MON-690 Impact of GLP-1 Receptor Agonists on Late Complications Following Bariatric Surgery

Abstract Disclosure: K. Gadalla: None. N. Blocher: None. S. Ali: None. A. Jacob: None. D. Lewis: None. C. Polycarpe: None. Background: Bariatric surgery is an effective intervention for severe obesity. However, late complications, including dumping syndrome, malabsorption, gallstone disease, and gastroesophageal reflux disease (GERD), are common. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used for weight management, including optimizing weight loss after bariatric surgery. Despite their growing use, the effects of GLP-1RAs on outcomes beyond weight loss in bariatric surgery patients remain poorly understood. This study aims to assess the impact of GLP-1RAs on the incidence of late complications following bariatric surgery. Methods: This retrospective study utilized data from the TriNetX Global Collaborative Network, including 141 healthcare organizations. Non-diabetic adult patients (≥18 years) who underwent Roux-en-Y gastric bypass or sleeve gastrectomy were categorized into two cohorts: those receiving GLP-1RA therapy postoperatively (Cohort 1, n = 6,609) and those who did not (Cohort 2, n = 67,623). Propensity score matching was applied to balance baseline characteristics, reducing the final matched sample to 6,571 patients per cohort. Outcomes were assessed over five years, including the incidence of dumping syndrome (ICD-10: K91.1), malabsorption (ICD-10: K91.2), gallstone disease (ICD-10: K80.1/K80.2), and GERD (ICD-10: K21). Results: GLP-1RA therapy was associated with a significantly lower incidence of dumping syndrome (relative risk [RR] 0.651; 95% CI: 0.434-0.978; p=0.037), malabsorption (RR 0.216; 95% CI: 0.189-0.248; p<0.001), gallstone disease (RR 0.703; 95% CI: 0.567-0.872; p=0.001), and GERD (RR 0.645; 95% CI: 0.539-0.773; p<0.001) compared to non-users. Kaplan-Meier analysis demonstrated improved long-term complication-free survival among GLP-1RA users, with hazard ratios favoring GLP-1RA therapy across all outcomes. Conclusions: This confirmatory analysis provides evidence that postoperative GLP-1RA therapy is associated with a reduced risk of key complications following bariatric surgery. In addition to its role in promoting weight loss, GLP-1RA therapy may contribute to improved post-bariatric outcomes by mitigating late surgical complications. These findings highlight the potential benefits of GLP-1RA therapy in post-bariatric care and warrant further prospective investigations to clarify its role in improving long-term surgical outcomes. Presentation: Monday, July 14, 2025