肥胖是一个全球性的健康问题，需要有效的减肥干预措施。本研究旨在比较索马鲁肽（一种药物治疗选择）与减肥手术（一种常用的减肥手术干预措施）的有效性和安全性。对临床试验进行了系统回顾，包括STEP（索马鲁肽对人体的治疗效果）试验、维持试验、先锋试验和STAMPEDE（手术治疗和药物有效根除糖尿病）试验，以评估这些干预措施的结果。临床试验分析表明，索马鲁肽可显着减轻参与者的体重。然而，也观察到了胃肠道（GI）紊乱、脉搏加快以及罕见的甲状腺癌等不良反应。长期效果显示，索马鲁肽停药后，体重部分恢复，某些心脏代谢变量恢复至基线水平。相比之下，正如减肥手术纵向评估 (LABS) 联盟所证明的那样，并得到 STAMPEDE 试验的支持，减肥手术在减轻体重和治疗肥胖引起的并发症（如糖尿病）方面表现出更高的功效。 STAMPEDE 试验表明，与单纯药物治疗相比，减肥手术，特别是 Roux-en-Y 胃绕道手术 (RYGB) 和袖状胃切除术 (SG)，实现糖尿病治疗目标的患者比例显着提高。虽然减肥手术显示出优越的疗效，但并发症的风险也较高。相比之下，索马鲁肽提供了一种非侵入性替代方案，可显着减轻体重并降低不良反应的发生率。总之，这项研究强调，减肥手术，如 Roux-en-Y 胃绕道手术和袖状胃切除术，仍然是减肥和管理肥胖引起的并发症的高效干预措施。然而，索马鲁肽是一种有价值的非侵入性替代品，可显着减轻体重并降低不良反应的风险。这些干预措施之间的选择应基于患者个体特征和风险效益概况的综合评估。版权所有 © 2023，Klair 等人。

Obesity is a global health concern, necessitating effective weight-loss interventions. This study aimed to compare the efficacy and safety of semaglutide, a pharmacotherapeutic option, with bariatric surgery, a commonly utilized surgical intervention, for weight reduction. A systematic review of clinical trials, including the STEP (Semaglutide Treatment Effect in People) trials, sustain trials, pioneer trials, and the STAMPEDE (Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiently) trial, was conducted to evaluate the outcomes of these interventions. The analysis of the clinical trials revealed that semaglutide demonstrated significant weight reduction in participants. However, adverse effects such as gastrointestinal (GI) disturbances, increased pulse rate, and rare cases of thyroid cancer were observed. Long-term effects showed partial weight regain and a return of certain cardiometabolic variables to baseline levels after semaglutide withdrawal. Comparatively, bariatric surgery, as demonstrated in the Longitudinal Assessment of Bariatric Surgery (LABS) consortium and supported by the STAMPEDE trial, exhibited higher efficacy in weight reduction and the management of obesity-induced complications such as diabetes. The STAMPEDE trial demonstrated that bariatric surgery, specifically Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), led to a significantly higher percentage of patients achieving desired diabetes treatment targets compared to medical therapy alone. While bariatric surgery showed superior efficacy, it also carried a higher risk of complications. In contrast, semaglutide presented a noninvasive alternative with significant weight reduction and lower incidences of adverse effects. In conclusion, this study highlights that bariatric surgery, such as Roux-en-Y gastric bypass and sleeve gastrectomy, remains a highly effective intervention for weight loss and management of obesity-induced complications. However, semaglutide represents a valuable noninvasive alternative, offering significant weight reduction and lower risks of adverse effects. The choice between these interventions should be based on individual patient characteristics and a comprehensive assessment of the risk-benefit profile.Copyright © 2023, Klair et al.