Are Anti-Obesity Medications Safe for GI Patients?

This transcript has been edited for clarity. 

Hi everyone. My name is Octavia Pickett-Blakely. I'm a gastroenterologist in Philadelphia, Pennsylvania. Today, we're going to talk about utilizing anti-obesity medications in patients with gastrointestinal conditions. 

With the increased utilization of GLP-1 receptor agonists, such as semaglutide or liraglutide, the question often arises as to whether these medications are safe for patients with underlying GI conditions.

Let's take an example of a patient with Crohn's disease. We know that Crohn's disease is a chronic inflammatory condition, and steroids are often used to induce remission. Steroids are associated with weight gain, and in some instances, patients end up with a tremendous amount of excess body weight in the setting of trying to treat their disease.

The utilization of medications for obesity, specifically GLP-1 receptor agonists, is safe in patients with inflammatory bowel disease, provided their disease is in remission. Consultation with a gastroenterologist to discuss whether the patient is in remission and the appropriate timing of medication initiation will result in the best outcome for the patient.

Similarly, in patients who may have conditions such as gastroparesis or reduced gastric emptying, the utilization of medications such as GLP-1 receptor agonists may not be ideal. Other anti-obesity medications, such as phentermine/topiramate or naltrexone/bupropion, may be more appropriate in that setting. 

It's important to have an understanding of the patient's underlying gastrointestinal disease as well as the side effect profile of the anti-obesity medication you are considering using when making that decision.

As always, feel free to consult your gastroenterologist.