Effects of Semaglutide and Tirzepatide on Recurrent Weight Gain After Bariatric Surgery: A Systematic Review and Meta-analysis.

Obesity surgery2025PMID: 41313431

View on PubMed DOI: 10.1007/s11695-025-08414-2

ReviewMeta-AnalysisTirzepatide

Plain Language Summary

Systematic review and meta-analysis of 8 retrospective studies (964 patients) evaluating semaglutide and tirzepatide for recurrent weight gain after metabolic bariatric surgery. Tirzepatide achieved greater percent total weight loss (−13.63%) versus semaglutide (−10.97%) in post-bariatric weight regain. Provides the first meta-analytic evidence for pharmacological management of post-bariatric weight regain using incretin therapy—establishing tirzepatide's superior weight loss in this population and informing clinical decision-making when patients seek treatment for recidivism after bariatric procedures.

Abstract

Fifteen to forty% of patients experience recurrent weight gain (RWG) after metabolic bariatric surgery (MBS). Glucagon-like peptide receptor agonists (GLP-1 RAs) are effective treatments for obesity in nonsurgical patients. To assess the effects of semaglutide and tirzepatide after MBS, we conducted a meta-analysis of data from inception to August 2025. Eight retrospective studies and 964 patients were included. The percentage total weight loss (%TWL) was - 10.97% [95% CI, - 13.41 to - 8.53; p < 0.05] for semaglutide and - 13.63% [95% CI, - 22.59 to - 4.67; p < 0.05] for tirzepatide. The evidence suggests that semaglutide and tirzepatide result in weight reduction in patients with RWG after MBS.

Authors

Osorio Manyari, Angel Alois; Armas Alvarez, Azucena Lirio; Osorio Manyari, Joel Davis; Onieva Gonzalez, Francisco; Pouwels, Sjaak