{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:42:18Z","timestamp":1791978138872,"version":"4.4.0"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004191","name":"Novo Nordisk","doi-asserted-by":"publisher","award":["ISS Scheme"],"award-info":[{"award-number":["ISS Scheme"]}],"id":[{"id":"10.13039\/501100004191","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"DH | National Institute for Health Research","doi-asserted-by":"publisher","award":["NIHR UCLH BRC (BRC530)"],"award-info":[{"award-number":["NIHR UCLH BRC (BRC530)"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000282","name":"Sir Jules Thorn Charitable Trust","doi-asserted-by":"publisher","award":["Salary contribution and consumable support"],"award-info":[{"award-number":["Salary contribution and consumable support"]}],"id":[{"id":"10.13039\/501100000282","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012317","name":"NIHR University College London Hospitals Biomedical Research Centre","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012317","id-type":"DOI","asserted-by":"crossref"}]},{"name":"NIHR UCL\/UCLH Biomedical Research Centre Obesity Theme"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Nat Med"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    A suboptimal clinical response after metabolic and bariatric surgery (MBS) is common and carries considerable health concerns. Here a double-blinded, randomized (1:1), placebo-controlled trial using semaglutide 2.4\u2009mg weekly (BARI-STEP) recruited adult participants at least 1 year after gastric bypass or sleeve gastrectomy with a suboptimal clinical response, defined as less than 20% weight loss from surgery. This was an adjunct to lifestyle intervention with a 500-kcal daily energy deficit. The primary outcome was percentage weight loss after 68-week treatment on an intention-to-treat analysis. Seventy participants (mean (s.d.) age\u2009=\u200947.3 (10.3) years, 58 (82.9%) female and 12 (17.1%) male) were randomized to receive 2.4\u2009mg semaglutide (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200935) or placebo (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200935). The intention-to-treat sample included 63 participants. Estimated change in mean (s.d.) percentage weight loss from baseline to week 68 was \u221218.0 (9.2) with semaglutide 2.4\u2009mg (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200934) versus +0.4 (7.0) with placebo (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200929). The mean adjusted treatment difference in percentage body weight change for semaglutide 2.4\u2009mg versus placebo was \u221219.18 (95% confidence interval \u221223.4 to \u221214.8;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001). Adverse events (AEs) were consistent with the known safety and tolerability profile of semaglutide, with no new safety concerns for the post-bariatric population. There were eight serious AEs, one suspected unexpected serious adverse reaction and no treatment-related deaths. BARI-STEP demonstrates that in people with a suboptimal clinical response after MBS, semaglutide results in substantial and clinically significant body weight reduction along with improvement in metabolic parameters and quality of life, compared to placebo. These findings suggest that semaglutide 2.4\u2009mg is a safe and effective treatment option for this patient population. ClinicalTrials.gov:\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\/study\/NCT05073835\" ext-link-type=\"uri\">NCT05073835<\/jats:ext-link>\n                    .\n                  <\/jats:p>","DOI":"10.1038\/s41591-026-04416-4","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T09:03:00Z","timestamp":1779440580000},"page":"2662-2672","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Semaglutide versus placebo in individuals with poor weight loss after bariatric surgery: a double-blinded, randomized, placebo-controlled trial"],"prefix":"10.1038","volume":"32","author":[{"given":"Chloe","family":"Stanley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritwika","family":"Mallik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nausheen","family":"Hamid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedrich C.","family":"Jassil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Reuven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tapiwa","family":"Ruwona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5663-1715","authenticated-orcid":false,"given":"Samuel