Journal Watch 12/3/2025

Welcome to our weekly round-up of the latest bariatric and obesity-related papers published in the medical literature. As ever, we have looked far and wide to give you an overview of papers including swallowable biofragmentable magnetic anastomosis system, BMS vs GLP-1 RA therapy for cardiovascular outcomes, choosing bariatric surgery tourism, Predicting pregnancy at the first year post-BMS and metabolic outcomes of BMS vs versus lifestyle intervention in adolescents, and more (please note, log-in maybe required to access the full paper).

First-in-Human Side-to-Side Duodeno-Ileal Bipartition for Weight Loss and Type 2 Diabetes with the Swallowable Biofragmentable Magnetic Anastomosis System

Researchers from Canada have concluded that a swallowable, biofragmentable magnetic anastomosis system (BMAS) is feasible, safe,and effective in achieving incisionless, suture/staple-free magnetic duodeno-ileostomy.

Reporting in the Journal of the American College of Surgeons, they a BMAS is endo-laparoscopically placed to effect magnetic duodeno-ileostomy (MagDI) bipartition for reduction of weight and type 2 diabetes (T2D). MagDI obviates major risks associated with enterotomy, stapling/suturing, and retained foreign materials.

This is the first-in-human prospective investigation of feasibility, safety and efficacy in adults with BMI ≥30.0-≤35.0 kg/m2. An initial BMAS magnet, swallowed by the patient or delivered under anaesthesia by endoscopy, was guided laparoscopically to the distal ileum; a second magnet was endoscopically positioned in the post-pyloric duodenum; magnets were aligned to fuse over 7-21 days forming the duodeno-ileostomy.

In total, 15 patients (mean BMI 33.0±0.4 kg/m2), all with T2D (HbA1C 8.2±0.4%, glucose 187.9±15.5 mg/dL, on T2D medications) underwent MagDI. Mean operative time, 51.3±5.3 minutes. Feasibility at 90 days was confirmed in 100.0% with 0.0% leakage, bleeding, infection, stricture, mortality. 89.4% of AEs were mild; 3 CD-III SAEs were resolved. At one year, 100.0% of anastomoses were patent; BMI (n=8) 30.1±0.9; excess weight loss 38.8%; HbA1C 6.6±0.1%; glucose 142.8±9.5 mg/dL.

“The device and procedure provide a promising minimally invasive option for moderate, clinically meaningful weight loss and T2D mitigation,” they concluded.

To access this paper, please click here

Metabolic and bariatric surgery versus glucagon-like peptide-1 receptor agonist therapy: A comparison of cardiovascular outcomes in patients with obesity    

US researchers have found there is a lower risk of adverse cardiovascular outcomes was noted after BMS compared with glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy in patients with obesity.

Reporting in The American Journal of Surgery, they compared cardiovascular outcomes associated with surgery and GLP-1 RA therapy in individuals with obesity.

They reported that BMS was associated with lower hazard of the primary composite outcome of CVD (HR, 0.54, 95 ​% CI, 0.49–0.60) and the secondary outcomes of incident HF (HR, 0.45, 95 ​% CI, 0.39–0.52), CAD (HR, 0.54, 95 ​% CI, 0.45–0.66), and cerebrovascular disease (HR, 0.64, 95 ​% CI, 0.53–0.77).

To access this paper, please click here

Relationship Between Preoperative Surgical Fear, Anxiety, and Satisfaction Levels in Individuals Choosing Bariatric Surgery Tourism: A Descriptive, Cross-Sectional Study

Preoperative knowledge levels and satisfaction with the information provided significantly impacted surgical fear and anxiety levels among bariatric surgery tourism patients, investigators from Yeditepe University, Istanbul, Turkey, have found.

The study, featured in Obesity Surgery, evaluated the preoperative surgical fear, anxiety, and satisfaction levels regarding bariatric surgery tourism processes and to examine the relationships between these variables.

This descriptive, cross-sectional study was conducted with foreign patients who visited the general surgery clinic of a healthcare institution for bariatric surgery within the scope of health tourism. Data were collected through face-to-face interviews using the Patient Information Form, Surgical Fear Scale, and Surgical Anxiety Scale.

The mean age of the patients was 39.39 ± 9.35 years, and 88.5% were from the UK. Additionally, 88.5% reported choosing bariatric surgery tourism due to high surgical costs in their home country.

The mean score for surgical fear was 37.68±20.58, while the mean score for surgical anxiety was 19.53±12.90. Patients who lacked prior knowledge about bariatric surgery tourism had significantly higher surgical fear and anxiety scores (p<0.05). Age, fear and anxiety associated with undergoing surgery in a foreign country, and total surgical anxiety scale score were identified as independent predictors of patients’ satisfaction with their bariatric surgery tourism experience (p<0.01).

To access this paper, please click here

Predicting pregnancy at the first year following metabolic-bariatric surgery: development and validation of machine learning models

Researchers from Iran University of Medical Sciences, Tehran, Iran, have concluded that developing the machine learning (ML) models that predict pregnancy within 12 months after BMS, can help bariatric surgeons and obstetricians to prevent and manage suboptimal surgical response and adverse pregnancy outcomes.

Published in Surgical Endoscopy, the study aimed to present a prediction model for pregnancy at the first year following BMS ML algorithms. The case–control study included 473 women with a history of pregnancy after surgery.

This model considered thirteen important factors to predict pregnancy at the first 12 months following surgery, including menstrual irregularity, marital status, a history of abnormal fetal development, age, infertility type, parity, gravidity, fertility treatment, presurgery body mass index (BMI), infertility, infertility duration, polycystic ovary syndrome (PCOS), and type 2 diabetes (T2DM).

To access this paper, please click here

Metabolic outcomes of bariatric surgery versus lifestyle intervention in adolescents with severe obesity: A systematic review and meta-analysis

An international team of researchers have found that larger, longer-term trials that include multinational and multiethnic representation are essential for making solid clinical practice recommendations regarding BMS for children with obesity.

Writing in Clinical Obesity, their systematic review and meta-analysis (SRM) sought to evaluate the effectiveness and safety of BMS compared to lifestyle modifications (LSM) in children and adolescents with obesity are scarce.  Five trials (three randomised, open-label and two non-randomised) with 1-2 years follow-up durations were analysed, including 367 participants aged 10-19 years.

BMS resulted in greater reductions in body weight (mean difference [MD] -25.83 kg, 95% confidence interval [CI] [-36.91, -14.75], p<0.00001) and per cent body weight (MD -24.54%, 95% CI [-33.19, -15.89], p<0.00001) compared to LSM. Furthermore, MBS outperformed LSM in reducing body mass index (BMI), BMI z-score, waist circumference, glycated haemoglobin, fasting plasma glucose, insulin resistance, triglycerides, alanine aminotransferase, high sensitivity C-reactive protein and an overall improvement of physical functioning and quality of life. The safety profile was comparable between the two groups; however, data was scarce.

To access this paper, please click here