Weight Loss Outcomes Between GLP ‐1 Receptor Agonists and Bariatric Surgery in Adults With Obesity: A Systematic Review, Meta‐Analysis and Meta‐Regression
Authors' conclusion
Although substantial heterogeneity was present, BS was associated with greater and sustained reductions observed over multi-year follow up in weight, BMI and glycaemic indices compared to GLP-1 RAs, with similar effects on serum lipids and blood pressure, supporting its use in appropriately selected adults with obesity.
Study context
- Population
- Adults with obesity; MEDLINE, EMBASE and CENTRAL searched to 5 October 2025
- Participants
- 20,594 adults15 studies
- Comparison
- Bariatric surgery vs GLP-1 RAs
- Outcome
- Change in BMI
Methodological detailsrandom-effects models, meta-regression
- Random-effects models
- Meta-regression
Pooled result
As reported in the abstract
MD
−6.77 kg/m²
P = 0.02
at 6 months
MD
−5.10 kg/m²
P < 0.001
at ≤ 1 year
MD
−6.61 kg/m²
P < 0.001
at > 1 year
Further pooled results
| Outcome | Estimate | P value |
|---|---|---|
| Change in weightBS vs GLP-1 RAs · at 6 months; not significant | MD −12.19 kg | P = 0.13 |
| Change in weightBS vs GLP-1 RAs · at ≤ 1 year | MD −16.97 kg | P = 0.02 |
| Change in weightBS vs GLP-1 RAs · at > 1 year | MD −19.78 kg | P < 0.001 |
| HbA1c reduction · beyond one yearGreater reduction with BS | MD −1.69 % | P < 0.001 |
| Fasting glucose · overall | MD −1.22 mmol/L | P = 0.03 |
Serum lipids and blood pressure
- No significant between-group differences in serum lipids and blood pressure
Meta-regression of body mass index (BMI) change
- Larger BMI reductions with bariatric surgery (BS) in older patients, male patients and those with higher baseline BMI
Original publication
Weight Loss Outcomes Between GLP ‐1 Receptor Agonists and Bariatric Surgery in Adults With Obesity: A Systematic Review, Meta‐Analysis and Meta‐Regression. Diabetes Obes Metab. Published 23 March 2026. doi:10.
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