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How Anti-Obesity Medications Can Help With Surgery > News > Yale Medicine

Wegovy®, Zepbound®, and similar medications continue to gain attention for effectively treating obesity, and now there is discussion—with research underway—about their potential for improving certain surgical outcomes.

The brand-name medications mentioned above belong to a class called GLP-1 (glucagon-like peptide-1) agonists. GLP-1s mimic the actions of the GLP-1 hormone, which is secreted in the gut and sends an “I’m full” signal to the brain after you eat.

GLP-1 medications aren’t new. Ozempic® (generic name: semaglutide) received approval from the U.S. Food and Drug Administration (FDA) to treat type 2 diabetes in 2017. After its weight-loss effects were studied, semaglutide (at a higher dose and sold under the name Wegovy) was approved by the FDA as an anti-obesity medication in 2021, and others have since followed.

Most recently, the FDA approved Wegovy for patients with cardiovascular disease and obesity or overweight after a study showed that those taking the medication had a lower overall risk of major cardiac events, such as heart attack, stroke, or cardiovascular-related death.

Now, some Yale Medicine surgeons believe, based on their ongoing research, that taking anti-obesity medications before and sometimes after total joint replacement and bariatric surgery can be beneficial.

“These medications have been transformative, in terms of expanding the pool of people who can safely undergo joint replacement surgery,” says Daniel Wiznia, MD, a Yale Medicine orthopaedic surgeon and co-director of the Avascular Necrosis Program. “These anti-obesity medications are game-changers; they are changing the way people practice medicine.”

Often, patients who need a total hip or knee replacement must delay surgery until they lose enough weight to meet specific body mass index (BMI) standards. This is important in protecting the patient’s health. “Weight increases a patient’s risk of postoperative complications, including wound-healing problems, stroke, heart attack, blood clots, and infection,” he says.

However, having patients take a GLP-1 medication before surgery, as well as improving their diet, has allowed more patients to reach a safe preoperative BMI, Dr. Wiznia says.

Likewise, John Morton, MD, MPH, medical director of bariatric surgery for the Yale New Haven Health System, says he has found that putting patients on GLP-1s before weight-loss surgery helps them achieve better results.

Still, there are many unknowns, including whether patients will need to stay on anti-obesity medications after surgery and whether insurance will cover the cost of the drugs.

Below, we talk more with Drs. Wiznia and Morton about the use of anti-obesity medications before surgery.

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