morbid obesity requiring bariatric surgery

Obesity research has been transformed by the GLP-1 receptor agonist class (semaglutide, tirzepatide), which achieves 15–22% body weight reduction — approaching surgical outcomes — and reduces cardiovascular events in overweight adults. The pipeline now includes amylin analogs, glucose-dependent insulinotropic polypeptide (GIP) agonists, and oral small molecules targeting appetite regulation.

Active trials investigate next-generation GLP-1 combinations, bimagrumab (anti-ActRII for muscle-sparing weight loss), retatrutide, cagrilintide combinations, and gut microbiome modulators. Trials also study weight regain prevention after GLP-1 discontinuation — an emerging clinical challenge.

Obesity trials typically require a BMI ≥30 or ≥27 with weight-related comorbidities; prior bariatric surgery often excludes participants.