Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026
Effects of Semaglutide on Dumping Syndrome and Reactive Hypoglycemia After Bariatric Surgery: A Systematic Review and Meta-Analysis.
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Eisa Naseem, Barood Omar
Аннотация
BACKGROUND: Dumping syndrome and reactive hypoglycemia are common complications after bariatric surgery, particularly Roux-en-Y gastric bypass (RYGB). Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has emerged as a potential therapeutic option, but evidence regarding its efficacy remains scattered.
OBJECTIVE: This study aims to systematically evaluate the effects of semaglutide on dumping syndrome symptoms and reactive hypoglycemia in post-bariatric surgery patients.
METHODS: We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines. PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to September 2025. Randomized controlled trials and observational studies evaluating semaglutide in post-bariatric surgery patients with dumping syndrome or reactive hypoglycemia were included. Primary outcomes were changes in dumping symptom scores and hypoglycemic episode frequency. Random-effects meta-analyses were performed.
RESULTS: Seven studies (three RCTs, three cohort studies, one case series) with 337 patients were included. Semaglutide significantly improved dumping symptom scores (standardized mean difference [SMD] -1.18; 95% CI -1.64 to -0.72; p < 0.001; I2 = 39%) and reduced hypoglycemic episodes (SMD -0.85; 95% CI -1.22 to -0.48; p < 0.001; I2 = 35%). Quality of life improved significantly (SMD 0.73; 95% CI 0.38-1.08; p < 0.001). Glycemic variability decreased (SMD -0.71; 95% CI -1.08 to -0.34; p < 0.001), as did time in hypoglycemia (SMD -0.62; 95% CI -0.95 to -0.29; p < 0.001). Gastrointestinal adverse events were common but rarely led to treatment discontinuation.
CONCLUSIONS: Semaglutide demonstrates significant efficacy in improving dumping syndrome symptoms and reactive hypoglycemia after bariatric surgery, with an acceptable safety profile. These findings support its consideration as a therapeutic option for these challenging post-bariatric complications.
OBJECTIVE: This study aims to systematically evaluate the effects of semaglutide on dumping syndrome symptoms and reactive hypoglycemia in post-bariatric surgery patients.
METHODS: We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines. PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to September 2025. Randomized controlled trials and observational studies evaluating semaglutide in post-bariatric surgery patients with dumping syndrome or reactive hypoglycemia were included. Primary outcomes were changes in dumping symptom scores and hypoglycemic episode frequency. Random-effects meta-analyses were performed.
RESULTS: Seven studies (three RCTs, three cohort studies, one case series) with 337 patients were included. Semaglutide significantly improved dumping symptom scores (standardized mean difference [SMD] -1.18; 95% CI -1.64 to -0.72; p < 0.001; I2 = 39%) and reduced hypoglycemic episodes (SMD -0.85; 95% CI -1.22 to -0.48; p < 0.001; I2 = 35%). Quality of life improved significantly (SMD 0.73; 95% CI 0.38-1.08; p < 0.001). Glycemic variability decreased (SMD -0.71; 95% CI -1.08 to -0.34; p < 0.001), as did time in hypoglycemia (SMD -0.62; 95% CI -0.95 to -0.29; p < 0.001). Gastrointestinal adverse events were common but rarely led to treatment discontinuation.
CONCLUSIONS: Semaglutide demonstrates significant efficacy in improving dumping syndrome symptoms and reactive hypoglycemia after bariatric surgery, with an acceptable safety profile. These findings support its consideration as a therapeutic option for these challenging post-bariatric complications.