J.","family":"Dicken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sulmaaz","family":"Qamar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Norton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Kingett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Pucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cormac","family":"Magee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0320-5234","authenticated-orcid":false,"given":"David","family":"Boniface","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5477-8585","authenticated-orcid":false,"given":"Rachel L.","family":"Batterham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalpana","family":"Devalia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Mok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Elkalaawy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Loy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Jenkinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haris","family":"Markakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Adamo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0104-3251","authenticated-orcid":false,"given":"Alanna","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1045-2871","authenticated-orcid":false,"given":"Janine","family":"Makaronidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"4416_CR1","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1016\/S0140-6736(23)02750-2","volume":"403","author":"NH Phelps","year":"2024","unstructured":"Phelps, N. H. et al. Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet 403, 1027\u20131050 (2024).","journal-title":"Lancet"},{"key":"4416_CR2","doi-asserted-by":"publisher","first-page":"1822","DOI":"10.1007\/s11695-015-1657-z","volume":"25","author":"L Angrisani","year":"2015","unstructured":"Angrisani, L. et al. Bariatric surgery worldwide 2013. Obes. Surg. 25, 1822\u20131832 (2015).","journal-title":"Obes. Surg."},{"key":"4416_CR3","unstructured":"Obesity: identification, assessment and management. Clinical Guideline CG189. National Institute for Health and Care Excellence www.nice.org.uk\/guidance\/cg189 (2014)."},{"key":"4416_CR4","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1007\/s11695-014-1512-7","volume":"25","author":"A De Hollanda","year":"2015","unstructured":"De Hollanda, A. et al. Patterns of weight loss response following gastric bypass and sleeve gastrectomy. Obes. Surg. 25, 1177\u20131183 (2015).","journal-title":"Obes. Surg."},{"key":"4416_CR5","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/j.pmedr.2016.12.021","volume":"5","author":"D-C Seo","year":"2017","unstructured":"Seo, D.-C., Lee, C. G., Torabi, M. R. & Lohrmann, D. K. The longitudinal trajectory of post-surgical % total weight loss among middle-aged women who had undergone bariatric surgery. Prev. Med. Rep. 5, 200\u2013204 (2017).","journal-title":"Prev. Med. Rep."},{"key":"4416_CR6","doi-asserted-by":"publisher","first-page":"1580","DOI":"10.1007\/s11695-012-0731-z","volume":"22","author":"RML Neto","year":"2012","unstructured":"Neto, R. M. L., Herbella, F. A. M., Tauil, R. M., Silva, F. S. & De Lima, S. E. Jr. Comorbidities remission after Roux-en-Y gastric bypass for morbid obesity is sustained in a long-term follow-up and correlates with weight regain. Obes. Surg. 22, 1580\u20131585 (2012).","journal-title":"Obes. Surg."},{"key":"4416_CR7","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.1097\/SLA.0000000000001920","volume":"265","author":"M Sundbom","year":"2017","unstructured":"Sundbom, M. et al. Substantial decrease in comorbidity 5 years after gastric bypass: a population-based study from the Scandinavian Obesity Surgery Registry. Ann. Surg. 265, 1166\u20131171 (2017).","journal-title":"Ann. Surg."},{"key":"4416_CR8","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1097\/SLA.0000000000000945","volume":"260","author":"R Caiazzo","year":"2014","unstructured":"Caiazzo, R. et al. Roux-en-Y gastric bypass versus adjustable gastric banding to reduce nonalcoholic fatty liver disease: a 5-year controlled longitudinal study. Ann. Surg. 260, 893\u2013899 (2014).","journal-title":"Ann. Surg."