GLP-1 Therapy After Bariatric Surgery in Chinese Patients With Obesity

  • STATUS
    Recruiting
  • End date
    May 1, 2028
  • participants needed
    200
  • sponsor
    China-Japan Friendship Hospital
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Updated on 15 June 2026
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Summary

Obese patients exhibit considerable heterogeneity and complex comorbidities, making long-term effective management challenging with monotherapy. While bariatric surgery remains the most effective weight-loss intervention, postoperative weight regain and metabolic deterioration remain significant concerns. glucagon-like peptide-1 receptor agonists (GLP-1RA) offer distinct advantages for weight loss and metabolic control, and their combination with surgery may produce synergistic effects. This study investigates the efficacy and safety of bariatric surgery combined with adjuvant GLP-1 receptor agonist therapy for Chinese patients with obesity.

Description

Bariatric surgery is guideline-recommended as an effective obesity treatment. Substantial evidence demonstrates its ability to significantly reduce weight, improve comorbidities like type 2 diabetes (T2DM) and dyslipidemia, and lower cardiovascular risk. However, the significant heterogeneity and complex comorbidity profiles among obese patients challenge long-term effective management with single therapeutic approaches. While currently the most effective weight-loss intervention, bariatric surgery requires attention to issues such as postoperative weight regain and metabolic deterioration.

In parallel, glucagon-like peptide-1 receptor agonists (GLP-1RA) have demonstrated significant efficacy in obesity management. Agents like Semaglutide promote weight loss and metabolic improvement through mechanisms including insulin secretion promotion, appetite suppression, delayed gastric emptying, and enhanced satiety. Tirzepatide, as the first approved GLP-1/GIP dual-target agonist, demonstrates superior hypoglycemic and weight loss effects compared to Semaglutide through its synergistic interaction with GLP-1. Mazdutide, the first GLP-1/GCG dual-target agonist to enter phase III clinical trials in China, promotes fatty acid oxidation and energy consumption while acting synergistically with GLP-1's appetite-suppressing effect. It can effectively reduce liver fat content while achieving weight loss.

Given the distinct advantages of both bariatric surgery and GLP-1RA therapy in weight and metabolic control, this study will combine these modalities into a comprehensive treatment strategy. We will compare the long-term safety and effectiveness of different combination regimens for weight management and metabolic improvement in Chinese patients with obesity.

Details
Condition Obesity
Age 18years - 60years
Clinical Study IdentifierNCT07633639
SponsorChina-Japan Friendship Hospital
Last Modified on15 June 2026

Eligibility

 Yes No Not Sure

Inclusion Criteria

Patients undergoing initial laparoscopic sleeve gastrectomy (LSG)
obesity:BMI ≥30 kg/m²
Metabolic comorbidities: Diagnosis of metabolic syndrome or type 2 diabetes mellitus (T2DM) meeting standard criteria
Age range: 18-60 years (inclusive)
Informed consent: Willing participation with documented consent

Exclusion Criteria

Recent GLP-1RA use: Treatment with GLP-1 receptor agonists within 6 months preoperatively
Prior bariatric surgery: History of any metabolic/bariatric surgical procedure
Postoperative complications: Requiring reoperation for severe complications (e.g., hemorrhage, anastomotic leak)
Non-indicated candidates: Patients not meeting standard bariatric surgery indications
Significant comorbidities
1Advanced hepatic/renal dysfunction (Child-Pugh C or eGFR <30
mL/min/1.73m²). 5.2Active malignancy (except non-melanoma skin cancers)
3Autoimmune disorders requiring immunosuppression. 5.4Uncontrolled
psychiatric conditions (e.g., active psychosis, severe depression)
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