Efficacy of the Glucagon-Like Peptide-1 Receptor Agonists Liraglutide and Semaglutide for the Treatment of Weight Regain After Bariatric surgery: a Retrospective Observational Study
Open accessAbstract
Purpose Weight regain after bariatric surgery occurs in up to a third of patients and reduces treatment-associated health benefits. The efficacy of glucagon-like peptide-1 receptor agonists (GLP1-RA) for treatment of type 2 diabetes mellitus and obesity is well established, but their role in the treatment of weight regain after bariatric surgery remains to be defined. Materials and methods This was a single centre retrospective observational study conducted at a Swiss bariatric reference centre. Patients with 6 months of treatment with GLP1-RA, up until November 2021, due to weight regain after bariatric surgery were identified. Data on body weight and relevant clinical parameters were collected before and after 6 months of treatment with GLP1-RA. Data are presented as median (interquartile range). Results Fifty patients (82% female) were included. Before GLP1-RA treatment (liraglutide, n=29; semaglutide, n=21), weight and BMI were 90.5 kg (83.4, 107.9) and 34.0 kg/m 2 (31.7, 38.7), respectively, with a post-bariatric weight regain of 15.1% (10.6, 22.8) of total body weight and 4.6 kg/m 2 (3.3, 6.2). After 6 months of GLP1-RA treatment, a reduction in weight and BMI of 8.8% (5.2, 11.4) of total body weight and 2.9 kg/m 2 (1.8, 4.0) was observed (P value <0.0001), corresponding to 67.4% (40.4, 92.2) of the weight regain. No serious adverse events were reported. Conclusion For patients experiencing weight regain after bariatric surgery, two-thirds of the weight regain can be safely lost with GLP1-RA, providing clinicians with a therapeutic option for this clinical challenge, and highlights the need for a large-scale randomized clinical trial.
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- Findingown data
No serious adverse events were reported.
“No serious adverse events were reported.”
Quote in the paperNot a substantial claim - Findingown data
Overall, 76.0% of patients achieved at least 5% total body weight loss.
“Overall, a total body weight loss of ≥5% of baseline weight was achieved by 76.0% (n=38), ≥10% loss by 38.0% (n=19), and ≥15% loss by 12.0% of the patients (n=6).”
Quote in the paperSubstantial claim - Findingown data
Treatment with semaglutide compared with liraglutide resulted in a significantly greater reduction in BMI (3.9 vs 2.5 kg/m2, P < 0.001).
“treatment with semaglutide (1.0 mg, weekly subcutaneous injection [n=20] or 14 mg, daily oral intake [n=1]) as compared to liraglutide (daily subcutaneous injection with 3.0 mg [n=28] or 1.8 mg [n=1]) resulted in a significantly greater reduction in BMI (3.9 kg/m2 (2.9, 4.8) vs 2.5 kg/m2 (1.1, 3.3), P value <0.001”
Quote in the paperSubstantial claim - Findingown data
The present study's sensitivity analysis showed a significantly greater magnitude of weight loss with semaglutide compared to liraglutide.
“our sensitivity analysis showed a significantly greater magnitude of weight loss with semaglutide as compared to liraglutide (Fig. 4).”
Quote in the paperSubstantial claim - Findingown data
A non-statistically significant tendency toward greater weight loss was observed when GLP1-RA treatment was initiated at least 72 months after bariatric surgery compared with less than 72 months (P = 0.12).
“A tendency towards an increased effect of GLP1-RAs on weight loss if treatment was initiated ≥72 months as compared to <72 months after bariatric surgery was observed, albeit not statistically significant (−3.1 kg/m2 (−2.5, −4.6) vs −2.6 kg/m2 (−1.1, −3.6), P value =0.12”
Quote in the paperNot a substantial claim
- Findingown data
Despite different study durations, a similar proportion (69.0%) of patients in the present study achieved at least 5% weight loss.
“Despite the difference in study duration, a similar proportion (69.0%) of the patients in our study achieved a weight loss of ≥5%.”
Quote in the paperSubstantial claim - Findingreasoning
A tendency toward greater weight loss was observed when GLP1-RA was initiated more than 72 months after bariatric surgery.
“a tendency to a greater weight loss when GLP1-RA was initiated more than 72 months after bariatric surgery was observed (Supplement).”
Quote in the paperSubstantial claim - Findingown data
A sensitivity analysis among patients treated with liraglutide showed no significant difference in weight loss between non-self-payers and self-payers.
“a sensitivity analysis among patient treated with liraglutide showed no significant difference in weight loss between non-self-payers and self-payers”
Quote in the paperSubstantial claim - Findingown data
All reported adverse events were transient.
“Adverse events were reported in 36.0% of the patients, all of which were transient, considered mild, and primarily related to the gastrointestinal system (Table 2).”
Quote in the paperNot a substantial claim - Findingown data
All reported adverse events were considered mild.
“Adverse events were reported in 36.0% of the patients, all of which were transient, considered mild, and primarily related to the gastrointestinal system (Table 2).”
Quote in the paperNot a substantial claim - Findingown data
The reported adverse events were primarily related to the gastrointestinal system.
“Adverse events were reported in 36.0% of the patients, all of which were transient, considered mild, and primarily related to the gastrointestinal system (Table 2).”
Quote in the paperNot a substantial claim - Findingown data
Overall, 38.0% of patients achieved at least 10% total body weight loss.
“Overall, a total body weight loss of ≥5% of baseline weight was achieved by 76.0% (n=38), ≥10% loss by 38.0% (n=19), and ≥15% loss by 12.0% of the patients (n=6).”
Quote in the paperSubstantial claim - Findingown data
Adverse events were reported in 36.0% of patients.
“Adverse events were reported in 36.0% of the patients, all of which were transient, considered mild, and primarily related to the gastrointestinal system (Table 2).”
Quote in the paperNot a substantial claim - Findingown data
Overall, 12.0% of patients achieved at least 15% total body weight loss.
“Overall, a total body weight loss of ≥5% of baseline weight was achieved by 76.0% (n=38), ≥10% loss by 38.0% (n=19), and ≥15% loss by 12.0% of the patients (n=6).”
Quote in the paperSubstantial claim - Findingown data
The presence of a potential anatomical cause for weight regain did not significantly change the efficacy of GLP1-RA on body weight loss.
