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A big Cleveland Clinic examine has discovered that folks with weight problems and kind 2 diabetes who endure weight-loss surgical procedure reside longer and face fewer critical well being issues in contrast with these handled with GLP-1 receptor agonist medicines alone.
Sufferers who had weight-loss surgical procedure (also referred to as bariatric or metabolic surgical procedure) misplaced extra weight, achieved higher blood sugar management, and relied much less on diabetes and coronary heart drugs over 10 years. The analysis is revealed in Nature Medication.
“Even with today’s best medicines, metabolic surgery offers unique and lasting benefits for people with obesity and diabetes,” stated Ali Aminian, M.D., director of Cleveland Clinic’s Bariatric & Metabolic Institute and first investigator of the examine. “The benefits we observed went beyond weight loss. Surgery was linked to fewer heart problems, less kidney disease, and even lower rates of diabetes-related eye damage.”
GLP-1 (glucagon-like peptide-1) receptor agonists are a category of medicines extensively used to deal with kind 2 diabetes and weight problems and to cut back well being dangers. Each metabolic surgical procedure and GLP-1 medicines enhance cardiovascular well being and metabolism.
The M6 examine (Macrovascular and Microvascular Morbidity and Mortality after Metabolic Surgical procedure versus Medicines) adopted 3,932 adults with diabetes and weight problems who acquired care at Cleveland Clinic for as much as 10 years. Amongst them, 1,657 underwent metabolic surgical procedure (together with gastric bypass or sleeve gastrectomy), whereas 2,275 had been handled with GLP-1 medicines (together with liraglutide, dulaglutide, exenatide, semaglutide, and tirzepatide).
On the finish of the examine, sufferers who had metabolic surgical procedure had:
32% decrease threat of dying
35% decrease threat of main coronary heart issues (similar to coronary heart assault, coronary heart failure, or stroke)
47% decrease threat of significant kidney illness
54% decrease threat of diabetes-related eye injury (retinopathy)
On common, individuals who had metabolic surgical procedure misplaced 21.6% of their physique weight over 10 years, in contrast with 6.8% weight reduction in individuals who took GLP-1 medicines. Hemoglobin A1c, a marker of common blood sugar, improved extra with surgical procedure (-0.86%) than with GLP-1 medicines (-0.23%). Sufferers within the surgical procedure group additionally required fewer prescriptions for diabetes, blood stress, and ldl cholesterol.
“Even in the era of these powerful new drugs to treat obesity and diabetes, metabolic surgery may provide additional benefits, including a survival advantage,” stated Steven Nissen, M.D., Chief Tutorial Officer of the Coronary heart, Vascular & Thoracic Institute at Cleveland Clinic and senior creator of the examine.
“Our findings indicate that surgery should remain an important treatment option for obesity and diabetes,” stated Dr. Aminian. “These long-term benefits are harder to achieve with GLP-1 medicines alone, as many patients stop using the medications over time.”
In line with the authors, the examine has some limitations. It was observational relatively than a randomized comparability of medication and surgical procedure, and it didn’t focus solely on the latest and simplest GLP-1 medicines. The researchers word that future research ought to instantly evaluate surgical procedure with newer GLP-1 therapies, similar to semaglutide and tirzepatide, to additional information therapy choices.
Extra data:
Macrovascular and microvascular outcomes of metabolic surgical procedure versus GLP-1 receptor agonists in sufferers with diabetes and weight problems, Nature Medication (2025). DOI: 10.1038/s41591-025-03893-3.
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Cleveland Clinic
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Bariatric surgical procedure for weight reduction exhibits larger long-term advantages than GLP-1 medicines (2025, September 16)
retrieved 16 September 2025
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