Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery
Efficacy and safety of GLP-1 receptor agonists combined with bariatric surgery for obesity: a timing-stratified systematic review
By He MC, Hua R, Shao YK and 6 others.
Abstract
Objective
To systematically evaluate the efficacy and safety of GLP-1 receptor agonists applied at different stages before and after bariatric surgery, and to compare the clinical benefits of preoperative use, early postoperative use, and rescue use after insufficient weight loss or weight regain according to medication timing.
Methods
PubMed, Web of Science, and Embase via Ovid were searched from inception to June 20, 2026. A relatively strict three-concept search strategy was used, consisting of terms related to bariatric surgery, GLP-1 receptor agonists and specific drug names, and perioperative or weight-management scenarios. Searches were mainly restricted to title and abstract fields, and animal-only studies were excluded. Clinical studies involving patients who underwent metabolic and bariatric surgery and received GLP-1 receptor agonists before or after surgery were included. Studies were classified into three groups according to medication timing: preoperative use, early postoperative use, and rescue use after insufficient weight loss or weight regain. Mean difference or standardized mean difference was used for continuous variables, and odds ratio was used for categorical variables. Meta-analysis was performed using a random-effects model.