide 1, a hormone that tells your pancreas to release more insulin after you eat. This helps people with type 2 diabetes keep their blood sugar levels in check.
Semaglutide also delays gastric emptying and prevents the release of more glucagon into your bloodstream. These effects prevent further blood sugar spikes, another benefit for people with type 2 diabetes. But, they also lead people to feel full sooner. Soon, drug makers and scientific researchers realized that many people taking Ozempic were losing weight. This led Novo Nordisk, the manufacturer of Ozempic, to seek FDA approval for semaglutide as a weight loss drug, under the brand name Wegovy. Today, both Ozempic and Wegovy may be prescribed for weight loss, although only Wegovy is officially FDA approved for this purpose.
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How much weight can you lose on semaglutide?
The average person loses nearly 15% of their body weight within a year and a half of a weekly injection of 2.4mg semaglutide.
In addition to slowing down digestion and reducing one’s appetite, Ozempic and Wegovy may have other sustained benefits for weight loss, according to one study of almost 200 people with obesity and overweight. Researchers checked in continuously with participants over a period of two years. They found that semaglutide significantly reduced cravings for salty and spicy food, dairy, and starches. Participants also found it easier to resist the cravings that did come up. This lines up nicely with other research that suggests semaglutide affects the way your brain reacts and thinks about food, which can lead you to eat less.
Can you use Wegovy or Ozempic after bariatric surgery?
While bariatric metabolic surgery is safe and effective, as many as one in three people regain weight after the procedure. GLP-1 medications like Wegovy and Ozempic can help them lose about two-thirds of that weight regain, according to one study. In the study, participants had gained back 15% of their body weight after bariatric surgery. Just six months later, after starting semaglutide, they had lost nearly 9% of the weight.
About one in three people experienced gastrointestinal side effects, which are common to Ozempic and Wegovy, but — also like Ozempic and Wegovy — the side effects were mild and went away as their body got used to the medication. No serious adverse reactions were reported.
Other studies have found similar improvements in weight loss. In one study, participants began semaglutide treatment about a year, give or take, after their bariatric surgery. Similar to the other study, these participants had regained 12% of their body weight since the surgery. Three months after beginning semaglutide treatment, they lost 6% of their weight. After another three months, they had lost 10%.
Another study compared the effectiveness of Ozempic and Wegovy vs. non-GLP-1 weight loss drugs in reducing post-bariatric weight regain over the period of one year. At three months, six months, and nine months, semaglutide proved to be more effective — and faster — at weight loss than the other weight loss drugs or lifestyle changes. At three months, participants taking semaglutide had lost 4.5% of their body weight, more than twice as much as those taking a non-GLP-1 drug and more than three times as much as those making lifestyle changes alone. These results were consistent regardless of the type of bariatric surgery.
Ozempic vs. Saxenda after bariatric surgery
Wegovy and Ozempic produce more weight loss than other GLP-1 medications as well. One study compared the effects of Wegovy and Ozempic vs. liraglutide, the active ingredient in Saxenda, another GLP-1 drug. Over 200 people participated in the study, about half of whom had had a sleeve gastrectomy. The others had undergone either roux-en-y gastric bypass (RYGB) or adjustable gastric banding. Twelve months after starting treatment, those taking semaglutide had lost nearly 13% of their body weight, compared with less than 9% for those taking liraglutide. In other words, those taking semaglutide were more than twice as likely to have lost at least 10% to 15% of their body weight. Semaglutide produced similar reductions in weight loss, regardless of the type of procedure the person had done, their age, or their sex.
Semaglutide is not safe for everybody, including people with a personal or family history of thyroid cancer. People with a history of pancreatitis, diabetic retinopathy, and kidney or gallbladder problems, may need to use caution when taking Ozempic or Wegovy. Your healthcare provider can advise you on whether Ozempic, Wegovy, or another GLP-1 medication is a good option for you based on your other health conditions and medications.
Benefits of weight loss
While diet and exercise are a foundational first step in any weight loss program, for many people with (severe) obesity, surgery, medication, or both are needed to achieve serious weight loss and keep it off.
There is no magic number when it comes to a “healthy weight,” but weight loss offers significant benefits for people with obesity. In people with overweight and obesity, reducing one's body weight by 10% or more could help reduce the risk of cancer, improve your quality of life, and relieve comorbid health conditions like osteoarthritis and sleep apnea. In addition to helping you lose weight, GLP-1s like semaglutide can improve your physical functioning, while reducing cardiometabolic risk factors like blood pressure and cholesterol.
Similarly, bariatric surgery does much more than help you lose weight. Bariatric surgery has been shown to reduce cardiovascular risk by 42%, and death from any cause by 30%. The weight loss from bariatric surgery also relieves obesity-related health conditions, improves cholesterol, and enhances your quality of life.
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
Felix Gussone, MD
Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.
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