},{"key":"4416_CR9","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1053\/j.gastro.2015.04.014","volume":"149","author":"G Lassailly","year":"2015","unstructured":"Lassailly, G. et al. Bariatric surgery reduces features of nonalcoholic steatohepatitis in morbidly obese patients. Gastroenterology 149, 379\u2013388 (2015).","journal-title":"Gastroenterology"},{"key":"4416_CR10","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1111\/dme.13532","volume":"35","author":"A Pucci","year":"2018","unstructured":"Pucci, A. et al. Type 2 diabetes remission 2 years post Roux-en-Y gastric bypass and sleeve gastrectomy: the role of the weight loss and comparison of DiaRem and DiaBetter scores. Diabet. Med. 35, 360\u2013367 (2018).","journal-title":"Diabet. Med."},{"key":"4416_CR11","doi-asserted-by":"publisher","first-page":"2048","DOI":"10.1007\/s11695-014-1314-y","volume":"24","author":"E Mohos","year":"2014","unstructured":"Mohos, E. et al. Quality of Life, weight loss and improvement of co-morbidities after primary and revisional laparoscopic Roux Y gastric bypass procedure\u2014comparative match pair study. Obes. Surg. 24, 2048\u20132054 (2014).","journal-title":"Obes. Surg."},{"key":"4416_CR12","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1007\/s11695-014-1513-6","volume":"25","author":"M Raoof","year":"2015","unstructured":"Raoof, M. et al. Health-related quality-of-life (HRQoL) on an average of 12 years after gastric bypass surgery. Obes. Surg. 25, 1119\u20131127 (2015).","journal-title":"Obes. Surg."},{"key":"4416_CR13","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1001\/jamasurg.2023.2930","volume":"158","author":"J Mok","year":"2023","unstructured":"Mok, J. et al. Safety and efficacy of liraglutide, 3.0 mg, once daily vs placebo in patients with poor weight loss following metabolic surgery: the BARI-OPTIMISE randomized clinical trial. JAMA Surg. 158, 1003\u20131011 (2023).","journal-title":"JAMA Surg."},{"key":"4416_CR14","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1016\/S2213-8587(19)30157-3","volume":"7","author":"AD Miras","year":"2019","unstructured":"Miras, A. D. et al. Adjunctive liraglutide treatment in patients with persistent or recurrent type 2 diabetes after metabolic surgery (GRAVITAS): a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol. 7, 549\u2013559 (2019).","journal-title":"Lancet Diabetes Endocrinol."},{"key":"4416_CR15","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1007\/s11695-025-07733-8","volume":"35","author":"Y Nie","year":"2025","unstructured":"Nie, Y., Zhang, Y., Liu, B. & Meng, H. Glucagon-like peptide-1 receptor agonists for the treatment of suboptimal initial clinical response and weight gain recurrence after bariatric surgery: a systematic review and meta-analysis. Obes. Surg. 35, 808\u2013822 (2025).","journal-title":"Obes. Surg."},{"key":"4416_CR16","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12134288","volume":"12","author":"M Torrego-Ellacur\u00eda","year":"2023","unstructured":"Torrego-Ellacur\u00eda, M. et al. Combined effect of genetic variants on long-term weight response after bariatric surgery. J. Clin. Med. 12, 4288 (2023).","journal-title":"J. Clin. Med."},{"key":"4416_CR17","doi-asserted-by":"publisher","first-page":"2291","DOI":"10.1038\/s41366-020-0576-9","volume":"44","author":"MS Nielsen","year":"2020","unstructured":"Nielsen, M. S. et al. Predictors of weight loss after bariatric surgery\u2014a cross-disciplinary approach combining physiological, social, and psychological measures. Int. J. Obes. 44, 2291\u20132302 (2020).","journal-title":"Int. J. Obes."},{"key":"4416_CR18","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1097\/SLA.0b013e3180caa3e3","volume":"246","author":"CW Le Roux","year":"2007","unstructured":"Le Roux, C. W. et al. Gut hormones as mediators of appetite and weight loss after Roux-en-Y gastric bypass. Ann. Surg. 246, 780\u2013785 (2007).","journal-title":"Ann. Surg."},{"key":"4416_CR19","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1001\/jama.2021.23619","volume":"327","author":"DM Rubino","year":"2022","unstructured":"Rubino, D. M. et al. Effect of weekly subcutaneous semaglutide vs daily liraglutide on body weight in adults with overweight or obesity without diabetes: the STEP 8 randomized clinical trial. JAMA 327, 138\u2013150 (2022).","journal-title":"JAMA"},{"key":"4416_CR20","doi-asserted-by":"publisher","first-page":"2221","DOI":"10.1056\/NEJMoa2307563","volume":"389","author":"AM Lincoff","year":"2023","unstructured":"Lincoff, A. M. et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N. Engl. J. Med. 389, 2221\u20132232 (2023).","journal-title":"N. Engl. J. Med."