Comparative Efficacy of Metabolic/Bariatric Surgery Versus GLP-1 Receptor Agonists: A Network Meta-Analysis of Randomized Controlled Trials.

Sabatella L, Ortega PM, Azcárate VV, Sastre FR, Pagola AU, Ahmed A, Purkayastha S, Ojanguren CT, Asensio NB, Landecho MF

Obesity (Silver Spring, Md.)1 Dec 2025Cited by 8 (Europe PMC)

PMID41326176PMCIDPMC13032060DOI10.1002/oby.70100PepBankPUB-41326176

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Summary

The text of this summary is not shown here, because the article license does not allow reuse. Read it at the source (opens in a new tab)

Text rights: CC BY-NC-ND. Results still quote short attributed sentences.

Results from this study10

1 result from studies that gave the peptide. 1 result from people.

01HumanSystematic reviewEfficacy outcome
In adults with overweight or obesity, tirzepatide-only analyses found no significant difference versus metabolic/bariatric surgery.
In plain wordsIn adults with obesity, tirzepatide alone did not differ significantly from weight-loss surgery in this indirect comparison.
Peptide
Tirzepatide
Outcome
No significant changeTirzepatide-only versus metabolic/bariatric surgery
Study
n: not reported in source
Comparator
Metabolic/bariatric surgery
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated
Source sentences
Summary
In tirzepatide-only analyses, differences versus MBS were not significant.
1 context sentence(design, population, supporting numbers)
Summary · context
A network meta-analysis of randomized controlled trials compared MBS or GLP-1 RAs versus lifestyle intervention in adults with overweight or obesity.
Report a problemFND-4132617601

Studies that did not test the peptide alone9

In this study, Tirzepatide was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking Tirzepatide.

