SAT-695 The Effect of GLP-1 Administration on Food Intake in People With Weight Loss Failure Post-metabolic Surgery

Abstract Disclosure: K. Alexiadou: None. K. Narula: None. K. Malallah: None. C. Coimbra de Brito Lobato: None. A. Kowalka: None. S. Purkayastha: None. C. Tsironis: None. P. Ortega: None. S. Hakky: None. L. Brolly: None. S. Scholtz: None. L. Tweedlie: None. H. Chahal: None. K. O'Donnell: None. C. Bovill-Taylor: None. A. Sackey: None. R. Houghton: None. S. Hameed: None. C. Izzi-Engbeaya: None. A. Ahmed: None. T. Tan: None. Background: Metabolic surgery is still the most effective treatment for obesity, delivering sustainable weight loss long-term. Sleeve Gastrectomy is one of the commonly performed procedures. However, the prevalence of weight loss failure ranges between 20-30% and depending on the definition, category and surgery type, it can vary between 3.9 to 71%. The mechanisms behind this phenomenon are not well understood and especially the determining factors for primary and secondary weight loss failure.Hypothesis: The aim of our study was to examine patients who did not achieve an adequate weight loss after Sleeve Gastrectomy and those who initially achieved good weight loss but regained weight. We hypothesised that these two patient groups presenting with different weight trajectories, may display different food intake responses to exogenous GLP-1 administration. Methods: This was a single blinded study. We enrolled six patients whose nadir weight was less than 20% of their pre-operative weight (“poor responders”) and nine patients who achieved more than 20% weight loss as nadir but regained weight (“regainers”). We administered 2 different infusions at random order, one placebo infusion and one native GLP-1(7-36)·NH2 infusion for 4.5 hours. At the 4-hour timepoint, we performed an Ad Libitum meal study, where the participants were presented with excess portions of a standardised meal and were asked to eat until they were comfortably full. The primary outcome was food intake. Results: The poor responders did not demonstrate any significant difference in their food intake between the placebo and GLP-1 day (p=0.621), whereas the regainers showed significant food intake reduction with the GLP-1 infusion (p=0.047). Conclusion: Our results raise the possibility that primary poor response to sleeve gastrectomy may relate to a reduced anorectic effect from GLP-1, but that "regainers" retain sensitivity to the effects of GLP-1. GLP-1 based therapies may be considered as an adjunctive option in the management of patients who regain weight after metabolic surgery. Presentation: Saturday, July 12, 2025