},{"key":"4416_CR21","doi-asserted-by":"publisher","first-page":"2490","DOI":"10.1007\/s11695-025-07848-y","volume":"35","author":"T Jamialahamdi","year":"2025","unstructured":"Jamialahamdi, T. et al. Impact of semaglutide administration on weight loss after bariatric surgery: a meta-analysis. Obes. Surg. 35, 2490\u20132497 (2025).","journal-title":"Obes. Surg."},{"key":"4416_CR22","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1016\/S0140-6736(21)00213-0","volume":"397","author":"M Davies","year":"2021","unstructured":"Davies, M. et al. Semaglutide 2\u00b74 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet 397, 971\u2013984 (2021).","journal-title":"Lancet"},{"key":"4416_CR23","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1056\/NEJMoa2032183","volume":"384","author":"JPH Wilding","year":"2021","unstructured":"Wilding, J. P. H. et al. Once-weekly semaglutide in adults with overweight or obesity. N. Engl. J. Med. 384, 989\u20131002 (2021).","journal-title":"N. Engl. J. Med."},{"key":"4416_CR24","doi-asserted-by":"publisher","first-page":"94","DOI":"10.15277\/bjd.2023.418","volume":"23","author":"T Crabtree","year":"2023","unstructured":"Crabtree, T. et al. The factors predicting glucose and weight response to injectable semaglutide (Ozempic): real-world data from the Association of British Clinical Diabetologists\u2019 audit programme. Br. J. Diabetes 23, 94\u2013100 (2023).","journal-title":"Br. J. Diabetes"},{"key":"4416_CR25","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1016\/j.jacc.2024.06.001","volume":"84","author":"S Verma","year":"2024","unstructured":"Verma, S. et al. Efficacy of semaglutide by sex in obesity-related heart failure with preserved ejection fraction. J. Am. Coll. Cardiol. 84, 773\u2013785 (2024).","journal-title":"J. Am. Coll. Cardiol."},{"key":"4416_CR26","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1002\/oby.23922","volume":"32","author":"J Bonnet","year":"2024","unstructured":"Bonnet, J. et al. Semaglutide 2.4 mg\/wk for weight loss in patients with severe obesity and with or without a history of bariatric surgery. Obesity 32, 50\u201358 (2024).","journal-title":"Obesity"},{"key":"4416_CR27","doi-asserted-by":"publisher","unstructured":"Medhati, P. et al. GLP-1RA in the real world: 1-year compliance and outcomes of semaglutide use in patients with or without previous history of bariatric surgery. Ann. Surg. https:\/\/doi.org\/10.1097\/SLA.0000000000006748 (2025).","DOI":"10.1097\/SLA.0000000000006748"},{"key":"4416_CR28","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1111\/dom.70141","volume":"28","author":"M Alissou","year":"2026","unstructured":"Alissou, M. et al. Impact of Semaglutide on fat mass, lean mass and muscle function in patients with obesity: the SEMALEAN study. Diabetes Obes. Metab. 28, 112\u2013121 (2026).","journal-title":"Diabetes Obes. Metab."},{"key":"4416_CR29","doi-asserted-by":"publisher","first-page":"A16","DOI":"10.1210\/jendso\/bvab048.030","volume":"5","author":"JPH Wilding","year":"2021","unstructured":"Wilding, J. P. H. et al. Impact of semaglutide on body composition in adults with overweight or obesity: exploratory analysis of the STEP 1 study. J. Endocr. Soc. 5, A16\u2013A17 (2021).","journal-title":"J. Endocr. Soc."},{"key":"4416_CR30","doi-asserted-by":"publisher","first-page":"2898","DOI":"10.1210\/jc.2011-0435","volume":"96","author":"P Srikanthan","year":"2011","unstructured":"Srikanthan, P. & Karlamangla, A. S. Relative muscle mass is inversely associated with insulin resistance and prediabetes. Findings from the Third National Health and Nutrition Examination Survey. J. Clin. Endocrinol. Metab. 96, 2898\u20132903 (2011).","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"4416_CR31","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1016\/j.amjmed.2014.02.007","volume":"127","author":"P Srikanthan","year":"2014","unstructured":"Srikanthan, P. & Karlamangla, A. S. Muscle mass index as a predictor of longevity in older adults. Am. J. Med. 127, 547\u2013553 (2014).","journal-title":"Am. J. Med."},{"key":"4416_CR32","doi-asserted-by":"publisher","first-page":"57","DOI":"10.17476\/jmbs.2023.12.2.57","volume":"12","author":"K Ataya","year":"2023","unstructured":"Ataya, K. et al. Roux-en-Y gastric bypass versus one anastomosis gastric bypass as revisional surgery after failed sleeve gastrectomy: a systematic review and meta-analysis. J. Metab. Bariatr. Surg. 12, 57\u201366 (2023).","journal-title":"J. Metab. Bariatr. Surg."