Effect of bariatric surgery and pharmacological treatments on cardiovascular risk factors for adults with overweight and obesity: a systematic review and network meta-analysis

Bariatric surgery provides the most potent efficacy for weight loss and cardiometabolic improvement, with BPD being the most effective but also highest-risk procedure. Semaglutide emerges as a formidable therapeutic alternative, offering a degree of efficacy comparable to RYGB and SG in many key domains but with a superior safety profile. These findings underscore the need to shift from a "one-size-fits-all" approach to an evidence-based, individualized strategy that aligns each intervention's distinct efficacy and safety profile with specific patient goals and risk tolerance.