02HumanNot a test of Tirzepatide aloneSystematic reviewEfficacy outcome
In adults with obesity, metabolic/bariatric surgery achieved greater percent total weight loss than pooled GLP-1 receptor agonists at under 104 weeks (ETD -10.3%).
In plain wordsIn adults with obesity, weight-loss surgery gave more weight loss than GLP-1 drugs as a group within two years.
Peptide
Tirzepatide
Outcome
Not applicablePercent total weight loss, surgery versus GLP-1 RAs, under 104 weeks
Study
n: not reported in source
Comparator
Metabolic/bariatric surgery
Outcome group
Body weight · Metabolic and weight
Measurements
ETD
−10.3%
MBS vs GLP-1 RAs, <104 weeks
Source sentences
Summary
At < 104 weeks, MBS achieved greater reductions than GLP-1 RAs in %TWL (ETD -10.3%; p = 0.001)
1 context sentence(design, population, supporting numbers)
Summary · context
A network meta-analysis of randomized controlled trials compared MBS or GLP-1 RAs versus lifestyle intervention in adults with overweight or obesity.
In this study, Tirzepatide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Tirzepatide.
Report a problemFND-4132617602
03HumanNot a test of Tirzepatide aloneSystematic reviewEfficacy outcome
In adults with obesity, metabolic/bariatric surgery reduced BMI more than pooled GLP-1 receptor agonists at under 104 weeks.
In plain wordsIn adults with obesity, weight-loss surgery lowered BMI more than GLP-1 drugs as a group within two years.
Peptide
Tirzepatide
Outcome
Not applicableBMI, surgery versus GLP-1 RAs, under 104 weeks
Study
n: not reported in source
Comparator
Metabolic/bariatric surgery
Outcome group
Body weight · Metabolic and weight
Measurements
ETD
−4.5 kg/m<sup>2</sup>
MBS vs GLP-1 RAs, <104 weeks
Source sentences
Summary
BMI (-4.5 kg/m²; p < 0.001)
1 context sentence(design, population, supporting numbers)
Summary · context
A network meta-analysis of randomized controlled trials compared MBS or GLP-1 RAs versus lifestyle intervention in adults with overweight or obesity.
In this study, Tirzepatide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Tirzepatide.
Report a problemFND-4132617603
04HumanNot a test of Tirzepatide aloneSystematic reviewEfficacy outcome
In adults with obesity, metabolic/bariatric surgery reduced body weight by 11.7 kg more than pooled GLP-1 receptor agonists at under 104 weeks.
In plain wordsIn adults with obesity, weight-loss surgery reduced weight more than GLP-1 drugs as a group within two years.
Peptide
Tirzepatide
Outcome
Not applicableBody weight, surgery versus GLP-1 RAs, under 104 weeks
Study
n: not reported in source
Comparator
Metabolic/bariatric surgery
Outcome group
Body weight · Metabolic and weight
Measurements
ETD
−11.7 kg
MBS vs GLP-1 RAs, <104 weeks
Source sentences
Summary
body weight (-11.7 kg; p < 0.001)
1 context sentence(design, population, supporting numbers)
Summary · context
A network meta-analysis of randomized controlled trials compared MBS or GLP-1 RAs versus lifestyle intervention in adults with overweight or obesity.
In this study, Tirzepatide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Tirzepatide.
Report a problemFND-4132617604
05HumanNot a test of Tirzepatide aloneSystematic reviewEfficacy outcome
In adults with obesity, metabolic/bariatric surgery reduced waist circumference by 12.6 cm more than pooled GLP-1 receptor agonists at under 104 weeks.
In plain wordsIn adults with obesity, weight-loss surgery reduced waist size more than GLP-1 drugs as a group within two years.
Peptide
Tirzepatide
Outcome
Not applicableWaist circumference, surgery versus GLP-1 RAs, under 104 weeks
Study
n: not reported in source
Comparator
Metabolic/bariatric surgery
Outcome group
Body weight · Metabolic and weight
Measurements
ETD
−12.6 cm
MBS vs GLP-1 RAs, <104 weeks
Source sentences
Summary
waist circumference (-12.6 cm; p < 0.001)
1 context sentence(design, population, supporting numbers)
Summary · context
A network meta-analysis of randomized controlled trials compared MBS or GLP-1 RAs versus lifestyle intervention in adults with overweight or obesity.
In this study, Tirzepatide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Tirzepatide.
Report a problemFND-4132617605
06HumanNot a test of Tirzepatide aloneSystematic reviewEfficacy outcome
In adults with obesity, metabolic/bariatric surgery reduced HbA1c by 0.5% more than pooled GLP-1 receptor agonists at under 104 weeks.
In plain wordsIn adults with obesity, weight-loss surgery lowered HbA1c more than GLP-1 drugs as a group within two years.
Peptide
Tirzepatide
Outcome
Not applicableHbA1c, surgery versus GLP-1 RAs, under 104 weeks
Study
n: not reported in source
Comparator
Metabolic/bariatric surgery
Outcome group
Glycemic control · Metabolic and weight
Measurements
ETD
−0.5%
MBS vs GLP-1 RAs, <104 weeks
Source sentences
Summary
and HbA1c (-0.5%; p = 0.033).
