By Lori Solomon

Restarting obesity medications, including glucagon-like peptide-1 (GLP-1) receptor agonists, soon after sleeve gastrectomy (SG) is associated with greater one-year weight loss than surgery alone in adolescents, according to a research letter published online July 22 in

JAMA Surgery.

Dr. Alaina P. Vidmar, from Children's Hospital Los Angeles, and colleagues evaluated the 12-month safety, weight trajectory and eating behavior outcomes associated with early reinitiation of obesity medications following metabolic and bariatric surgery. The analysis included 99 youths ages 7–20 who underwent SG between November 2023 and February 2026.

The researchers found that 53 patients reinitiated obesity medications, with a median time to reinitiation of 1.0 month. Among those reinitiating, most resumed the same preoperative medication class, although postoperative regimens were generally consolidated, with fewer youths requiring multiagent therapy following surgery.

Through six months, both groups experienced similar early postoperative weight loss. However, the early reinitiation group achieved greater mean body mass index (BMI) percentage reduction at 12 months than the SG-only group (−29.3% versus −25.5%), as well as greater excess BMI loss percentage (−53.6% versus −45.7%). Improvements in eating behaviors were significantly greater in the early reinitiation group at 12 months compared with the SG-only group (for example, median hunger Adult Eating Behavior Questionnaire scores, −3.5 versus 0.2). There was no difference between the groups in postoperative complications, including biliary events requiring cholecystectomy, readmissions, emergency department visits and reoperations.

"Bariatric surgery is the most durable and effective treatment for severe obesity, but for youth with severe disease, we need a multimodal approach, which means combining medication and surgery over the lifespan," Vidmar said in a statement.

More information: Alaina P. Vidmar et al, Early Reinitiation of

Obesity Medication After Sleeve Gastrectomy in Youths, JAMA Surgery (2026). DOI: 10.1001/jamasurg.2026.2786

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