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Ozempic after Gastric Bypass: Pros, Cons, and Can You Take It?

Craig Primack, MD, FACP, FAAP, FOMA

Reviewed by Craig Primack, MD, FACP, FAAP, FOMA

Written by Vanessa Gibbs

Published 06/10/2024

Updated 06/27/2024

Gastric bypass surgery can help you lose significant amounts of weight. But it’s common to regain some of this weight or hit a weight loss plateau.

So, can you take Ozempic® after gastric bypass surgery to help you keep the weight off?

Research suggests that it is safe for most people to take GLP-1 agonists after a gastric bypass. This class of drugs includes semaglutide, the active ingredient in Ozempic. While Ozempic is only FDA-approved to treat type 2 diabetes, it is sometimes prescribed off-label to treat obesity.

Read on to learn about Ozempic after gastric bypass, whether you can take Ozempic after gastric sleeve surgery, and alternative weight loss medications that may be safe to take after surgery.

Yes, it’s safe for most people to take Ozempic after gastric bypass surgery — aka Roux-en-Y gastric bypass — but it’s important to talk to your surgeon or another healthcare provider first.

Research on semaglutide, the active ingredient in Ozempic, indicates that people can safely lose two-thirds of the weight they regain after bariatric surgery with GLP-1 medications.

That’s because Ozempic can:

  • Help you feel fuller

  • Reduce your food cravings

  • Help you get back in control of your eating habits

More research is needed, but here’s what we know so far.

Ozempic May Help You Lose Weight You've Regained

About 20 to 25 percent of people experience insufficient weight loss or regain some of the weight they’ve lost after bariatric surgery — which is a term for any kind of weight loss surgery, including gastric bypass.

The research we have on weight loss medications after gastric bypass surgery is promising though.

One small 2022 study looked at 44 people without type 2 diabetes who underwent bariatric surgery. In this study, participants had either a gastric bypass or a gastric sleeve.

Study participants experienced insufficient weight loss or weight regain after surgery.

They started taking a once-a-week 0.5 milligram (mg) dose of semaglutide — the active ingredient in Ozempic and Wegovy® — about five years, give or take, after surgery.

Participants had regained an average of 12 percent of their body weight (starting from their lowest post-surgery body weight).

While taking semaglutide, participants lost six percent of their body weight after three months and about 10 percent after six months.

Ozempic (Semaglutide) May Be More Effective than Other Weight Loss Drugs

There are several GLP-1 medications used to treat type 2 diabetes and obesity. Research has shown that semaglutide (the active ingredient in Ozempic) may be more effective than other options for treating weight gain after weight loss surgery.

A 2023 study compared semaglutide to liraglutide — the active ingredient in Victoza® and Saxenda®.

The study included 207 participants who had regained weight after either gastric bypass, gastric sleeve, or gastric banding surgeries.

Participants took either 1mg of semaglutide weekly or 3mg of liraglutide daily.

After a year of treatment, participants taking semaglutide lost an average of almost 13 percent of their body weight, whereas participants taking liraglutide lost an average of almost nine percent.

When to Take Ozempic After a Gastric Bypass

The best time to take Ozempic after bariatric surgery will vary from person to person, so it’s important to consult a healthcare provider before starting treatment.

Research shows that taking weight loss medication when you hit a weight loss plateau after surgery — instead of waiting until you regain weight — could help you lose more weight in the long run.

Taking weight loss medication before surgery could be more effective than taking it after, and may even help you lose more weight overall. More research is needed to know for sure.

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Generally, it’s okay for most people to take semaglutide (Ozempic, Wegovy) after a gastric sleeve or sleeve gastrectomy. Semaglutide can help you lose weight if you’ve regained weight after the surgery or if the surgery wasn’t as successful as you hoped.

Several studies support the use of semaglutide after bariatric surgery.

For example, the 2022 study we mentioned above looked into the use of semaglutide after gastric sleeve and gastric bypass procedures. There weren’t any significant weight loss differences between the two types of surgery and semaglutide helped participants lose weight after both surgeries.

Ozempic is one of several treatment options for people looking to lose weight after a bariatric procedure.

