Daijiworld Media Network – New York
New York, Feb 24: Metabolic and bariatric surgery (MBS) offers greater cardiovascular protection than glucagon-like peptide-1 (GLP-1) receptor agonists in individuals with obesity and type 2 diabetes, according to a 2026 systematic review and meta-analysis.
The analysis found that surgery was more favourable in reducing major adverse cardiovascular events (MACE) as well as all-cause mortality when compared to GLP-1 receptor agonist therapy.
Both MBS and GLP-1 receptor agonists are established and effective interventions for managing obesity and type 2 diabetes. GLP-1 receptor agonists are widely used to improve metabolic parameters and are known to lower cardiovascular mortality and hospitalisation rates. Meanwhile, MBS has emerged as a highly effective treatment option, with diabetes remission reported in approximately 31% to 56% of patients.
The review evaluated outcomes in nearly 20,000 individuals with obesity and type 2 diabetes. Findings showed that MBS was associated with a 52% relative risk reduction in MACE and all-cause mortality compared to GLP-1 receptor agonist therapy.
Researchers noted that MBS leads to greater and more sustained weight loss than GLP-1 drugs. The cardiovascular benefits observed with surgery extended beyond glycaemic control and weight reduction, reflecting its broader metabolic impact.
While both treatment pathways provide substantial clinical benefit, the study indicated that surgical intervention offers more pronounced and durable risk reduction, particularly in patients with longstanding diabetes and higher cardiovascular risk.
However, researchers stressed that GLP-1 receptor agonists remain a vital treatment option, especially for patients who are ineligible for surgery or prefer non-surgical management.
The findings add to growing evidence from recent meta-analyses and large cohort studies supporting the superiority of metabolic and bariatric surgery over GLP-1 receptor agonists in reducing cardiovascular events and overall mortality among individuals with obesity and type 2 diabetes.