Kenneth Blum^1,3*, Panayotis K Thanos^1,2, Kai Uwe Lewandrowski³, Albert Pinhasov¹, Morgan P Lorio⁴, Alireza Sharafshah⁵, Edward J Modestino⁶, Mark S Gold⁵, Alexander PL Lewandrowski⁸, Kavya Mohankumar⁹, Abdalla Bowirrat², Debasis Bagchi¹⁰ and Rajendra D Badgaiyan¹¹

¹Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel, Israel
^2,7Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, and Department of Psychology, University at Buffalo, Buffalo, NY, USA Adelson school of medicine and molecular biology, Ariel University
³Center for Advanced Spine Care of Southern Arizona, Tucson AZ, USA
⁴Advanced Orthopedics, Altamonte Springs, FL, USA
⁵Cellular and Molecular Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
⁶Brain and Behavior Laboratory, Department of Psychology, Curry College, Milton, MA, USA
⁷Department of Psychiatry, Washington University in St. Louis Euclid Ave, St. Louis, MO, USA
⁸Department of Biological Sciences, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, USA
⁹Division of Genomic Medicine, The Blum Institute of Neurogenetics and Behavior, LLC., Austin, ,TX., USA
¹⁰Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Texas Southern University, Houston, USA
¹¹Department of Psychiatry, Texas Tech University Health Sciences, School of Medicine, Midland, TX, USA

*Corresponding Author: Kenneth Blum, Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel, Israel.

Received: May 16, 2025; Published: May 28, 2025

Abstract

By 2030, over 2.16 billion adults globally are projected to be overweight, with 1.12 billion classified as obese. Glucagon-like peptide-1 (GLP-1) receptor agonists have recently shown 15-20% weight loss in adults with obesity, outcomes comparable to those achieved through bariatric surgery. However, meta-analyses of clinical trials indicate bariatric surgery still yields greater reductions in weight and BMI, with similar improvements in glycemic control. Although GLP-1 agonists have gained popularity in treating obesity and metabolic disorders, concerns are emerging regarding adverse effects, including gastrointestinal distress, pancreatitis, and potential neuropsychiatric risks such as depression. In particular, GLP-1 agonists may attenuate dopamine function, raising concerns for individuals with Reward Deficiency Syndrome (RDS), a genetically influenced condition linked to compulsive eating and addiction. Our laboratory examined genetic and psychosocial data from bariatric surgery patients and found that 76% had high Genetic Addiction Risk Severity (GARS) scores, suggesting hypodopaminergia. Certain gene variants, such as DRD2, DRD4, and OPRM1, correlated with weight loss outcomes and addiction-related traits. Moreover, addiction transfer, where patients replace food addiction with other compulsive behaviors post-surgery, was observed, likely due to shared dopaminergic pathways. These findings support the need for a precision medicine approach. Routine genetic screening may help identify patients at risk of poor outcomes or addiction transfer and guide the judicious use of GLP-1 agonists. Caution is warranted when prescribing these agents to individuals with hypodopaminergic traits.

Keywords: Glp1 Agonists; Weight Loss; Bariatric Surgery; Hypodopaminergia; Adverse Effects; Genetic Testing

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Citation

Citation: Kenneth Blum., et al. “Would it be Medically Smart to Offer GLP1 Agonists to Patients Instead of Bariatric Surgery: Looking into the Mirror for Evidence?".Acta Scientific Neurology 8.6 (2025): 22-32.

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Copyright: © 2025 Kenneth Blum., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.