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Review
. 2023 Dec;33(12):4147-4158.
doi: 10.1007/s11695-023-06909-4. Epub 2023 Nov 2.

Bariatric Surgery for Patients with Overweight/Obesity. A Comprehensive Grading Methodology and Network Metanalysis of Randomized Controlled Trials on Weight Loss Outcomes and Adverse Events

Maurizio De Luca  1 , Monica Zese  2 , Giovanni Antonio Silverii  3 , Benedetta Ragghianti  3 , Giulia Bandini  3 , Pietro Forestieri  4 , Marco Antonio Zappa  5 , Giuseppe Navarra  6 , Diego Foschi  7 , Mario Musella  4 , Giuliano Sarro  8 , Vincenzo Pilone  9 , Enrico Facchiano  10 , Mirto Foletto  11 , Stefano Olmi  12 , Marco Raffelli  13 , Rosario Bellini  14 , Paolo Gentileschi  15 , Maria Rosaria Cerbone  16 , Ilenia Grandone  17 , Giovanna Berardi  4 , Nicola Di Lorenzo  18 , Marcello Lucchese  19 , Luigi Piazza  20 , Giovanni Casella  21 , Emilio Manno  22 , Alberto Zaccaroni  23 , Alessandro Balani  24 , Edoardo Mannucci  3 , Matteo Monami  3
Affiliations
Review

Bariatric Surgery for Patients with Overweight/Obesity. A Comprehensive Grading Methodology and Network Metanalysis of Randomized Controlled Trials on Weight Loss Outcomes and Adverse Events

Maurizio De Luca et al. Obes Surg. 2023 Dec.

Abstract

This study aims to compare different types of metabolic bariatric surgery (MBS) with lifestyle intervention/medical therapy (LSI/MT) for the treatment of overweight/obesity. The present and network meta-analysis (NMA) includes randomized trials. MBS was associated with a reduction of BMI, body weight, and percent weight loss, when compared to LSI/MT, and also with a significant reduction of HbA1c and a higher remission of diabetes. Meta-regression analyses revealed that BMI, a higher proportion of women, and a longer duration of trial were associated with greater effects of MBS. The NMA showed that all surgical procedures included (except greater curvature plication) were associated with a reduction of BMI. MBS is an effective option for the treatment of obesity. The choice of BMI thresholds for eligibility for surgery of patients with different complications should be performed making an evaluation of risks and benefits in each BMI category.

Keywords: Best choice in treatment of obesity; Metabolic surgery for diabetes; Network meta-analysis.

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