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| Hauptverfasser: | , , , , , , , , , |
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| Format: | Artículo Open Access |
| Veröffentlicht: |
Wiley
2025
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| Online-Zugang: | https://onlinelibrary.wiley.com/doi/10.1002/oby.70100 |
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Inhaltsangabe:
- Comparative Efficacy of Metabolic/Bariatric Surgery Versus GLP ‐1 Receptor Agonists: A Network Meta‐Analysis of Randomized Controlled Trials Lucas Sabatella Patricia M. Ortega Víctor Valentí Azcárate Fernando Rotellar Sastre Adriana Uriz Pagola Ahmed Ahmed Sanjay Purkayastha Carlota Tuero Ojanguren Nuria Blanco Asensio Manuel F. Landecho Obesity ABSTRACT Objective This study compared the efficacy of metabolic/bariatric surgery (MBS) and GLP‐1 receptor agonists (GLP‐1 RAs), including dual GLP‐1/GIP analogues, for weight and metabolic outcomes in adults with obesity. Methods A network meta‐analysis of randomized controlled trials compared MBS or GLP‐1 RAs versus lifestyle intervention in adults with overweight or obesity. Primary outcomes were percent total weight loss (TWL) and BMI; secondary outcomes included body weight, waist circumference, HbA1c, and systolic blood pressure. Random‐effects models used lifestyle intervention as the common comparator; all MBS versus GLP‐1 RA comparisons were indirect. Results Thirty randomized controlled trials ( n = 20,015) were included. At < 104 weeks, MBS achieved greater reductions than GLP‐1 RAs in %TWL (ETD –10.3%; p = 0.001), BMI (−4.5 kg/m 2 ; p < 0.001), body weight (−11.7 kg; p < 0.001), waist circumference (−12.6 cm; p < 0.001), and HbA1c (−0.5%; p = 0.033). At ≥ 104 weeks, differences remained for %TWL (−9.1%; p = 0.022) and body weight (−14.6 kg; p = 0.049). In tirzepatide‐only analyses, differences versus MBS were not significant. Among participants with type 2 diabetes, MBS produced greater reductions in BMI, weight, waist, and %TWL, with similar HbA1c improvement. Conclusions Both MBS and GLP‐1 RAs provide substantial metabolic benefits. MBS remains superior, but tirzepatide is a promising nonsurgical option supporting personalized obesity care. 10.1002/oby.70100 http://creativecommons.org/licenses/by-nc-nd/4.0/