Bariatric (weight-loss) surgery and glucagon-like peptide 1 (GLP-1) medications may offer similar long-term benefits for heart, liver, and kidney health for people with type 2 diabetes, obesity, and types of fatty liver disease, according to a new study.

GLP-1s such as semaglutide and liraglutide are injectable medications that help regulate blood sugar and support weight loss. Bariatric surgery reduces the size of the stomach and may reroute the digestive tract to limit the amount of food the body can absorb. For people with type 2 diabetes and higher body weights, this can help with weight loss and blood glucose (sugar) control.

The study compared more than 1,400 people who had bariatric surgery with a matched group of people using GLP-1 medications. All participants were diagnosed with type 2 diabetes, obesity, and either metabolic dysfunction-associated steatotic liver disease (MASLD) or metabolic dysfunction-associated steatohepatitis (MASH).

After five and 10 years, both groups had similar rates of survival and heart-related outcomes. None of the participants developed cirrhosis (severe liver scarring caused by long-term damage) during the study period.

While both treatments showed similar benefits overall, each had unique strengths. Bariatric surgery was more effective in lowering the risk of chronic kidney disease. On the other hand, people taking GLP-1 medications saw more improvement in blood pressure control.

GLP-1s: A Noninvasive Alternative to Surgery?

Past research has found that bariatric surgery can help people with type 2 diabetes and higher body weight better control their blood glucose levels and weight, among other health benefits. However, not all people are candidates for this type of surgery, due to health issues or personal preference to avoid this type of invasive approach.

This research suggests GLP-1 medications may be a viable alternative to bariatric surgery for some people managing diabetes, obesity, and fatty liver disease. Notably, GLP-1s — like any other treatment — come with their own risk of potential side effects.

Ultimately, people living with type 2 diabetes can speak with their doctor to determine which treatment option best meets their unique health needs and goals. They can help weigh the pros and cons of different therapies.

Learn more about the many treatment options available for type 2 diabetes.

Find Your Team

On DiabetesTeam, the social network for people living with type 2 diabetes, members come together to ask questions, share advice, and connect with others who understand life with diabetes.

Have you considered bariatric surgery or started GLP-1 treatment? What did your healthcare team recommend? Share your experience in the comments, on your Activities page, or in a Groups conversation.