A Review of Weight Loss With Glucagon-Like Peptide 1 Agonist Therapy: Is There a Role for Its Preoperative Use in Gynecology?

Abstract

Glucagon-like peptide 1 (GLP-1) agonist use for weight loss has skyrocketed. Dramatic weight loss with GLP-1 agonist use is frequently portrayed on social media. Contrastingly, such extensive weight loss has not been reported in published randomized controlled trials on weight loss after GLP-1 agonist use. However, these medications have been used for perioperative optimization in bariatric and orthopedic surgery. Therefore, there may be some applications in other surgical fields, particularly for reducing weight prior to surgery. Rising rates of obesity warrant the evaluation of preoperative GLP-1 agonists in gynecology to reduce surgery morbidity. We reviewed clinical trial-level data on GLP-1 agonist-related weight loss in hopes of completing a cost-effectiveness analysis. However, our review demonstrated that there are no current publications in patients undergoing benign hysterectomy to complete a robust cost-effectiveness analysis. Despite this, this review revealed important information about the use of GLP-1 agonists. It informs both clinicians and patients about realistic expectations for weight loss and how these therapies may be considered in a surgical framework. The goal of this narrative review is to report expected weight loss after these medications, frame the current data into a clinical context in gynecology, and demonstrate the urgent need to scientifically evaluate the role of preoperative GLP-1 agonist use in patients undergoing hysterectomy.