“The presence of a potential anatomical cause for weight regain did also not significantly change the efficacy on body weight loss of GLP1-RA”
Quote in the paperSubstantial claim - Findingown data
In the present study, no statistically significant difference in weight loss was observed between patients with and without type 2 diabetes.
“no statistically significant difference was observed in this study (Supplement).”
Quote in the paperSubstantial claim - Findingown data
Based on sensitivity analysis, the magnitude of weight regain did not seem to influence the effect of GLP1-RA on weight loss.
“Based on the sensitivity analysis, the magnitude of weight regain did not seem to influence the effect of GLP1-RA on weight loss.”
Quote in the paperSubstantial claim - Premisecitation
In the GRAVITAS trial, liraglutide compared with placebo produced a mean weight loss difference of 4.2 kg after 26 weeks in patients with persistent or recurrent type 2 diabetes after bariatric surgery.
“Although the primary outcome was change in HbA1c, the results showed a difference in mean weight loss of 4.2 kg in the liraglutide vs placebo group after 26 weeks of treatment [21].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [21] Miras AD, Pérez-Pevida B, Aldhwayan M, Kamocka A, McGlone ER, Al-Najim W, Chahal H, Batterham RL, McGowan B, Khan O, Greener V, Ahmed AR, Petrie A, Scholtz S, Bloom SR, Tan TM. Adjunctive liraglutide treatment in patients with persistent or recurrent type 2 diabetes after metabolic surgery (GRAVITAS): a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol. 2019;7(7):549–59. source
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- Premisecitation
Glucagon-like peptide-1 receptor agonists are currently the most effective drugs for lowering weight.
“Glucagon-like peptide-1 receptor agonists (GLP1-RAs) are the currently most efficacious weight lowering drugs.”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [6] Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JFE, Nauck MA, Nissen SE, Pocock S, Poulter NR, Ravn LS, Steinberg WM, Stockner M, Zinman B, Bergenstal RM, Buse JB. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375(4):311–22. source
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- cites [7] Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jódar E, Leiter LA, Lingvay I, Rosenstock J, Seufert J, Warren ML, Woo V, Hansen O, Holst AG, Pettersson J, Vilsbøll T. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375(19):1834–44. source
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- cites [8] Kristensen SL, Rørth R, Jhund PS, Docherty KF, Sattar N, Preiss D, Køber L, Petrie MC, McMurray JJV. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet Diabetes Endocrinol. 2019;7(10):776–85. source
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- Premisecitation
The STEP 1 and 2 studies reported weight loss of 12.4% and 6.2%, respectively, with semaglutide 2.4 mg weekly versus placebo over 68 weeks.
“The STEP 1 and 2 studies, investigating the weight effect of semaglutide 2.4 mg weekly versus placebo over 68 weeks, reported a weight loss of 12.4% and 6.2%, respectively [32, 33].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [32] Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989–1002. source
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- cites [33] Davies M, Færch L, Jeppesen OK, Pakseresht A, Pedersen SD, Perreault L, Rosenstock J, Shimomura I, Viljoen A, Wadden TA, Lingvay I. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. The Lancet. 2021;397(10278):971–84. source
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- Premisecitation
The rapid delivery of nutrients to L-cells in the distal small intestine and colon after bariatric surgery leads to increased secretion of gut hormones, especially postprandial GLP-1 and peptide YY.
“The rapid delivery of nutrients to the L-cells in the distal small intestine and colon after bariatric surgery leads to increased secretion of gut hormones, especially postprandial GLP-1 and peptide YY.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [34] Papamargaritis D, le Roux CW. Do gut hormones contribute to weight loss and glycaemic outcomes after bariatric surgery? Nutrients. 2021;13(3):762. source
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- Premisecitation
In the SCALE diabetes study, patients with type 2 diabetes randomized to liraglutide 3.0 mg lost 6.0% total body weight versus 2.0% with placebo after 56 weeks.
“In the SCALE diabetes study, a total body weight loss of 6.0% was seen in patients with T2D randomized to liraglutide (3.0 mg, daily subcutaneous injection) versus 2.0% with placebo after 56 weeks of treatment [30].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [30] Davies MJ, Bergenstal R, Bode B, Kushner RF, Lewin A, Skjøth TV, Andreasen AH, Jensen CB, DeFronzo RA, for the NN8022-1922 Study Group. Efficacy of liraglutide for weight loss among patients with type 2 diabetes: the SCALE diabetes randomized clinical trial. JAMA. 2015;314(7):687. source
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- Premisecitation
A prospective observational study from the United Arab Emirates found 6.1% weight loss after 16 weeks of liraglutide 3.0 mg daily in patients with prior bariatric surgery and obesity without type 2 diabetes.
“A prospective observational study from the United Arab Emirates including patients with previous bariatric surgery and obesity without T2D showed a 6.1% weight loss after 16 weeks of therapy with liraglutide (3.0 mg, daily subcutaneous injection) [15].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [15] Suliman M, Buckley A, Al Tikriti A, Tan T, le Roux CW, Lessan N, Barakat M. Routine clinical use of liraglutide 3 mg for the treatment of obesity: outcomes in non-surgical and bariatric surgery patients. Diabetes Obes Metab. 2019;21(6):1498–501. source
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- Premisecitation
Clinical studies have shown that semaglutide produces significantly greater weight loss than liraglutide.
“Clinical studies have shown that the efficacy of weight loss with semaglutide is significantly better than with liraglutide [25, 26].”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [25] O’Neil PM, Birkenfeld AL, McGowan B, Mosenzon O, Pedersen SD, Wharton S, Carson CG, Jepsen CH, Kabisch M, Wilding JPH. Efficacy and safety of semaglutide compared with liraglutide and placebo for weight loss in patients with obesity: a randomised, double-blind, placebo and active controlled, dose-ranging, phase 2 trial. The Lancet. 2018;392(10148):637–49. source
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- cites [26] Pratley R, Amod A, Hoff ST, Kadowaki T, Lingvay I, Nauck M, Pedersen KB, Saugstrup T, Meier JJ. Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes (PIONEER 4): a randomised, double-blind, phase 3a trial. The Lancet. 2019;394(10192):39–50. source
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- Interpretationcitation
Considering the shorter duration and lower dose of semaglutide, the 34% greater weight loss with semaglutide versus liraglutide seen in the present study is in line with previous clinical studies.
