Body Composition Changes After Bariatric Surgery or Treatment With GLP-1 Receptor Agonists

How are bariatric surgery and treatment with newer glucagon-like peptide-1 receptor agonists (GLP1-RAs; semaglutide and tirzepatide) associated with body composition in a clinical setting?In this single-center cohort study of 3066 patients, both bariatric surgery and GLP-1RA treatment were associated with substantial fat mass loss, modest fat-free mass loss, and increased fat-free mass to fat mass ratio over 24 months. All these changes were more evident among patients who underwent bariatric surgery.This study suggests that both bariatric surgery and GLP-1RAs are associated with effective reduction of fat mass over 2 years, with bariatric surgery associated with a more favorable fat-free mass to fat mass ratio than GLP-1RAs due to greater fat mass loss.

Corresponding Authors: Jason M. Samuels, MD, Department of Surgery, Vanderbilt University Medical Center, 1121 21st Ave S, Nashville, TN 37232 (jason.m.samuels@vumc.org); and Danxia Yu, PhD, Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, 2525 West End Ave, Nashville, TN 37203 (danxia.yu@vumc.org).

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