- 2026-06
- Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery 22(6)
Study Design
- Type
- Meta-Analysis
- Sample size
- n = 5,461
- Population
- patients with obesity undergoing metabolic and bariatric surgery (MBS)
- Methods
- systematic review and meta-analysis of 10 studies with 5461 subjects; searches from PubMed, Embase, and Web of Science up to September 2025
Background
The perioperative effect of preoperative administration of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in individuals with obesity scheduled to receive metabolic and bariatric surgery (MBS) remains uncertain.Objectives
The objective of this systematic review and meta-analysis was to evaluate the efficacy of preoperative GLP-1 RAs in patients with obesity undergoing MBS.Setting
All over the world.Methods
Original studies were searched from the inception of PubMed, Embase, and Web of Science up to September 2025. Primary outcomes were the variation of weight from the initial to the preoperative period and postoperative total weight loss percentage (TWL%). Secondary outcomes included the incidence of postoperative complications, postoperative glycated hemoglobin level, and the proportion of patients with remission of diabetes.Results
After screening, 10 studies consisting of 5461 subjects were included in the final meta-analysis. The results showed that preoperative GLP-1 RAs were associated with a moderate reduction in preoperative weight (total median of weight reduction: 4.87 kg vs 3.84 kg; SMD: .4, 95% CI: -.37 to 1.18, P < .01) but did not significantly affect postoperative TWL% (SMD: -.20, 95% CI: -.27 to -.13, P = .21). Preoperative administration of GLP-1 RAs did not significantly increase the incidence of postoperative complications (RR: 1.62, 95% CI: .76-3.45, P = .12) nor improve the comorbidities (P = .23).Conclusions
Our study indicates that preoperative GLP-1 RAs are generally safe for patients with obesity undergoing MBS. However, this benefit only correlates with a certain degree of preoperative weight loss, and its effect on postoperative weight loss and improvement of comorbidities are limited.