“Taking in consideration the shorter duration and lower dose of semaglutide, the 34% greater weight loss with semaglutide as compared to liraglutide seen in the current study is in line with previous clinical studies.”
Quote in the paperSubstantial claim - Premisecitation
In that randomized study, after 12 months, 67.2% of patients in the liraglutide arm versus 4.4% in the placebo arm had lost at least 5% of body weight.
“After 12 months, 67.2% of the patients in the liraglutide arm versus 4.4% in the placebo arm had lost at least 5% of body weight [22].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [22] Clinical Efficacy and safety of using 3.0mg liraglutide to treat weight regain after Roux-en-Y gastric bypass surgery. [Internet]. [cited 2022 Oct 15]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT03048578
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- Premisecitation
A retrospective observational study from Germany reported an average total body weight loss of 10.3% after 6 months of weekly subcutaneous semaglutide at a maximum dose of 0.5 mg in patients with insufficient weight loss or weight regain after bariatric surgery.
“After 6 months of weekly subcutaneous therapy with semaglutide at a maximum dose of 0.5 mg, an average total body weight loss of 10.3% was observed [24].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [24] Lautenbach A, Wernecke M, Huber TB, et al. The potential of semaglutide once-weekly in patients without type 2 diabetes with weight regain or insufficient weight loss after bariatric surgery—a retrospective analysis. Obes Surg. 2022;32(10):3280–3288. source
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- Premisecitation
In SUSTAIN 1, patients with type 2 diabetes and a mean BMI of 32.9 kg/m2 on semaglutide 0.5 or 1.0 mg had a total body weight loss of 4.5 kg (4.9%) versus 1.0 kg (1.1%) with placebo after 30 weeks.
“In SUSTAIN 1 comparing semaglutide (0.5 or 1.0 mg, weekly subcutaneously injection) with placebo in patients with T2D and a mean BMI of 32.9 kg/m2, a total body weight loss of 4.5 kg (4.9%) and 1.0 kg (1.1%) was seen in the patients with semaglutide vs placebo after 30 weeks of treatment [31].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [31] Sorli C, Harashima S, ichi, Tsoukas GM, Unger J, Karsbøl JD, Hansen T, Bain SC. Efficacy and safety of once-weekly semaglutide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1): a double-blind, randomised, placebo-controlled, parallel-group, multinational, multicentre phase 3a trial. Lancet Diabetes Endocrinol. 2017;5(4):251–60. source
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- Premisecitation
Preliminary results from a randomized trial of liraglutide 3.0 mg versus placebo for 12 months in patients with weight regain after Roux-en-Y gastric bypass showed that 67.2% of the liraglutide group and 4.4% of the placebo group lost at least 5% of baseline body weight.
“Preliminary results of a randomized study of liraglutide (3.0 mg, daily subcutaneous injection) versus placebo for 12 months in patients with weight regain after Roux-en-Y gastric bypass show that 67.2% of the patients in the liraglutide group versus 4.4% in the placebo group lost at least 5% of their baseline body weight [22].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [22] Clinical Efficacy and safety of using 3.0mg liraglutide to treat weight regain after Roux-en-Y gastric bypass surgery. [Internet]. [cited 2022 Oct 15]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT03048578
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- Interpretationcitation
Lower endogenous GLP-1 levels in poor responders to bariatric surgery could potentially enable a larger effect of exogenous GLP1-RA.
“thus potentially enabling a larger effect of exogenously given GLP1-RA [34].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [34] Papamargaritis D, le Roux CW. Do gut hormones contribute to weight loss and glycaemic outcomes after bariatric surgery? Nutrients. 2021;13(3):762. source
Not checked in the free run.
- Premisecitation
In a comparison of weekly subcutaneous semaglutide 2.4 mg versus daily subcutaneous liraglutide 3.0 mg in patients with overweight or obesity without type 2 diabetes, total body weight loss was 15.8% with semaglutide and 6.4% with liraglutide after 68 weeks.
“The latest published results comparing weight loss with weekly subcutaneous semaglutide (2.4 mg) vs daily subcutaneous liraglutide (3.0 mg) in patients with overweight or obesity without T2D demonstrated a total body weight loss of 15.8% with semaglutide vs 6.4% with liraglutide after 68 weeks of therapy [27].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [27] Rubino DM, Greenway FL, Khalid U, O’Neil PM, Rosenstock J, Sørrig R, Wadden TA, Wizert A, Garvey WT, STEP 8 Investigators, Arauz-Pacheco C, Cannon K, Downey HJ, Fitz-Patrick D, Geohas J, Gerety G, Gilbert J, Hollander P, Klein E, Laufer K, O’Donnell P, Rosenblit P, Toth P. Effect of weekly subcutaneous semaglutide vs daily liraglutide on body weight in adults with overweight or obesity without diabetes: the STEP 8 randomized clinical trial. JAMA. 2022;327(2):138. source
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- Premisecitation
In the SCALE obesity and prediabetes study, patients with obesity without type 2 diabetes on liraglutide 3.0 mg lost 8.0% of total body weight versus 2.6% with placebo after 56 weeks.
“In the SCALE obesity and prediabetes study, in patients with obesity without T2D, patients on liraglutide (3.0 mg, daily subcutaneous injection) lost 8.0% of their total body weight versus 2.6% in the placebo group after 56 weeks of treatment [29].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [29] Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, Lau DCW, le Roux CW, Violante Ortiz R, Jensen CB, Wilding JPH. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med. 2015;373(1):11–22. source
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- Premisenone given
Lautenbach et al. included patients without type 2 diabetes who had both insufficient weight loss and weight regain after bariatric surgery.
“Lautenbach et al. included patients without T2D with both insufficient weight loss and weight regain after bariatric surgery”
Quote in the paperSubstantial claim - Interpretationcitation
The authors' results are consistent with non-randomized studies in patients with prior bariatric surgery.
“Our results are also in line with non-randomized studies in patients with previous bariatric surgery.”
Quote in the paperSubstantial claim - Interpretationown data
The present study's results are consistent with the only randomized study of liraglutide 3.0 mg versus placebo in patients with weight regain after Roux-en-Y gastric bypass.
