Trends in preoperative weight loss modalities among patients receiving body contouring surgery.

BACKGROUND: While pharmacologic weight loss therapies like glucagon-like peptide-1 receptor agonists (GLP-1RAs) have increased in popularity, body contouring patients' utilization of other weight loss modalities remains unclear. OBJECTIVES: This retrospective cohort study examined the weight loss modalities used by body contouring patients and their impacts on procedure choice and surgical outcomes. SETTING: University Hospital, United States. METHODS: The TriNetX Research Network was queried for patients who received abdominoplasties, panniculectomies, thighplasties, and brachioplasties between 2012 and 2024. The incidence and prevalence of weight loss modalities were extracted. Trends in weight loss modality utilization were evaluated by Mann-Kendall test. RESULTS: A total of 27,443 body contouring patients were included. Bariatric surgery (15.86%) was the most prevalent weight loss modality. Bariatric surgery (τ = .87, P < .001), naltrexone (τ = .87, P < .001), phentermine (τ = .82, P = .001), and liraglutide (τ = .78, P = .002) demonstrated the strongest increases in utilization overall. Subgroup analysis demonstrated increasing utilization of semaglutide among GLP-1RA users and increasing utilization of sleeve gastrectomy and gastric bypass among bariatric surgery recipients. Patients utilizing bariatric surgery (95.86% vs 92.62%, P < .001) and phentermine (94.29% vs 92.62%, P = .009) had significantly higher rates of abdominal contouring than non-medical weight loss controls. Bariatric surgery recipients also had lower rates of extremity contouring than controls (7.67% vs 9.31%, P = .003). CONCLUSIONS: Body contouring patients utilize a variety of surgical and pharmacologic weight loss modalities. Patients using potent weight loss modalities may more frequently undergo abdominal contouring compared to extremity contouring, potentially due to preferential abdominal skin laxity from massive weight loss.