Woman measuring waistline while wondering if you can use glp 1 after gastric bypass

Can You Use A GLP-1 After Gastric Bypass?

Written on November 18, 2023 by Sendra Yang, PharmD, MBA. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

Glucagon-like peptide-1 receptor agonists, also known as GLP-1s, are a class of drugs used to treat type 2 diabetes and obesity.[1] The first GLP-1 medication approved by the U.S. Food and Drug Administration (FDA) was exenatide in 2005. Semaglutide (Wegovy®) and liraglutide (Saxenda®) are GLP-1s currently approved by the FDA for chronic weight management in individuals who are obese and overweight.[2-4]

Gastric bypass is another treatment option that can assist with weight loss in individuals with severe obesity.[5] Continue reading to learn more about GLP1s, gastric bypass, and whether you can use a GLP-1 after gastric bypass surgery.

More On GLP-1s

GLP-1s work by imitating the naturally forming GLP-1 hormones in the body. GLP-1 binds to and activates GLP-1 receptors, leading to various effects. GLP-1s can increase insulin production, delay gastric emptying, promote beta-cell proliferation, and decrease appetite. GLP-1s aid in controlling appetite through a series of complex brain signaling pathways, making you feel full faster. As a class of drugs, GLP-1s have been shown to result in weight loss.[2]

Common side effects of GLP-1s include nausea, vomiting, diarrhea, constipation, injection site reactions, headache, hypoglycemia, dyspepsia, fatigue, dizziness, abdominal pain, and gastroenteritis.[1-4] All GLP-1s carry a boxed warning for the risk of thyroid c-cell tumors and a contraindication for a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2. Additional warnings and precautions with GLP-1s consist of acute pancreatitis, acute gallbladder disease, hypoglycemia, acute kidney injury, hypersensitivity reactions, diabetic retinopathy complications in type 2 diabetics, and increased heart rate.

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About Gastric Bypass

Another obesity treatment option is gastric bypass.[3] Gastric bypass, also known as Roux-en-Y gastric bypass, was developed in the 1960s as a procedural operation for peptic ulcer disease. The surgery also resulted in significant weight loss. Traditionally, gastric bypass operations were performed with an open surgery approach. Nowadays, over 90% of gastric bypass surgeries are done laparoscopically, a minimally invasive operation. Gastric bypass is a type of bariatric surgery that involves making a small pouch from the stomach and connecting the newly created pouch directly to the small intestine.[6]

Gastric bypass is an option for individuals with extreme obesity or a body mass index (BMI) above 40.[6] The surgery is also available for individuals with a BMI between 35 and 39.9 who also have a serious weight-related health issue such as type 2 diabetes or high blood pressure.

Weight loss surgery is not for everyone who is severely overweight.[7] Risks of bariatric surgery can include infection, excessive bleeding, blood clots, breathing issues, leaks in the gastrointestinal system, bowel obstruction, gallstones, hernias, hypoglycemia, malnutrition, ulcers, and, in rare cases, death.

Gastric bypass surgery can result in long-term weight loss in appropriate patients. However, post-surgery weight gain can occur if the recommended lifestyle changes, such as regular exercise and healthy eating plans, are not followed.

Can You Use GLP-1s After Gastric Bypass?

Since it is possible to regain weight after weight loss surgery, you may be wondering if you can use medications like GLP-1s after gastric bypass. The prescribing information for the two GLP-1s currently approved by the FDA for chronic weight management makes no mention of gastric bypass surgery.[3,4] You need to discuss the use of GLP-1 medication after gastric bypass surgery with your healthcare provider. Your healthcare provider can make appropriate recommendations based on your individual situation and your needs for weight loss post-gastric bypass.

Next Steps With Everlywell

If you are trying to lose weight, Everlywell's Weight Care+ program pairs GLP-1 prescriptions with regular clinical care, lab testing, and support for related conditions. You will partner with a healthcare provider to discuss your weight goals and ways to optimize your medications to achieve your health goals.

During your initial telehealth visit, your clinician will review and evaluate your medical history and order appropriate lab testing to determine whether weight loss medication is for you. Your following visit may include your healthcare provider evaluating your lab testing results, discussing your health and weight-related goals, and helping design an individualized care plan. You will then have regular check-ins to review your weight loss progress, assess your medications, order follow-up lab testing, and adjust your care plan as necessary.

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References

  1. Latif W, Lambrinos KJ, Rodriguez R. Compare and Contrast the Glucagon-Like Peptide-1 Receptor Agonists (GLP1RAs) [Updated 2023 Mar 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572151/.
  2. Collins L, Costello RA. Glucagon-Like Peptide-1 Receptor Agonists.[Updated 2023 Jan 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551568/.
  3. Wegovy [package insert]. Plainsboro, NJ: Novo Nordisk Inc.; 2021. https://www.novo-pi.com/wegovy.pdf. Accessed October 23, 2023.
  4. Saxenda [package insert]. Plainsboro, NJ: Novo Nordisk Inc.; 2021. https://www.novo-pi.com/saxenda.pdf. Accessed October 23, 2023.
  5. Seeras K, Philip K, Baldwin D, et al. Laparoscopic Gastric Bypass.[Updated 2023 Apr 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518968/.
  6. Gastric Bypass (roux-en-Y). Mayo Clinic. https://www.mayoclinic.org/tests-procedures/gastric-bypass-surgery/about/pac-20385189. June 25, 2022. Accessed October 23, 2023.
  7. Bariatric surgery. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-20394258. October 18, 2023. Accessed October 23, 2023.
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