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This evaluation should include: Review of surgical history and any ongoing post-cholecystectomy symptoms Assessment of current medications and potential drug interactions Evaluation of weight management goals and suitability for GLP-1 therapy Baseline measurements including weight, BMI, blood pressure, and HbA1c (if diabetic) Renal function tests, particularly in those at risk of dehydration Retinal assessment for patients with diabetes (as rapid improvement in glucose control may worsen diabetic retinopathy) Pregnancy status and contraception needs where relevant Discussion of realistic expectations and commitment to lifestyle modifications NICE Technology Appraisal 875 recommends that specialist weight management services should provide Wegovy as part of a comprehensive programme including dietary advice, physical activity support, and behavioural interventions

Gut Microbes (2017) 8(3):25367.10.1080/19490976.2017.1293224 Summary Keywords incretin hormones, bariatric surgery, gastric emptying, gastric accommodation, insulin secretion, insulin action, vagus nerve Citation Ma J and Vella A (2018) What Has Bariatric Surgery Taught Us About the Role of the Upper Gastrointestinal Tract in the Regulation of Postprandial Glucose Metabolism

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