Evidence mapPaperPMID 41738616Full record

ArticleInternational journal of surgery (London, England)2026

Effect of bariatric surgery and pharmacological treatments on cardiovascular risk factors for adults with overweight and obesity: a systematic review and network meta-analysis.

You Yang, Xiaohong Cheng, Siming Chen, Jiatong Xie, Gowen Chen, Lifa Li, Yue Feng, Yi Chen, Guanqun Liu, Yuan Yin and 2 more

Abstract read
In one paragraph

Article in International journal of surgery (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
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. Review
  2. Development of a predictive model for postoperative erectile function recovery in male patients with incomplete traumatic cervical spinal cord injury.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    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

12 authors.

You YangThe Second Department of Gastrointestinal Surgery, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China.
Xiaohong ChengDepartment of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Siming ChenDepartment of Measurement, Evaluation, Statistics, and Assessment, Lynch School of Education and Human Development, Boston College, Chestnut Hill, MA, USA.
Jiatong XieDepartment of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Gowen ChenSouthwest Medical University, Luzhou City, Sichuan Province, China.
Lifa LiThe Second Department of Gastrointestinal Surgery, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China.
Yue FengDepartment of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
Yi ChenDepartment of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Guanqun LiuDepartment of Anesthesiology, Laiwu People's Hospital, Jinan City, Shandong Province, China.
Yuan YinDepartment of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Tong ZhouThe Second Department of Gastrointestinal Surgery, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China.
Rui ZhaoDepartment of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.ORCID 0000-0003-1783-4610

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo comprehensively evaluate the relative efficacy and safety of lifestyle interventions, pharmacological therapies (orlistat, liraglutide, and semaglutide), and bariatric surgeries [Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and biliopancreatic diversion (BPD)] on body weight and cardiovascular risk factors in adults with overweight and obesity. We conducted a systematic review and network meta-analysis of randomized controlled trials (RCTs). MATERIALS AND

methodsComprehensive searches were performed in PubMed, MEDLINE, Embase, and the Cochrane Library through 1 February 2025. The analysis focused on interventions in adults with overweight or obesity, assessing outcomes including changes in body mass index (BMI), glycated hemoglobin (HbA1c), lipids, blood pressure, and adverse events.

resultsThis network meta-analysis included 26 RCTs. Bariatric surgery was the most effective modality for improving body weight and the majority of cardiovascular risk factors. Among surgeries, BPD demonstrated the greatest reductions in weight, BMI, and low-density lipoprotein cholesterol, but was also associated with the highest risk of serious adverse events (SAEs). RYGB and SG produced comparable weight loss, though RYGB showed unique advantages in improving high-density lipoprotein cholesterol and metabolic outcomes. Among pharmacological agents, semaglutide was the most efficacious, achieving weight loss, BMI reduction, and blood pressure control comparable to RYGB and SG. While liraglutide showed strong effects on glycemic control, semaglutide consistently outperformed both liraglutide and orlistat across most other outcomes and had a lower risk of discontinuation than liraglutide. Importantly, pharmacological agents, particularly semaglutide, had a significantly lower risk of SAEs than surgery.

conclusionBariatric surgery provides the most potent efficacy for weight loss and cardiometabolic improvement, with BPD being the most effective but also highest-risk procedure. Semaglutide emerges as a formidable therapeutic alternative, offering a degree of efficacy comparable to RYGB and SG in many key domains but with a superior safety profile. These findings underscore the need to shift from a "one-size-fits-all" approach to an evidence-based, individualized strategy that aligns each intervention's distinct efficacy and safety profile with specific patient goals and risk tolerance.

Indexed as

bariatric surgerycardiovascular diseasenetwork meta-analysisobesitypharmacotherapy

Identifiers

PMID41738616
PMCPMC13105548

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.