Metabolic Surgery Has Greater Long-Term Benefits Than GLP-1 Receptor Agonists
WEDNESDAY, Oct. 1, 2025 -- People with obesity and type 2 diabetes who undergo metabolic surgery live longer and face fewer serious health problems compared with patients treated with glucagon-like peptide-1 receptor agonists (GLP-1 RAs), according to a study published online Sept. 16 in Nature Medicine.
Hamlet Gasoyan, Ph.D., M.P.H., from the Cleveland Clinic, and colleagues compared long-term macrovascular and microvascular outcomes for metabolic surgery and GLP-1 RAs among patients with diabetes and obesity. The a nalysis included 1,657 patients with type 2 diabetes and obesity who underwent metabolic surgery and 2,275 similar patients receiving GLP-1 RAs.
The researchers found that the 10-year cumulative incidence of all-cause mortality was 9.0 percent in the metabolic surgery group versus 12.4 percent in the GLP-1 RA group (adjusted hazard ratio [aHR], 0.68). Metabolic surgery was also associated with a lower risk for major adverse cardiovascular events (aHR, 0.65), nephropathy (aHR, 0.53), and retinopathy (aHR, 0.46) compared with the GLP-1 RA group.
"Our findings indicate that surgery should remain an important treatment option for obesity and diabetes," senior author Ali Aminian, M.D., also from the Cleveland Clinic, said in a statement. "These long-term benefits are harder to achieve with GLP-1 medicines alone, as many patients stop using the medications over time."
Several authors disclosed ties to relevant organizations.
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