Do you recommend restarting a GLP-1RA after bariatric surgery if the patient tolerated it before the surgery?

While there are no clear recommendations on whether/when to resume GLP-1 RA after bariatric surgery, current 2025 guideline statements (ASMBS, ADA, AACE, Obesity Society) and expert consensus documents suggest the following approach:

1. Hold GLP-1RA in the acute perioperative period.
   • For daily-dosed ...

This is a great question. I usually would not recommend the medication for two major reasons.

1. Post bariatric surgery, the increased small intestine nutrient delivery leads to a physiologic increase in GLP and lesser extent GIP, which has the same mechanism of action as the GLP-1RA (Casimiro et al., ...