There are other injectable GLP-1s, including:

  • Wegovy (semaglutide)

  • Mounjaro® (tirzepatide)

  • Zepbound® (tirzepatide)

  • Victoza (liraglutide)

  • Saxenda (liraglutide)

  • Compounded semaglutide

There are also non-injectable weight loss drugs, including:

Curious how these drugs compare? We put Ozempic vs. Wegovy head-to-head to get you started.

Semaglutide drugs may lead to greater weight loss than liraglutide drugs, but liraglutide can still help with weight loss.

A randomized clinical trial compared a 3mg daily liraglutide injection to a placebo in 70 participants who had experienced 20 percent or less weight loss after gastric bypass or gastric sleeve surgery.

After 24 weeks of treatment, participants taking liraglutide lost an average of almost nine percent of their body weight. Those taking the placebo lost an average of about 0.5 percent.

There were no serious side effects for those taking liraglutide.

While research into the safety and efficacy of weight loss medications beyond semaglutide and liraglutide is limited, the available data suggests that the following ingredients could help you lose weight after weight loss surgery:

  • Semaglutide

  • Liraglutide

  • Phentermine

  • Topiramate

  • Orlistat

So far, there are no studies on tirzepatide, naltrexone, or bupropion on people after bariatric surgery.

How to Choose the Right Weight Loss Medication After a Bariatric Procedure

A healthcare provider can walk you through the pros and cons of each medication, whether it’s safe for you to take post-surgery, and which would be most suitable for you.

They’ll take any medical conditions you might have and your weight loss results after surgery into account.

And, just so you know, they may recommend lifestyle changes alongside medication to help with weight loss and weight management.

These might include:

A gastric bypass can help treat obesity, but it’s not always successful and regaining some of the weight you’ve lost is common. This is where Ozempic can come in to help you lose weight after surgery.

Here’s the TL;DR:

  • Most people can take Ozempic after a gastric bypass. More research is needed, but from what we know so far, semaglutide (Ozempic) appears to be safe and effective for weight loss after a gastric bypass. It can help you continue losing weight or lose some of the weight you’ve regained.

  • You can take Ozempic after other types of weight loss surgery. Studies on semaglutide after weight loss surgery usually include participants who have undergone gastric bypass, gastric sleeve, or gastric banding procedures. Semaglutide appears to help promote weight loss after all types of surgery.

  • Semaglutide may be more effective than other options. There’s not much research comparing weight loss drugs after surgery. But one study found that semaglutide is more effective than liraglutide — although liraglutide could still help you lose weight.

If there’s one thing to know about weight loss, it’s that you’ve got plenty of options.

There are different types of lifestyle adjustments, different types of surgery, and different types of medication — including FDA-approved and off-label medications. A healthcare provider can help find the best treatment plan for you, your body, and your weight loss journey.

To learn more and get expert advice, take our free weight loss assessment.

6 Sources

  1. Jensen, AB, et al. (2023). Efficacy of the glucagon-like peptide-1 receptor agonists liraglutide and semaglutide for the treatment of weight regain after bariatric surgery: a retrospective observational study. https://link.springer.com/article/10.1007/s11695-023-06484-8
  2. Lautenbach, A, et al. (2022). The potential of semaglutide once-weekly in patients without type 2 diabetes with weight regain or insufficient weight loss after bariatric surgery—a retrospective analysis. https://link.springer.com/article/10.1007/s11695-022-06211-9
  3. Lautenbach, A, et al. (2023). Sustained weight loss with semaglutide once weekly in patients without type 2 diabetes and post-bariatric treatment failure. https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/cob.12593
  4. Lucas, E, et al. (2023). Pharmacologic management of weight regain following bariatric surgery. https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.1043595/full
  5. Mok, J, et al. (2023). Safety and Efficacy of Liraglutide, 3.0 mg, Once Daily vs Placebo in Patients With Poor Weight Loss Following Metabolic Surgery. The BARI-OPTIMISE Randomized Clinical Trial. https://jamanetwork.com/journals/jamasurgery/fullarticle/2807724
  6. Murvelashvili, N, et al. (2022). Effectiveness of semaglutide versus liraglutide for treating post-metabolic and bariatric surgery weight recurrence. https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/oby.23736
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