“The results from the present study are consistent with the published results of the only randomized study of liraglutide (3.0 mg, subcutaneous daily injection) versus placebo in patients with weight regain following Roux-en-Y gastric bypass.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [22] Clinical Efficacy and safety of using 3.0mg liraglutide to treat weight regain after Roux-en-Y gastric bypass surgery. [Internet]. [cited 2022 Oct 15]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT03048578
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- Premisecitation
Weight loss with GLP1-RA in clinical studies has consistently been shown to be smaller with liraglutide than with semaglutide.
“weight loss with GLP1-RA in clinical studies has been consistently shown to be smaller with liraglutide vs semaglutide [25, 26, 35].”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [25] O’Neil PM, Birkenfeld AL, McGowan B, Mosenzon O, Pedersen SD, Wharton S, Carson CG, Jepsen CH, Kabisch M, Wilding JPH. Efficacy and safety of semaglutide compared with liraglutide and placebo for weight loss in patients with obesity: a randomised, double-blind, placebo and active controlled, dose-ranging, phase 2 trial. The Lancet. 2018;392(10148):637–49. source
Not checked in the free run.
- cites [26] Pratley R, Amod A, Hoff ST, Kadowaki T, Lingvay I, Nauck M, Pedersen KB, Saugstrup T, Meier JJ. Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes (PIONEER 4): a randomised, double-blind, phase 3a trial. The Lancet. 2019;394(10192):39–50. source
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- cites [35] Capehorn MS, Catarig AM, Furberg JK, Janez A, Price HC, Tadayon S, Vergès B, Marre M. Efficacy and safety of once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg as add-on to 1–3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10). Diabetes Metab. 2020;46(2):100–9. source
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- Interpretationown data
The sensitivity analysis indicates that self-payer status likely did not significantly influence the weight outcome.
“indicating that self-payer status likely did not significantly influence the outcome.”
Quote in the paperNot a substantial claim - Interpretationreasoning
The difference in patient characteristics between the present study and Lautenbach et al. could possibly explain the similar weight loss despite different semaglutide doses.
“this difference in patient characteristics could possibly explain the similar weight loss obtained in both studies despite the difference in dose.”
Quote in the paperSubstantial claim - Premisecitation
Lautenbach et al. included poor responders to bariatric surgery, who have been shown to have lower endogenous GLP-1 levels.
“the study by Lautenbach includes “poor” responders to bariatric surgery, which have been shown to have lower endogenous GLP-1 levels”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [34] Papamargaritis D, le Roux CW. Do gut hormones contribute to weight loss and glycaemic outcomes after bariatric surgery? Nutrients. 2021;13(3):762. source
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- Premisecitation
An observational study from Canada found 5.5% weight loss with liraglutide 3.0 mg daily over 7.6 months in patients with prior bariatric surgery.
“Similarly, an observational study from Canada demonstrated a 5.5% weight loss with liraglutide (3.0 mg, daily subcutaneous injection) over 7.6 months in patients with previous bariatric surgery [14].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [14] Wharton S, Kuk JL, Luszczynski M, et al. Liraglutide 3.0 mg for the management of insufficient weight loss or excessive weight regain post‐bariatric surgery. Clin Obes. 2019;9(4):e12323. source
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- Premisereasoning
A randomized head-to-head comparison between liraglutide 3.0 mg daily and semaglutide 1.0 mg weekly has not been done because of different indications.
“Given the different indications, a randomized head-to-head comparison between liraglutide 3.0 mg, daily subcutaneous injection, and semaglutide 1.0 mg, weekly subcutaneous injection has not been done.”
Quote in the paperSubstantial claim - Premisecitation
The present study includes patients with type 2 diabetes, who have been shown to lose less weight with GLP1-RA therapy.
“The current study includes patients with T2D that have been shown to lose less weight with GLP1-RA therapy [29, 30, 32, 33]”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [29] Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, Lau DCW, le Roux CW, Violante Ortiz R, Jensen CB, Wilding JPH. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med. 2015;373(1):11–22. source
Not checked in the free run.
- cites [30] Davies MJ, Bergenstal R, Bode B, Kushner RF, Lewin A, Skjøth TV, Andreasen AH, Jensen CB, DeFronzo RA, for the NN8022-1922 Study Group. Efficacy of liraglutide for weight loss among patients with type 2 diabetes: the SCALE diabetes randomized clinical trial. JAMA. 2015;314(7):687. source
Not checked in the free run.
- cites [32] Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989–1002. source
Not checked in the free run.
- cites [33] Davies M, Færch L, Jeppesen OK, Pakseresht A, Pedersen SD, Perreault L, Rosenstock J, Shimomura I, Viljoen A, Wadden TA, Lingvay I. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. The Lancet. 2021;397(10278):971–84. source
Not checked in the free run.
- Premisecitation
In the STEP8 trial, comparing semaglutide 2.4 mg weekly with liraglutide 3.0 mg daily in patients with overweight or obesity and no prior bariatric surgery or type 2 diabetes, mean weight change from baseline was −15.8% with semaglutide versus −6.4% with liraglutide after 68 weeks.
“In the STEP8 trial, comparing semaglutide (2.4 mg, weekly subcutaneous injection) with liraglutide (3.0 mg, daily subcutaneous injection) in patients with overweight or obesity and no previous bariatric surgery or T2D, a mean weight change from baseline of −15.8% with semaglutide vs −6.4% with liraglutide after 68 weeks was reported [27].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [27] Rubino DM, Greenway FL, Khalid U, O’Neil PM, Rosenstock J, Sørrig R, Wadden TA, Wizert A, Garvey WT, STEP 8 Investigators, Arauz-Pacheco C, Cannon K, Downey HJ, Fitz-Patrick D, Geohas J, Gerety G, Gilbert J, Hollander P, Klein E, Laufer K, O’Donnell P, Rosenblit P, Toth P. Effect of weekly subcutaneous semaglutide vs daily liraglutide on body weight in adults with overweight or obesity without diabetes: the STEP 8 randomized clinical trial. JAMA. 2022;327(2):138. source
Not checked in the free run.
- Interpretationown data
The amount of weight lost with GLP1-RA in this real-world group matches the results of the SCALE, SUSTAIN, and STEP trials.
“The magnitude of weight loss observed with GLP1-RA in this real-life patient population is consistent with findings from the SCALE, SUSTAIN, and STEP clinical trials, which are based on patients without bariatric surgery.”
