| Title: |
Efficacy and Safety of Pharmacological, Endoscopic, and Surgical Treatments for Obesity: A GRADE ‐Based Network Meta‐Analysis |
| Authors: |
Maurizio De Luca; Ricardo V. Cohen; Amanda Belluzzi; Giuseppe Navarra; Nicola Di Lorenzo; Tarissa B. Z. Petry; Paolo Sbraccia; Luca Busetto; Silvio Buscemi; Rocco Barazzoni; Benedetta Ragghianti; Edoardo Mannucci; Matteo Monami |
| Contributors: |
De Luca, Maurizio; Cohen, Ricardo V.; Belluzzi, Amanda; Navarra, Giuseppe; Di Lorenzo, Nicola; Petry, Tarissa B. Z.; Sbraccia, Paolo; Busetto, Luca; Buscemi, Silvio; Barazzoni, Rocco; Ragghianti, Benedetta; Mannucci, Edoardo; Monami, Matteo |
| Publisher Information: |
John Wiley and Sons Inc |
| Publication Year: |
2026 |
| Collection: |
Padua Research Archive (IRIS - Università degli Studi di Padova) |
| Subject Terms: |
endoscopic bariatric procedure; intervention; metabolic bariatric surgery; network meta‐analysi; no therapy; obesity; obesity management medication; placebo |
| Description: |
Objective: This review compared antiobesity strategies—obesity management medications (OMM), endoscopic bariatric procedures (EBP), and metabolic bariatric surgery (MBS)—with lifestyle intervention, placebo, or no therapy (LSI/Pbo/NT). Methods: This network meta-analysis included randomized clinical trials comparing OMM, EBP, and MBS versus LSI/Pbo/NT or active comparators in adults with obesity. MEDLINE and Embase were searched up to December 1, 2024. The primary endpoint was total body weight loss percentage (TBWL%), analyzed at 26–52, 53–104, 105–156, and ≥ 156 weeks. This study was registered with PROSPERO (CRD42024623707). Results: Of 139 RCTs, 54 evaluated MBS (n = 61,961), 21 EBP (n = 2934), and 64 OMM (n = 5991). At 26–52 weeks, most treatments showed significant effects versus the reference. TBWL% exceeded 10% with most surgeries and tirzepatide. Long-term data were lacking for most OMM and all EBP. Most treatments maintained their efficacy over time, except greater curvature plication. EBP and MBS were generally associated with a higher SAE risk than OMM; BPD showed the highest long-term SAE incidence. Conclusions: MBS appears superior in the long term (particularly for higher-efficacy procedures, such as RYGB, SG, SADI, and BPD). EBP, except ESG, was less effective than newer OMM. Semaglutide and tirzepatide showed no inferior short-term results in comparison with MBS. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/41539943; info:eu-repo/semantics/altIdentifier/wos/WOS:001661719900001; journal:OBESITY; https://hdl.handle.net/11577/3576033 |
| DOI: |
10.1002/oby.70083 |
| Availability: |
https://hdl.handle.net/11577/3576033; https://doi.org/10.1002/oby.70083 |
| Rights: |
info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.76B1A9B9 |
| Database: |
BASE |