Glucagon-Like Peptide-1 Receptor Agonist Use Is Associated With Increased Peripheral Nerve Compression After Bariatric Surgery
Andrea Biaggi-Ondina, Adam Boukind, Lillee Izadi, Aneri U. Patel, Caitlin Marks, Kelly CurrieBackground:
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) may reduce carpal tunnel syndrome (CTS) risk but are associated with acute compressive neuropathies after rapid weight loss (“slimmer’s palsy”). This study evaluated upper-extremity nerve compression rates in patients with massive weight loss after bariatric surgery alone versus concurrent GLP-1RAs.
Methods:
A retrospective cohort study was conducted using the TriNetX US Collaborative Network. Adults who underwent bariatric surgery (January 2015-February 2026) were stratified by concurrent GLP-1RA therapy versus surgery alone. Propensity score matching (1:1) balanced baseline demographics and comorbidities. Primary outcomes were new CTS and cubital tunnel syndrome (CuTS). Secondary outcomes included surgical release and electrodiagnostic testing rates. Risk ratios (RRs) with 95% CIs were calculated.
Results:
In total, 11 158 patients were included in each cohort. The GLP-1RA group was younger (50.6 ± 12.2 vs 53.5 ± 14.3 years,
Conclusion:
Adjunctive GLP-1RA therapy was associated with increased diagnoses of CTS and CuTS without higher surgical rates, suggesting greater susceptibility to nerve compression. Further studies are needed to clarify mechanisms and guide clinical monitoring.