Quote in the paperSubstantial claim0 of 5 sources checked- cites [29] Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, Lau DCW, le Roux CW, Violante Ortiz R, Jensen CB, Wilding JPH. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med. 2015;373(1):11–22. source
Not checked in the free run.
- cites [30] Davies MJ, Bergenstal R, Bode B, Kushner RF, Lewin A, Skjøth TV, Andreasen AH, Jensen CB, DeFronzo RA, for the NN8022-1922 Study Group. Efficacy of liraglutide for weight loss among patients with type 2 diabetes: the SCALE diabetes randomized clinical trial. JAMA. 2015;314(7):687. source
Not checked in the free run.
- cites [31] Sorli C, Harashima S, ichi, Tsoukas GM, Unger J, Karsbøl JD, Hansen T, Bain SC. Efficacy and safety of once-weekly semaglutide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1): a double-blind, randomised, placebo-controlled, parallel-group, multinational, multicentre phase 3a trial. Lancet Diabetes Endocrinol. 2017;5(4):251–60. source
Not checked in the free run.
- cites [32] Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989–1002. source
Not checked in the free run.
- cites [33] Davies M, Færch L, Jeppesen OK, Pakseresht A, Pedersen SD, Perreault L, Rosenstock J, Shimomura I, Viljoen A, Wadden TA, Lingvay I. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. The Lancet. 2021;397(10278):971–84. source
Not checked in the free run.
- Study design and conductreasoning
A limitation of the safety assessment is the lack of a standardized reporting procedure, which might have caused bias in documented safety-related data, particularly underreporting of transient mild events.
“A limitation of this approach is the lack of a standardized reporting procedure, which might have caused bias in the documented safety-related data, particularly with respect to the prevalence of transient mild events which might be underreported.”
Quote in the paperNot a substantial claim - Interpretationown data
Demonstrating significant weight loss with GLP1-RA therapy in line with previous clinical trial results, despite the heterogeneity of this real-world patient population, provides further support for the efficacy of implementing GLP1-RAs in this patient population.
“demonstrating a significant weight loss with GLP1-RA therapy in line with previous clinical trial results, despite the heterogeneity of this real-world patient population, provides further support for the efficacy of implementing GLP1-RAs in this patient population.”
Quote in the paperSubstantial claim - Study design and conductreasoning
The heterogeneity of patients concerning type and number of previous bariatric surgeries, time span after bariatric surgery until GLP1-RA initiation, magnitude of weight regain, GLP1-RA therapies given, and possibility of an anatomical cause for weight gain in 20% of patients is a weakness of the study.
“The heterogeneity of the patients concerning type and number of previous bariatric surgeries, the time span after bariatric surgery until GLP1-RA therapy initiation, the magnitude of weight regain, the GLP1-RA therapies given, and the possibility of an anatomical cause for weight gain following surgery among 20% of the patients certainly are a weakness of the study.”
Quote in the paperNot a substantial claim - Interpretationreasoning
With elevated endogenous GLP-1 secretion after bariatric surgery fading with time, exogenous stimulation of GLP-1 receptors with GLP1-RA could have a greater effect on weight.
“With the elevated endogenous GLP-1 secretion after bariatric surgery fading with time, exogenous stimulation of GLP-1 receptors with GLP1-RA could have a greater effect on weight.”
Quote in the paperSubstantial claim - Premisecitation
Santo et al. demonstrated decreased postprandial levels of glucose-dependent insulinotropic polypeptide and GLP-1 in patients with weight regain after gastric bypass compared to patients with favourable postoperative weight outcomes.
“A study by Santo et al. demonstrated decreased postprandial levels of glucose-dependent insulinotropic polypeptide and GLP-1 in patients with weight regain after gastric bypass as compared to patients with favourable postoperative weight outcomes [37].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [37] Santo MA, Riccioppo D, Pajecki D, Kawamoto F, de Cleva R, Antonangelo L, Marçal L, Cecconello I. Weight regain after gastric bypass: influence of gut hormones. Obes Surg. 2016;26(5):919–25. source
Not checked in the free run.
- Interpretationown data
This finding supports the use of GLP1-RA in patients with such anatomical changes.
“which supports the use of GLP1-RA in patients with such anatomical changes.”
Quote in the paperSubstantial claim - Study design and conductreasoning
The lack of randomization in this retrospective observational study allows for selection bias and confounding.
“The lack of randomization allows for selection bias and confounding.”
Quote in the paperSubstantial claim
- May combine two claims. 16
- The quote only partly states this claim. 1
- Classified as probably not a substantial claim. 10
May combine two claims.
Findingown dataThe greater weight loss with semaglutide was observed even though liraglutide was given at the higher weight-reduction dose (3.0 mg daily) in 28 of 29 patients, while semaglutide was given at the lower type 2 diabetes dose (1.0 mg weekly or 14 mg daily oral).
“the greater effect on weight loss with semaglutide was observed despite liraglutide in 28 out of 29 patients being administered in the higher dose approved for weight reduction (3.0 mg, daily subcutaneous injection), whereas semaglutide was administered at the lower dose approved for T2D (1.0 mg, weekly subcutaneous injection or 14 mg, daily oral intake).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataAt baseline, patients had regained 15.1% of total body weight (IQR 10.6-22.8) or 4.6 kg/m2 (IQR 3.3-6.2) after bariatric surgery.
“At baseline, 72.0 months (43.8, 96.0) after the last bariatric surgery, patients had regained 15.1% (10.6, 22.8) of total body weight or 4.6 kg/m2 (3.3, 6.2).”
Quote in the paperSubstantial claimThe quote only partly states this claim.
Findingown dataThe weight loss corresponded to 67.4% (IQR 40.4-92.2) of the weight regained after the last bariatric procedure.
“The median patient had lost 67.4% of the weight regained after the last bariatric procedure.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataExcluding outlier therapies did not significantly change the overall body weight results after 6 months of GLP1-RA therapy or the comparison between semaglutide and liraglutide.
“Excluding outlier therapies (liraglutide, 1.8 mg daily subcutaneous injection [n=1] and semaglutide, 14 mg daily oral intake [n=1]) did not significantly change the overall results on body weight after 6 months GLP1-RA therapy or the results of the comparison between semaglutide and liraglutide”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataAfter 6 months of GLP1-RA treatment, patients lost 8.8% of total body weight (IQR 5.2-11.4) and 2.9 kg/m2 (IQR 1.8-4.0), with a P value <0.0001.
