Bariatric Surgery for Patients with Overweight/Obesity. A Comprehensive Grading Methodology and Network Metanalysis of Randomized Controlled Trials on Weight Loss Outcomes and Adverse Events
Abstract
This study aims to compare different types of metabolic bariatric surgery (MBS) with lifestyle intervention/medical therapy (LSI/MT) for the treatment of overweight/obesity. The present and network meta-analysis (NMA) includes randomized trials. MBS was associated with a reduction of BMI, body weight, and percent weight loss, when compared to LSI/MT, and also with a significant reduction of HbA1c and a higher remission of diabetes. Meta-regression analyses revealed that BMI, a higher proportion of women, and a longer duration of trial were associated with greater effects of MBS. The NMA showed that all surgical procedures included (except greater curvature plication) were associated with a reduction of BMI. MBS is an effective option for the treatment of obesity. The choice of BMI thresholds for eligibility for surgery of patients with different complications should be performed making an evaluation of risks and benefits in each BMI category.
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Previous NMAs and a traditional meta-analysis on therapeutic options for overweight and obesity did not include more recently available OMMs such as tirzepatide, or included medications not approved for overweight/obesity, or adopted different inclusion criteria.
“Several NMAs20–23 and a traditional meta-analysis24 on different therapeutic options for overweight and obesity were published in the last few years, but they did not include more recently available OMMs, such as tirzepatide20–22, or they included medications not approved for the treatment of overweight/obesity (for example, metformin, SGLT2 inhibitors or GLP-1 agonists, such as dulaglutide)22, or”
From A systematic review and meta-analysis of the efficacy and safety of pharmacological treatments for obesity in adults (2025) · cites this paper as [23]
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McGowan, B., Ciudin, A., Baker, J. L., Busetto, L., Dicker, D., Frühbeck, G., Goossens, G. H., Monami, M., Sbraccia, P., Martinez-Tellez, B., et al. (2025) · Nature Medicine · doi:10.1038/s41591-025-03978-z · Cited by 100 · see citing works
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Phenotyping of Patients Seeking Third or Higher-Order Metabolic Bariatric Surgery
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- Authors
- De Luca, M., Zese, M., Silverii, G. A., Ragghianti, B., Bandini, G., Forestieri, P., Zappa, M. A., Navarra, G., Foschi, D., Musella, M., Sarro, G., Pilone, V., Facchiano, E., Foletto, M., Olmi, S., Raffelli, M., Bellini, R., Gentileschi, P., Cerbone, M. R., Grandone, I., Berardi, G., Di Lorenzo, N., Lucchese, M., Piazza, L., Casella, G., Manno, E., Zaccaroni, A., Balani, A., Mannucci, E., & Monami, M.
- Affiliations
- Ospedale Santa Maria della Misericordia di Rovigo (IT)
- Azienda Ospedaliero-Universitaria Careggi (IT)
- University of Naples Federico II (IT)
- ASST Fatebenefratelli Sacco (IT)
- Azienda Ospedaliera Universitaria Policlinico "G. Martino" (IT)
- Ospedale San Giuseppe (IT)
- University of Salerno (IT)
- Università Cattolica del Sacro Cuore (IT)
- Azienda Ospedaliera Universitaria Pisana (IT)
- University of Rome Tor Vergata (IT)
- Azienda Ospedaliera S.Maria (IT)
- Santa Maria Nuova Hospital (IT)
- Policlinico Umberto I (IT)
- Ospedale Antonio Cardarelli (IT)
- Ospedale G.B. Morgagni - L.Pierantoni (IT)
- Ospedale di Monfalcone (IT)
- Corresponding author
- Zese, Monica
- ORCID
- Venue
- Obesity Surgery
- Published
- 2023-11-02
- Volume
- 33
- Issue
- 12
- Pages
- 4147-4158
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- OpenAlex
- W4388219367
- Cited by
- 28
- References
- 92
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 13
- FWCI
- 1.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Obesity Surgery (publishedVersion)
- PubMed (publishedVersion)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
- Florence Research (University of Florence) (submittedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Keywords
- bariatric surgery
- MeSH terms
- Network Meta-Analysis, Diabetes Mellitus, Type 2, Female, Humans, Obesity, Obesity, Morbid, Weight Loss, Randomized Controlled Trials as Topic, Bariatric Surgery, Overweight
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