Patients experience with preoperative use of anti-obesity medications and associations with bariatric surgery expectations

Objective This study investigated associations between patients’ experiences with anti-obesity medications and weight loss expectations prior to bariatric surgery. Methods Patients were electronically surveyed with a 31-item questionnaire via email or the patient portal with a primary predictor variable of AOMs pre-surgery. Outcomes included degree of weight loss and weight regain and motivation for seeking surgery. Results 346 persons were invited to complete the survey. 112 (32.4%) were completed, with 7 excluded due to not answering the AOM question. 73% reported AOM use. Among those who took AOMs prior to seeking bariatric surgery, average weight loss was 13 kg (SD ±10 kg) corresponding to a 4.4 kg/m 2 decrease in BMI. Of past AOMs receipients, 87% reported weight regain upon stopping AOMs. Average weight regain was 18 kg (SD 13kg, 126% increase). Patients reported improved longevity and quality of life as motivation for seeking surgery with AOM use history having no effect. Subjects reported an average weight loss goal of 65.8 kg (39% of baseline weight) from bariatric surgery. Conclusion AOMs were commonly used in those seeking bariatric surgery but motivation for surgery did not differ by AOMs use history. Motivations were most often related to goals for better overall health. Study Importance Questions Minimal data exists regarding patients’ experience with anti-obesity medicaitons and whether prior experience with these medications impacts patients’ expectations or goals for bariatric surgery. This cross-sectional survey investigated the frequency of anti-obesity medication use prior to patients seeking bariatric surgery, finding nearly 3/4ths of patients seeking surgery have previously utilized pharmaceutical weight loss therapies. This study will ideally spur clinical trials to determine the most effective approach to combination therapy, thus moving obesity treatment to a multimodal approach.