GLP1 RA Superior to Bariatric Surgery for Improving Cardiovascular Outcomes in People With Obesity

Glucagon-like peptide 1 receptor agonist (GLP1 RA) provides a notably superior weight loss option for people with obesity compared with bariatric surgery, according to a study presented at ACC.25.

“Obesity is a chronic disease that leads to adverse cardiovascular (CV) events. Both bariatric surgery and GLP1 RA used for weight loss improve CV outcomes. We aim to understand the difference in CV outcomes in obese patients using GLP 1 RA or bariatric surgery for weight loss,” the researchers noted.

Investigators assessed 189,248 patients with obesity older than 18 years using the TriNetX database between 2012 and 2021. The population of interest was partitioned into 2 groups: those receiving GLP 1 RA and those undergoing bariatric surgery for weight loss. The main end points of interest were all-cause mortality, hospitalization, and CV adverse events over the study duration of 3 years.

The study found that compared with patients in the bariatric surgery group, those in the GLP1 RA group had appreciably lower rates of acute myocardial infarction, all-cause hospitalization, and all-cause mortality (odds ratio [OR], 0.48; 95% CI, 0.47-0.48).

Moreover, the researchers observed that the patients in the GLP RA group had a reduced risk of cerebrovascular accidents (OR, 0.89; 95% CI, 0.86-0.93) and acute heart failure (OR, 0.84; 95% CI, 0.82-0.87), as well as a lower risk of atrial fibrillation (OR, 0.74; 95% CI, 0.72-0.76).

“Compared to bariatric surgery, GLP1 RA provides a significantly superior noninvasive alternative to improve CV outcomes in obese patients,” the researchers concluded.

Vignarajah A, et al. Cardiovascular outcomes in obese patients treated with GLP1 RA vs bariatric surgery – a propensity matched analysis. Abstract presented at American College of Cardiology 2025; March 29-31, 2025; Chicago, IL.