“From a weight of 90.5 kg (83.4, 107.9) and BMI of 34.0 kg/m2 (31.7, 38.7) at baseline, patients had lost 8.8% (5.2, 11.4) of total body weight and 2.9 kg/m2 (1.8, 4.0) after 6 months of treatment (P value <0.0001)”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn the present study, total body weight loss after 6 months of semaglutide 1.0 mg weekly was 9.8%, and 85.7% of patients achieved at least 5% weight loss.
“In our study, the total body weight loss after 6 months of semaglutide, 1.0 mg, weekly subcutaneous injection, was 9.8% with 85.7% of the patients achieving a weight loss of ≥5%.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataAgent-specific total body weight loss was 7.3% (IQR 3.1-10.3) for liraglutide and 9.8% (IQR 8.2-13.0) for semaglutide, with a P value <0.05.
“Agent-specific total body weight loss was 7.3% (3.1, 10.3) for patients with liraglutide (n=29) and 9.8% (8.2, 13.0) for patients with semaglutide (n=21, P value <0.05).”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
PremisecitationThe role of GLP1-RAs in treating weight regain after bariatric surgery is still not defined.
“Their role in the treatment of weight regain after bariatric surgery remains to be defined.”
Quote in the paperSubstantial claim0 of 10 sources checked- cites [9] Rothkopf MM, Bilof ML, Haverstick LP, Nusbaum MJ. Synergistic weight loss and diabetes resolution with exenatide administration after laparoscopic gastric banding. Surg Obes Relat Dis. 2009;5(1):128–31. source
Not checked in the free run.
- cites [10] Pajecki D, Halpern A, Cercato C, Mancini M, de Cleva R, Santo MA. Tratamento de curto prazo com liraglutide no reganho de peso após cirurgia bariátrica. Rev Colégio Bras Cir. 2013;40(3):191–5. source
Not checked in the free run.
- cites [11] Gorgojo-Martínez JJ, Feo-Ortega G, Serrano-Moreno C. Effectiveness and tolerability of liraglutide in patients with type 2 diabetes mellitus and obesity after bariatric surgery. Surg Obes Relat Dis. 2016;12(10):1856–63. source
Not checked in the free run.
- cites [12] Creange C, Lin E, Ren-Fielding C, Lofton H. Use of liraglutide for weight loss in patients with prior bariatric surgery. Surg Obes Relat Dis. 2016;12(7):S157.
Not checked in the free run.
- cites [13] Rye P, Modi R, Cawsey S, Sharma AM. Efficacy of high-dose liraglutide as an adjunct for weight loss in patients with prior bariatric surgery. Obes Surg. 2018;28(11):3553–8. source
Not checked in the free run.
- cites [14] Wharton S, Kuk JL, Luszczynski M, et al. Liraglutide 3.0 mg for the management of insufficient weight loss or excessive weight regain post‐bariatric surgery. Clin Obes. 2019;9(4):e12323. source
Not checked in the free run.
- cites [15] Suliman M, Buckley A, Al Tikriti A, Tan T, le Roux CW, Lessan N, Barakat M. Routine clinical use of liraglutide 3 mg for the treatment of obesity: outcomes in non-surgical and bariatric surgery patients. Diabetes Obes Metab. 2019;21(6):1498–501. source
Not checked in the free run.
- cites [16] Bretault M, Carette C, Zaharia R, Vychnevskaia K, Bouillot JL, Czernichow S, Raffin-Sanson ML. Liraglutide 3 mg as a weight-loss strategy after failed bariatric surgery in a patient with hypothalamic obesity following craniopharyngioma. Diabetes Metab. 2020;46(6):514–5. source
Not checked in the free run.
- cites [17] Rubio MA, Ramos-Leví AM. Initial experience with alternate-day liraglutide for weight regain following bariatric surgery. Obes Surg. 2021;31(9):4216–8. source
Not checked in the free run.
- cites [18] Horber FF, Steffen R. Reversal of long-term weight regain after Roux-en-Y gastric bypass using liraglutide or surgical revision. A Prospective Study. Obes Surg. 2021;31(1):93–100. source
Not checked in the free run.
- Rests on an assumption: No established standard treatment exists for weight regain following bariatric surgery.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe safety profile of liraglutide and semaglutide is well documented, with gastrointestinal side effects that are usually transient and mild to moderate.
“The efficacy and safety profile of the GLP1-RAs liraglutide and semaglutide are well-documented, with an average body weight loss of up to 15%, usually transient mild to moderate gastrointestinal side effects, and cardiorenal benefits [6–8].”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [6] Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JFE, Nauck MA, Nissen SE, Pocock S, Poulter NR, Ravn LS, Steinberg WM, Stockner M, Zinman B, Bergenstal RM, Buse JB. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375(4):311–22. source
Not checked in the free run.
- cites [7] Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jódar E, Leiter LA, Lingvay I, Rosenstock J, Seufert J, Warren ML, Woo V, Hansen O, Holst AG, Pettersson J, Vilsbøll T. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375(19):1834–44. source
Not checked in the free run.
- cites [8] Kristensen SL, Rørth R, Jhund PS, Docherty KF, Sattar N, Preiss D, Køber L, Petrie MC, McMurray JJV. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet Diabetes Endocrinol. 2019;7(10):776–85. source
Not checked in the free run.
May combine two claims.
PremisecitationMost reports on GLP1-RA efficacy in patients with weight regain after bariatric surgery are limited to liraglutide and come from observational studies or case reports.
“Reports on the efficacy of GLP1-RAs in patients with weight regain after bariatric surgery are mostly limited to liraglutide in observational studies or case reports [9–20].”
Quote in the paperSubstantial claim0 of 10 sources checked- cites [9] Rothkopf MM, Bilof ML, Haverstick LP, Nusbaum MJ. Synergistic weight loss and diabetes resolution with exenatide administration after laparoscopic gastric banding. Surg Obes Relat Dis. 2009;5(1):128–31. source
Not checked in the free run.
- cites [10] Pajecki D, Halpern A, Cercato C, Mancini M, de Cleva R, Santo MA. Tratamento de curto prazo com liraglutide no reganho de peso após cirurgia bariátrica. Rev Colégio Bras Cir. 2013;40(3):191–5. source
Not checked in the free run.
