The studies included patients aged 18 and older with a body mass index (BMI) greater than 25 kg/m2.
Secondary outcomes included change in BMI, and for patients with type 2 diabetes, change in A1c.
The researchers identified three RCTs and three observational studies, with diverse drugs and diverse types of bariatric surgery, which enrolled 13 to 134 patients, with follow-up from 6 months to 10 years.
During follow-up, the overall mean weight loss was 22.7 kg greater in the bariatric surgery groups than in the GLP-1 agonist groups in the two RCTs with these data (Migrone et al. and Schauer et al.), and it was 25.1 kg greater in the two non-RCTs with these data (Capristo et al. and Cotugno et al.).
The overall mean decrease in BMI was 8.2 kg/m2 greater in the bariatric surgery groups than in the GLP-1 agonist groups in the two RCTs with these data (Migrone et al. and Schauer et al.), and it was 10.6 kg/m2 greater in the three non-RCTs with these data.
The overall mean decrease in A1c was 1.28% lower in the three RCTs with these data, and it was 0.9% lower in the one non-RCT with these data.
“In adults with obesity, bariatric surgery still confers the highest reductions in weight and BMI but confers similar effects in glycemic control when compared with GLP-1 agonists,” the researchers summarize.
Dr. Sarma received funding from the Clinical Investigator Program. The authors have reported no relevant financial relationships.
A version of this article first appeared on Medscape.com.