Evidence mapPaperPMID 41539943Full record

ArticleObesity (Silver Spring, Md.)2026

Efficacy and Safety of Pharmacological, Endoscopic, and Surgical Treatments for Obesity: A GRADE-Based Network Meta-Analysis.

Maurizio De Luca, Ricardo V Cohen, Amanda Belluzzi, Giuseppe Navarra, Nicola Di Lorenzo, Tarissa B Z Petry, Paolo Sbraccia, Luca Busetto, Silvio Buscemi, Rocco Barazzoni and 3 more

Abstract readNetwork Meta-Analysis
In one paragraph

Article in Obesity (Silver Spring, Md.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Maurizio De LucaDepartment of General Surgery, Rovigo Hospital, Rovigo, Italy.
Ricardo V CohenCenter for Obesity and Diabetes, Oswaldo Cruz German Hospital, São Paulo, Brazil.
Amanda BelluzziDepartment of General Surgery, Rovigo Hospital, Rovigo, Italy.
Giuseppe NavarraUniversity of Messina, Messina, Italy.
Nicola Di LorenzoUniversity La Sapienza, Rome, Italy.
Tarissa B Z PetryCenter for Obesity and Diabetes, Oswaldo Cruz German Hospital, São Paulo, Brazil.
Paolo SbracciaUniversity Hospital Policlinico Tor Vergata, Rome, Italy.
Luca BusettoUniversity of Padua, Padua, Italy.ORCID https://orcid.org/0000-0003-4883-8980
Silvio BuscemiUniversity Hospital Policlinico "P. Giaccone," Palermo, Italy.ORCID https://orcid.org/0000-0003-0730-7649
Rocco BarazzoniUniversity Hospital, Trieste, Italy.
Benedetta RagghiantiUnit of Diabetology and Metabolic Diseases. Careegi Teaching Hospital, University of Florence, Florence, Italy.
Edoardo MannucciUnit of Diabetology and Metabolic Diseases. Careegi Teaching Hospital, University of Florence, Florence, Italy.
Matteo MonamiUnit of Diabetology and Metabolic Diseases. Careegi Teaching Hospital, University of Florence, Florence, Italy.ORCID https://orcid.org/0000-0001-9349-828X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis review compared antiobesity strategies-obesity management medications (OMM), endoscopic bariatric procedures (EBP), and metabolic bariatric surgery (MBS)-with lifestyle intervention, placebo, or no therapy (LSI/Pbo/NT).

methodsThis network meta-analysis included randomized clinical trials comparing OMM, EBP, and MBS versus LSI/Pbo/NT or active comparators in adults with obesity. MEDLINE and Embase were searched up to December 1, 2024. The primary endpoint was total body weight loss percentage (TBWL%), analyzed at 26-52, 53-104, 105-156, and ≥ 156 weeks. This study was registered with PROSPERO (CRD42024623707).

resultsOf 139 RCTs, 54 evaluated MBS (n = 61,961), 21 EBP (n = 2934), and 64 OMM (n = 5991). At 26-52 weeks, most treatments showed significant effects versus the reference. TBWL% exceeded 10% with most surgeries and tirzepatide. Long-term data were lacking for most OMM and all EBP. Most treatments maintained their efficacy over time, except greater curvature plication. EBP and MBS were generally associated with a higher SAE risk than OMM; BPD showed the highest long-term SAE incidence.

conclusionsMBS appears superior in the long term (particularly for higher-efficacy procedures, such as RYGB, SG, SADI, and BPD). EBP, except ESG, was less effective than newer OMM. Semaglutide and tirzepatide showed no inferior short-term results in comparison with MBS.

Indexed as

Anti-Obesity AgentsBariatric SurgeryEndoscopyObesityAdultHumansRandomized Controlled Trials as TopicTreatment OutcomeWeight LossAnti-Obesity Agentsendoscopic bariatric proceduresinterventionmetabolic bariatric surgerynetwork meta‐analysisno therapyobesityobesity management medicationsplacebo

Identifiers

PMID41539943
PMCPMC12850565

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.