Metabolic and bariatric surgery (MBS) provides greater cardiovascular protection than glucagon-like peptide-1 (GLP-1) receptor agonists in individuals with obesity and type 2 diabetes. A recent systematic review and meta-analysis found surgery to be more favorable for reducing major adverse cardiovascular events (MACE) and all-cause mortality.
MBS and GLP-1 receptor agonists are both effective for obesity and type 2 diabetes. While GLP-1 therapy improves metabolic parameters and reduces cardiovascular events, MBS leads to diabetes remission in a significant percentage of patients. The review analyzed data from nearly 20,000 individuals.
MBS was associated with a substantial 52% reduction in the risk of MACE and all-cause mortality compared to GLP-1 therapy. Researchers noted that MBS also produces more sustained weight loss and offers broader metabolic and cardiovascular benefits beyond glycemic control.
While GLP-1 agonists remain crucial for those ineligible for surgery or preferring non-surgical options, the evidence strongly suggests MBS provides a more pronounced and durable risk reduction, particularly for patients with long-standing diabetes and higher cardiovascular risk.