For post-operative patients with 25% weight regain, which option is listed?

• A. Lifestyle intervention + Liraglutide OR phentermine/topiramate
• B. Metformin
• C. Orlistat
• D. Phentermine/topiramate only

Answer: (A)

When weight regain after bariatric surgery occurs, the strongest approach is to intensify lifestyle efforts while adding medication to support the extra loss. The best option pairs structured lifestyle modification with pharmacotherapy, using either liraglutide or the phentermine/topiramate combination. Liraglutide helps reduce appetite and slow emptying, aiding lower calorie intake, while phentermine/topiramate combines appetite suppression with signals that promote satiety, both leading to meaningful additional weight loss when paired with ongoing diet and activity changes. This combined strategy tends to yield better, more durable results than meds used alone or with less evidence for this setting. Metformin isn’t primarily an obesity treatment, orlistat tends to produce smaller, less durable losses and can have tolerability issues, and phentermine/topiramate alone misses the added benefit of reinforced lifestyle changes.