- cites [11] Gorgojo-Martínez JJ, Feo-Ortega G, Serrano-Moreno C. Effectiveness and tolerability of liraglutide in patients with type 2 diabetes mellitus and obesity after bariatric surgery. Surg Obes Relat Dis. 2016;12(10):1856–63. source
Not checked in the free run.
- cites [12] Creange C, Lin E, Ren-Fielding C, Lofton H. Use of liraglutide for weight loss in patients with prior bariatric surgery. Surg Obes Relat Dis. 2016;12(7):S157.
Not checked in the free run.
- cites [13] Rye P, Modi R, Cawsey S, Sharma AM. Efficacy of high-dose liraglutide as an adjunct for weight loss in patients with prior bariatric surgery. Obes Surg. 2018;28(11):3553–8. source
Not checked in the free run.
- cites [14] Wharton S, Kuk JL, Luszczynski M, et al. Liraglutide 3.0 mg for the management of insufficient weight loss or excessive weight regain post‐bariatric surgery. Clin Obes. 2019;9(4):e12323. source
Not checked in the free run.
- cites [15] Suliman M, Buckley A, Al Tikriti A, Tan T, le Roux CW, Lessan N, Barakat M. Routine clinical use of liraglutide 3 mg for the treatment of obesity: outcomes in non-surgical and bariatric surgery patients. Diabetes Obes Metab. 2019;21(6):1498–501. source
Not checked in the free run.
- cites [16] Bretault M, Carette C, Zaharia R, Vychnevskaia K, Bouillot JL, Czernichow S, Raffin-Sanson ML. Liraglutide 3 mg as a weight-loss strategy after failed bariatric surgery in a patient with hypothalamic obesity following craniopharyngioma. Diabetes Metab. 2020;46(6):514–5. source
Not checked in the free run.
- cites [17] Rubio MA, Ramos-Leví AM. Initial experience with alternate-day liraglutide for weight regain following bariatric surgery. Obes Surg. 2021;31(9):4216–8. source
Not checked in the free run.
- cites [18] Horber FF, Steffen R. Reversal of long-term weight regain after Roux-en-Y gastric bypass using liraglutide or surgical revision. A Prospective Study. Obes Surg. 2021;31(1):93–100. source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationDepending on the definition used, significant weight regain after bariatric surgery affects between 16% and 37% of patients.
“between one to two in five patients (16–37%) experience significant weight regain”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [2] Voorwinde V, Steenhuis IHM, Janssen IMC, Monpellier VM, van Stralen MM. Definitions of long-term weight regain and their associations with clinical outcomes. Obes Surg. 2020;30(2):527–36. source
Not checked in the free run.
- cites [3] Arterburn DE, Telem DA, Kushner RF, Courcoulas AP. Benefits and risks of bariatric surgery in adults: a review. JAMA. 2020;324(9):879. source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningA higher proportion of self-payers among patients using semaglutide versus liraglutide (100% and 55.2%, respectively) could have positively influenced the weight outcome for semaglutide.
“The higher proportion of self-payers among patients using semaglutide vs liraglutide (100 and 55.2%, respectively) could have positively influenced the weight outcome for semaglutide”
Quote in the paperNot a substantial claim- Rests on an assumption: Patients who pay for their own treatment tend to adhere better to it.
May combine two claims.
PremisecitationBoth GLP-1 and peptide YY are known to reduce food intake by stimulating satiety and decreasing appetite, which most likely plays a central role in the weight loss effect of bariatric surgery.
“Both hormones are known to reduce food intake by stimulating satiety and decreasing appetite, which most likely plays a central role for the weight loss effect of bariatric surgery [34].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [34] Papamargaritis D, le Roux CW. Do gut hormones contribute to weight loss and glycaemic outcomes after bariatric surgery? Nutrients. 2021;13(3):762. source
Not checked in the free run.
May combine two claims.
PremisecitationLautenbach et al.'s retrospective study reported mean weight loss of 10.3% and 85% achieving at least 5% weight loss after 6 months of semaglutide 0.5 mg weekly.
“In the retrospective study of Lautenbach et al., a mean weight loss of 10.3% with 85% of patients achieving a weight loss of ≥5% after 6 months GLP1-RA therapy was reported with semaglutide, 0.5 mg, weekly subcutaneous injection.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataThe results indicate that both GLP1-RAs can be used safely to produce a clinically meaningful loss of about two-thirds of the weight regained after bariatric surgery.
“Overall, our findings support the safe use of both GLP1-RAs to achieve a clinically significant weight loss of approximately two-thirds of the weight regained after bariatric surgery.”
Quote in the paperSubstantial claim- Rests on an assumption: No established standard treatment exists for weight regain following bariatric surgery.
- Rests on an assumption: The weight loss observed after 6 months of GLP1-RA therapy is attributable to the GLP1-RA treatment rather than to other factors.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenApproval for the study was granted by the regional ethics committee.
“The study was approved by the regional ethics committee.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
InterpretationreasoningBecause the centre provides care within the obligatory healthcare insurance framework, the patients are considered representative of the population of patients with obesity who have undergone bariatric surgery in Switzerland.
“The centre provides medical care within the framework of the obligatory healthcare insurance, and the patients are therefore to be considered representative of the population of patients with obesity having undergone bariatric surgery in Switzerland.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenAll patients included in the study had provided written informed general consent.
“A written informed general consent was present for all patients included in the study.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationSome studies indicate that the hormonal changes after bariatric surgery might wane with time, which may be associated with the development of weight regain.
“Some studies indicate that the observed hormonal changes after bariatric surgery might wane with time [36], which may be associated with the development of weight regain.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [36] Lampropoulos C, Alexandrides T, Tsochatzis S, Kehagias D, Kehagias I. Are the changes in gastrointestinal hormone secretion necessary for the success of bariatric surgery? A Critical Review of the Literature. Obes Surg. 2021;31(10):4575–84. source
Not checked in the free run.
May combine two claims.
Study design and conductown dataOf 108 patients identified, 50 were available for analysis after exclusions: 11 lacked informed consent, 11 never initiated treatment, and 36 had no 6-month follow-up data.
“Of the 108 patients identified, 11 had not provided informed general consent, and 11 patients ended up never initiating treatment. Of the remaining 86 patients, 36 did not have 6 months follow-up data available leaving 50 patients (82% female) available for analysis”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
PremisecitationPrevious studies have shown that GLP1-RAs tend to induce less weight loss in patients with type 2 diabetes than in those without.
