Evidence mapPaperPMID 41717546Full record

ReviewFrontiers in endocrinology2026

The effect of combining surgical or endoscopic bariatric interventions with anti-obesity medication or probiotics on weight loss: a narrative review.

J R de Waal, M Nieuwdorp, V E A Gerdes

Abstract readReview
In one paragraph

Review in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

J R de WaalSection of Vascular Medicine, Department of Internal Medicine, Amsterdam University Medical Centre, Amsterdam, Netherlands.
M NieuwdorpSection of Vascular Medicine, Department of Internal Medicine, Amsterdam University Medical Centre, Amsterdam, Netherlands.
V E A GerdesSection of Vascular Medicine, Department of Internal Medicine, Amsterdam University Medical Centre, Amsterdam, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Obesity is a multifactorial chronic disease associated with multiple health complications. While bariatric surgery and endoscopic sleeve gastroplasty (ESG) are effective treatments for severe obesity, patients may still experience challenges such as weight regain or inadequate weight loss. As a result, combining these interventions with adjunctive treatment such as anti-obesity medication (AOM) or probiotics has become an area of increasing clinical interest. This narrative review summarizes the current evidence on the effect of combining surgical or endoscopic bariatric interventions with AOM or probiotics. Available studies suggest that the combination of GLP-1 receptor agonists (GLP-1 RA) and ESG leads to more weight loss than ESG alone. In contrast, non-GLP-1 RA medication show less consistent benefits and generally lower weight loss. GLP-1 RAs and tirzepatide show clinically relevant short term weight loss in patients with weight regain or insufficient weight loss after bariatric surgery. Other AOM, such as topiramate, phentermine, orlistat and bupropion/naltrexone result in more modest and variable outcomes. Relatively small studies on probiotics and prebiotics in combination with bariatric surgery do not find a statistically significant difference in weight loss between probiotic and placebo groups. Although small benefits in waist circumference, liver enzymes and vitamin uptake are mentioned, the effects are modest and not consistent across studies. In conclusion, combining AOM, especially GLP-1 RAs, with surgical or endoscopic obesity treatments appears to enhance weight loss in patients with suboptimal outcomes. These findings support the use of AOM as an adjunct to bariatric procedures. In addition, additional adequately powered studies are needed to evaluate the role for probiotics in improving weight loss after bariatric surgery. Future research should focus on long-term outcomes, side effects, and identifying patient subgroups that may benefit most from combined therapy.

Indexed as

Anti-Obesity AgentsBariatric SurgeryObesityProbioticsWeight LossCombined Modality TherapyHumansAnti-Obesity Agentsanti-obesity medicationbariatric surgeryendoscopic sleeve gastroplastygastric sleeveinsufficient weight lossprobioticsRoux-en-Y gastric bypassweight regain

Identifiers

PMID41717546
PMCPMC12913063

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.