1 context sentence(design, population, supporting numbers)
Summary · context
A network meta-analysis of randomized controlled trials compared MBS or GLP-1 RAs versus lifestyle intervention in adults with overweight or obesity.
In this study, Tirzepatide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Tirzepatide.
Report a problemFND-4132617606
07HumanNot a test of Tirzepatide aloneSystematic reviewEfficacy outcome
In adults with obesity, metabolic/bariatric surgery still gave greater percent total weight loss than pooled GLP-1 receptor agonists at 104 weeks or more (-9.1%).
In plain wordsIn adults with obesity, weight-loss surgery still gave more weight loss than GLP-1 drugs as a group after two years.
Peptide
Tirzepatide
Outcome
Not applicablePercent total weight loss, surgery versus GLP-1 RAs, 104 weeks or more
Study
n: not reported in source
Comparator
Metabolic/bariatric surgery
Outcome group
Body weight · Metabolic and weight
Measurements
ETD
−9.1%
MBS vs GLP-1 RAs, >=104 weeks
Source sentences
Summary
At ≥ 104 weeks, differences remained for %TWL (-9.1%; p = 0.022)
1 context sentence(design, population, supporting numbers)
Summary · context
A network meta-analysis of randomized controlled trials compared MBS or GLP-1 RAs versus lifestyle intervention in adults with overweight or obesity.
In this study, Tirzepatide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Tirzepatide.
Report a problemFND-4132617607
08HumanNot a test of Tirzepatide aloneSystematic reviewEfficacy outcome
In adults with obesity, metabolic/bariatric surgery still reduced body weight by 14.6 kg more than pooled GLP-1 receptor agonists at 104 weeks or more.
In plain wordsIn adults with obesity, weight-loss surgery still reduced weight more than GLP-1 drugs as a group after two years.
Peptide
Tirzepatide
Outcome
Not applicableBody weight, surgery versus GLP-1 RAs, 104 weeks or more
Study
n: not reported in source
Comparator
Metabolic/bariatric surgery
Outcome group
Body weight · Metabolic and weight
Measurements
ETD
−14.6 kg
MBS vs GLP-1 RAs, >=104 weeks
Source sentences
Summary
and body weight (-14.6 kg; p = 0.049).
1 context sentence(design, population, supporting numbers)
Summary · context
A network meta-analysis of randomized controlled trials compared MBS or GLP-1 RAs versus lifestyle intervention in adults with overweight or obesity.
In this study, Tirzepatide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Tirzepatide.
Report a problemFND-4132617608
09HumanNot a test of Tirzepatide aloneSystematic reviewEfficacy outcome
In adults with type 2 diabetes, metabolic/bariatric surgery produced greater reductions in BMI, weight, waist and percent total weight loss than pooled GLP-1 receptor agonists.
In plain wordsIn adults with type 2 diabetes, weight-loss surgery reduced weight and waist more than GLP-1 drugs as a group.
Peptide
Tirzepatide
Outcome
Not applicableWeight and anthropometric outcomes in type 2 diabetes, surgery versus GLP-1 RAs
Study
n: not reported in source
Comparator
Metabolic/bariatric surgery
Outcome group
Body weight · Metabolic and weight
Source sentences
Summary
Among participants with type 2 diabetes, MBS produced greater reductions in BMI, weight, waist, and %TWL
1 context sentence(design, population, supporting numbers)
Summary · context
A network meta-analysis of randomized controlled trials compared MBS or GLP-1 RAs versus lifestyle intervention in adults with overweight or obesity.
In this study, Tirzepatide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Tirzepatide.
Report a problemFND-4132617609
10HumanNot a test of Tirzepatide aloneSystematic reviewEfficacy outcome
In adults with type 2 diabetes, metabolic/bariatric surgery and pooled GLP-1 receptor agonists gave similar HbA1c improvement.
In plain wordsIn adults with type 2 diabetes, weight-loss surgery and GLP-1 drugs as a group improved HbA1c about equally.
Peptide
Tirzepatide
Outcome
No significant changeHbA1c in type 2 diabetes, surgery versus GLP-1 RAs
Study
n: not reported in source
Comparator
Metabolic/bariatric surgery
Outcome group
Glycemic control · Metabolic and weight
Source sentences
Summary
with similar HbA1c improvement.
1 context sentence(design, population, supporting numbers)
Summary · context
A network meta-analysis of randomized controlled trials compared MBS or GLP-1 RAs versus lifestyle intervention in adults with overweight or obesity.
In this study, Tirzepatide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Tirzepatide.
Report a problemFND-4132617610

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 2Current
12 Oct 2026, 12:10 UTC
Study results updated
Version 1
9 Oct 2026, 03:07 UTC
First added · source update from Europe PMC

Subjects

Terms as the source lists them.

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