The headline trial: BARI-OPTIMISE
BARI-OPTIMISE (Semaglutide for Post-Bariatric Weight Regain)
Mok et al., Lancet Diabetes & Endocrinology, 2024
Semaglutide 2.4 mg weekly produced 8.8 percent mean body-weight reduction versus 0.5 percent for placebo over 16 weeks in adults with weight regain following bariatric surgery. Tolerability and adherence profiles were similar to non-surgical patients.
Trial enrollment criteria
- History of Roux-en-Y gastric bypass, sleeve gastrectomy, gastric bypass or duodenal switch at least 18 months prior
- Documented post-surgical weight nadir followed by weight regain
- Current BMI greater than or equal to 30 (or 27 with comorbidity, FDA labeling)
Does this trial apply to you?
Bariatric surgery history (ICD-10 Z98.84) does not exclude a patient from GLP-1 therapy. The qualifying criterion is current BMI plus comorbidities, regardless of how the patient reached that BMI. Most major payers approve PA for post-bariatric patients under the standard obesity indication.
What to ask your prescriber
- Type and date of prior bariatric surgery
- Documented weight nadir and current weight
- Whether your bariatric surgeon or obesity medicine specialist will co-sign the PA
- Any post-surgical complications (dumping syndrome, nutritional deficiencies) that need consideration
Editorial notes
- Post-bariatric patients sometimes experience more pronounced GI side effects on GLP-1. Slow titration is usually appropriate.
- Continue bariatric multivitamin and B12/iron monitoring; rapid weight loss can mask nutritional deficiencies.
- If the patient is within 12 months of surgery, defer the GLP-1 conversation; the surgical weight loss is still on its natural trajectory.
Clinical trials for Weight regain after bariatric surgery
Or browse the full GLP-1 clinical trials directory, filterable by condition, state and phase.
Take it to your prescriber: PA letter templates
Editable prior-authorization letter templates that cite the registration trial above. Pick the plan your prescriber will submit to, copy the template, fill in the patient-specific findings and have your clinician sign and submit.
Not seeing your plan? The full PA letter librarycovers 20 plans × 10 indications = 200 templates. The appeal letter library handles denials.
Drug profiles
Other GLP-1 conditions
Editorial provenance
Editorial review by John, Editor on 2026-05-23, against BARI-OPTIMISE (Mok et al., Lancet Diabetes & Endocrinology, 2024). We do not yet have a credentialed medical reviewer on staff (actively recruiting). This page summarises public registration-trial data and FDA labeling. It is not clinician-authored medical advice.
Disclaimer
Educational summary of published registration trial data. Not medical advice. Not a substitute for evaluation by a treating clinician. Trial-level results do not guarantee individual outcomes. Discuss eligibility, contraindications, dose adjustments and drug interactions with your prescriber. We do not have a credentialed medical reviewer on staff yet (actively recruiting); the content below is editor-written from public registration-trial publications and FDA labeling, not clinician-authored medical advice.