Patients experience with preoperative use of anti-obesity medications and associations with bariatric surgery expectations

Few studies have investigated the use of anti-obesity medications (AOMs) before bariatric surgery and how prior use impacts patients’ goals and expectations for surgery. This study investigated associations between patients’ experiences with AOMs and weight loss expectations before bariatric surgery. Single tertiary university hospital. Patients were electronically surveyed with a 31-item questionnaire via email or the patient portal with a primary predictor variable of AOMs presurgery. Outcomes included degree of weight loss and weight regain and motivation for seeking surgery. A total of 346 persons were invited to complete the survey; 112 surveys (32.4%) were completed, with 7 excluded because of not answering the AOM question. 73% reported AOM use. Among those who took AOMs before seeking bariatric surgery, average weight loss was 13 kg (SD 10) corresponding to a 4.4-kg/m2 decrease in BMI. Of past AOM recipients, 87% reported weight regain on stopping AOMs. Average weight regain was 18 kg (SD 13; 126% increase). Patients reported improved longevity and quality of life as motivation for seeking surgery, with AOM use history having no effect. Subjects reported an average weight loss goal of 65.8 kg (39% of baseline weight) from bariatric surgery. AOMs were commonly used in those seeking bariatric surgery, but motivation for surgery did not differ by AOM use history. Motivations were most often related to goals for better overall health. •This is a single-center survey study of patients seeking bariatric surgery.•More than 70% of respondents reported previously using anti-obesity medications.•Patients continue to overestimate their predicted weight loss with bariatric surgery.•Seventy-three percent reported interest in using medications to enhance weight loss after surgery.