“previous studies have shown that GLP1-RAs tend to induce less weight loss in patients with than without T2D [29, 30, 32, 33]”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [29] Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, Lau DCW, le Roux CW, Violante Ortiz R, Jensen CB, Wilding JPH. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med. 2015;373(1):11–22. source
Not checked in the free run.
- cites [30] Davies MJ, Bergenstal R, Bode B, Kushner RF, Lewin A, Skjøth TV, Andreasen AH, Jensen CB, DeFronzo RA, for the NN8022-1922 Study Group. Efficacy of liraglutide for weight loss among patients with type 2 diabetes: the SCALE diabetes randomized clinical trial. JAMA. 2015;314(7):687. source
Not checked in the free run.
- cites [32] Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989–1002. source
Not checked in the free run.
- cites [33] Davies M, Færch L, Jeppesen OK, Pakseresht A, Pedersen SD, Perreault L, Rosenstock J, Shimomura I, Viljoen A, Wadden TA, Lingvay I. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. The Lancet. 2021;397(10278):971–84. source
Not checked in the free run.
May combine two claims.
Interpretationown dataThe results of this retrospective observational study support the use of both liraglutide and semaglutide for the treatment of weight regain after bariatric surgery.
“the results from the present retrospective observational study support the use of both liraglutide and semaglutide for the treatment of weight regain after bariatric surgery”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S2 (checkable).
PremisecitationA clear consensus on what constitutes weight regain has not yet been defined.
“A clear consensus of what constitutes weight regain has not yet been defined [38, 39].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [38] Nedelcu M, Khwaja HA, Rogula TG. Weight regain after bariatric surgery—how should it be defined? Surg Obes Relat Dis. 2016;12(5):1129–30. source
Not checked in the free run.
- cites [39] Lauti M, Kularatna M, Hill AG, MacCormick AD. Weight regain following sleeve gastrectomy—a systematic review. Obes Surg. 2016;26(6):1326–34. source
Not checked in the free run.
May combine two claims.
Interpretationown dataPatients who completed 6 months of GLP1-RA treatment demonstrated a considerable weight loss effect, highlighting that GLP1-RA has the potential to offer substantial benefits to a considerable proportion of patients with weight regain after bariatric surgery, if available.
“the patients that completed 6 months of treatment with GLP1-RA demonstrated a considerable weight loss effect and highlight that GLP1-RA has the potential to offer substantial benefits to a considerable proportion of patients with weight regain after bariatric surgery, if available.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Premisenone givenTo the best of the authors' knowledge, this is the first observational study of GLP1-RAs including both liraglutide and semaglutide in the treatment of weight regain after bariatric surgery.
“To the best of our knowledge, this is the first observational study of GLP1-RAs including both liraglutide and semaglutide in the treatment of weight regain after bariatric surgery.”
Quote in the paperNot a substantial claimMay combine two claims.
InterpretationreasoningThe lack of a significant difference is most likely due to the small number of patients with type 2 diabetes (n=9), of whom only two (22.2%) were treated with insulin.
“This is most likely due to the small number of patients with T2D (n=9) of which only two (22.2%) were treated with insulin.”
Quote in the paperSubstantial claim- Rests on an assumption: Insulin promotes anabolism, and its use commonly leads to weight gain.
The paper relies on this without support.
No established standard treatment exists for weight regain following bariatric surgery.
“An effective standard therapy for weight regain after bariatric surgery has not been established.”
The paper relies on this without support.
The weight loss observed after 6 months of GLP1-RA therapy is attributable to the GLP1-RA treatment rather than to other factors.
“Overall, our findings support the safe use of both GLP1-RAs to achieve a clinically significant weight loss of approximately two-thirds of the weight regained after bariatric surgery.”
The paper relies on this without support.
Patients who pay for their own treatment tend to adhere better to it.
“since self-payer status tends to be associated with better adherence to treatment.”
The paper relies on this without support.
Insulin promotes anabolism, and its use commonly leads to weight gain.
“Insulin is an anabolic hormone and treatment is usually associated with weight gain, thus counteracting the weight loss effect of concomitant treatment with GLP1-RA.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Results from studies enrolling patients with previous bariatric surgery are in line with those including surgically naïve individuals.
“Results from studies enrolling patients with previous bariatric surgery are in line with those including surgically naïve individuals64,69,72”
From Incretin-based therapies for the treatment of obesity-related diseases (2024) · cites this paper as [69]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Adverse events were not exclusively gastrointestinal
MinorThe text describes the reported adverse events as gastrointestinal, but Table 2 also lists headache, dizziness, and an injection-site reaction.
“The reported adverse events when implementing GLP1-RAs in this patient population were of gastrointestinal nature, mild and transient.”
“| Headache | 1 (2.0) | | Dizziness | 1 (2.0) | | Injection site reaction | 1 (2.0) |”
The citation lists haven’t been fetched yet
References 37 · Cited by 161
Research works printed but not linked: 1
- Creange C, Lin E, Ren-Fielding C, Lofton H. Use of liraglutide for weight loss in patients with prior bariatric surgery. Surg Obes Relat Dis. 2016;12(7):S157.
- Authors
- Jensen, A. B., Renström, F., Aczél, S., Folie, P., Biraima-Steinemann, M., Beuschlein, F., & Bilz, S.
- Affiliations
- Kantonsspital St. Gallen (CH)
- University of Zurich (CH)
- Corresponding author
- Jensen, Anders Boisen
- Venue
- Obesity Surgery
- Published
- 2023-02-11
- Volume
- 33
- Issue
- 4
- Pages
- 1017-1025
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- PMC
- PMC9918402
- OpenAlex
- W4320032741
- Cited by
- 161
- References
- 37
- Citations by year
- 2026: 33 · 2025: 59 · 2024: 54 · 2023: 15
- FWCI
- 43.14
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Obesity Surgery (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Keywords
- GLP-1 receptor agonists
- MeSH terms
- Glucagon-Like Peptide-1 Receptor, Liraglutide, Semaglutide, Diabetes Mellitus, Type 2, Female, Humans, Hypoglycemic Agents, Male, Obesity, Morbid, Weight Gain, Bariatric Surgery
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-05.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-05.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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