Preliminary National Survey of Surgeons’ Perspectives on Obesity Management Medications After Metabolic Bariatric Surgery in Taiwan

Purpose: Metabolic bariatric surgery (MBS) remains the cornerstone for sustained weight loss in obesity management. However, suboptimal clinical response or recurrent weight gain remains significant challenges. Obesity management medications (OMMs) are increasingly used post-MBS, yet data on surgeons’ perspectives are limited, especially for glucagon-like peptide-1 receptor agonists (GLP-1 RAs). This study aimed to assess Taiwanese metabolic and bariatric surgeons’ attitudes, prescribing practices, and expectations regarding OMMs use after surgery. Materials and Methods: A 43-item survey was piloted and sent to primary surgeons at hospitals contributing to the annual report of the Taiwan Society for Metabolic and Bariatric Surgery. The practicing members were invited to participate in June 2024. Survey items included demographic information, questions pertaining to the percentage/indication of surgical revision during their practice, and rationales for OMMs after MBS. The consideration for prescribing OMMs and its priority were analyzed concomitantly. OMMs enrolled herein were Saxenda ® , Ozempic ® , Contrave ® , Rybelsus ® , Trulicity ® , and Victoza ® . Results: A total of 20 consultant surgeons participated in the survey (20/31; 64.5%), with 70% reporting experience exceeding 500 MBS cases, and 85% performing revisional bariatric surgery in less than 10% of their annual practice. The primary indication for prescribing OMMs after MBS was salvage therapy for suboptimal clinical response (85%), with 65% initiating treatment between 6 months and 2 years postoperatively. GLP-1 RAs, especially Ozempic ® and Rybelsus ® , were regarded as the most effective agents, although concerns about gastrointestinal side effects and cost were common. Surgeons consistently prioritized cost, adverse event, and efficacy when choosing OMMs, and More than 60% expressed a preference for future medications to have once-weekly or less frequent dosing, oral administration, greater weight loss efficacy, and lower cost. Conclusions: This national survey provides preliminary insight into consistent practices among Taiwanese surgeons in using OMMs after MBS, including indications, timing, and future preferences. Despite the modest sample size, these findings are valuable amid the lack of global consensus. The results highlight pharmacotherapy—especially GLP-1 RAs—as a key adjunct for managing post-surgical weight issues and underscore the need for further research and clear guidelines to support the integration of OMMs into obesity care.