Evidence mapPaperPMID 41826529Full record

SynthesisObesity surgery2026

Metabolic Bariatric Surgery versus GLP-1 Receptor Agonists for Obesity Management: A Systematic Review and Meta-Analysis.

Lucas Monteiro Delgado, Gabriel Barone, Giulia Garcia, Giovanna Pilon, Patrícia Viana, Fabio Israel Lima Castelo Branc Marques, Cristina Bellotti Formiga Bueno, Leonardo Del Grande, Cláudia Theis, Sérgio Poli de Figueiredo and 1 more

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Obesity surgery, 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. Article
  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

11 authors.

Lucas Monteiro DelgadoUniversidade Federal de Minas Gerais, Belo Horizonte, Brazil. ldelgado@ufmg.br.
Gabriel BaroneUniversidade Municipal de São Caetano do Sul, São Paulo, Brazil.
Giulia GarciaUniversidade Municipal de São Caetano do Sul, São Paulo, Brazil.
Giovanna PilonUniversidade Municipal de São Caetano do Sul, São Paulo, Brazil.
Patrícia VianaUniversidade do Extremo Sul Catarinense, Criciúma, Brazil.
Fabio Israel Lima Castelo Branc MarquesHospital Heliópolis, São Paulo, Brazil.
Cristina Bellotti Formiga BuenoIrmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
Leonardo Del GrandeFederal University of São Paulo, São Paulo, Brazil.
Cláudia TheisUniversity of North Carolina at Chapel Hill, Chapel Hill, USA.
Sérgio Poli de FigueiredoUniversity of North Carolina at Chapel Hill, Chapel Hill, USA.
Bernardo Fontel PompeuUniversidade Municipal de São Caetano do Sul, São Paulo, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMetabolic and bariatric surgery (MBS) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are both effective strategies for obesity management, but their comparative efficacy remains uncertain. This systematic review and meta-analysis aimed to compare weight loss outcomes between MBS and GLP-1 RA therapy in adults with obesity.

methodsA systematic search of PubMed, Scopus, and Cochrane Library was conducted from inception to September 22, 2025. Eligible studies included randomized and observational comparisons between MBS-specifically sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB)-and GLP-1 RA therapy in adults with obesity. Pooled mean differences (MDs) for total weight loss (TWL) and body mass index (BMI) change were calculated using a DerSimonian-Laird random-effects model. Risk of bias was assessed using ROBINS-I V2, and certainty of evidence was graded with GRADE.

resultsFive retrospective observational studies (n = 5,944; 3,489 MBS, 2,455 GLP-1 RA) met the inclusion criteria. Pooled analysis showed significantly greater TWL in the MBS group (MD - 18.15%; 95% CI 16.41 to 19.90; p < 0.0001; I² = 95%) and larger BMI reduction (MD 8.73 kg/m²; 95% CI 5.87 to 11.58; p = 0.0001; I² = 94.6%). Sensitivity analyses confirmed the robustness of these results. Overall risk of bias was moderate, primarily due to non-randomized designs and treatment selection bias. Certainty of evidence was rated as moderate.

conclusionsMBS achieves significantly greater and more durable weight loss compared with GLP-1 RA therapy, reaffirming its role as the most effective intervention for severe obesity. While GLP-1 RAs represent valuable noninvasive or adjunctive options, surgery remains the benchmark for sustained metabolic and weight outcomes.

Indexed as

Bariatric SurgeryGlucagon-Like Peptide-1 Receptor AgonistsObesityObesity ManagementObesity, MorbidHumansWeight LossGlucagon-Like Peptide-1 Receptor AgonistsBariatric surgeryDiabetes remissionmeta-analysisObesityRoux-en-Y gastric bypassSleeve gastrectomyWeight loss

Identifiers

What Socratic holds

Textmetadata
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.