},{"key":"4416_CR33","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13113104","volume":"13","author":"LA Evans","year":"2024","unstructured":"Evans, L. A., Castillo-Larios, R., Cornejo, J. & Elli, E. F. Challenges of revisional metabolic and bariatric surgery: a comprehensive guide to unraveling the complexities and solutions of revisional bariatric procedures. J. Clin. Med. 13, 3104 (2024).","journal-title":"J. Clin. Med."},{"key":"4416_CR34","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1002\/oby.22187","volume":"26","author":"RL Pearl","year":"2018","unstructured":"Pearl, R. L. et al. Short- and long-term changes in health-related quality of life with weight loss: results from a randomized controlled trial. Obesity 26, 985\u2013991 (2018).","journal-title":"Obesity"},{"key":"4416_CR35","doi-asserted-by":"publisher","first-page":"1414","DOI":"10.1001\/jama.2021.3224","volume":"325","author":"D Rubino","year":"2021","unstructured":"Rubino, D. et al. Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: the STEP 4 randomized clinical trial. JAMA 325, 1414\u20131425 (2021).","journal-title":"JAMA"},{"key":"4416_CR36","doi-asserted-by":"publisher","first-page":"2724","DOI":"10.1007\/s11695-017-2866-4","volume":"27","author":"B Sheng","year":"2017","unstructured":"Sheng, B. et al. The long-term effects of bariatric surgery on type 2 diabetes remission, microvascular and macrovascular complications, and mortality: a systematic review and meta-analysis. Obes. Surg. 27, 2724\u20132732 (2017).","journal-title":"Obes. Surg."},{"key":"4416_CR37","doi-asserted-by":"publisher","first-page":"A10","DOI":"10.1210\/jendso\/bvab048.019","volume":"5","author":"M Davies","year":"2021","unstructured":"Davies, M. et al. Efficacy and safety of semaglutide 2.4 mg once-weekly in adults with overweight or obesity and type 2 diabetes (STEP 2). J. Endocr. Soc. 5, A10\u2013A11 (2021).","journal-title":"J. Endocr. Soc."},{"key":"4416_CR38","doi-asserted-by":"publisher","first-page":"1350","DOI":"10.2337\/dc24-0491","volume":"47","author":"SE Kahn","year":"2024","unstructured":"Kahn, S. E. et al. Effect of semaglutide on regression and progression of glycemia in people with overweight or obesity but without diabetes in the SELECT trial. Diabetes Care 47, 1350\u20131359 (2024).","journal-title":"Diabetes Care"},{"key":"4416_CR39","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1007\/s11695-023-06913-8","volume":"34","author":"P Salminen","year":"2024","unstructured":"Salminen, P. et al. IFSO consensus on definitions and clinical practice guidelines for obesity management\u2014an international Delphi study. Obes. Surg. 34, 30\u201342 (2024).","journal-title":"Obes. Surg."},{"key":"4416_CR40","doi-asserted-by":"publisher","DOI":"10.1111\/cob.12310","volume":"9","author":"RL Kolotkin","year":"2019","unstructured":"Kolotkin, R. L. et al. Validation of a new measure of quality of life in obesity trials: Impact of Weight on Quality of Life-Lite clinical trials version. Clin. Obes. 9, e12310 (2019).","journal-title":"Clin. Obes."},{"key":"4416_CR41","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.annepidem.2023.08.001","volume":"86","author":"RR Yorlets","year":"2023","unstructured":"Yorlets, R. R., Lee, Y. & Gantenberg, J. R. Calculating risk and prevalence ratios and differences in R: developing intuition with a hands-on tutorial and code. Ann. Epidemiol. 86, 104\u2013109 (2023).","journal-title":"Ann. Epidemiol."}],"container-title":["Nature Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04416-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04416-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04416-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T14:02:12Z","timestamp":1784210532000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04416-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,22]]},"references-count":41,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["4416"],"URL":"https:\/\/doi.org\/10.1038\/s41591-026-04416-4","relation":{},"ISSN":["1078-8956","1546-170X"],"issn-type":[{"value":"1078-8956","type":"print"},{"value":"1546-170X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,22]]},"assertion":[{"value":"18 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"S.J.D. receives royalties from Amazon for a self-published book, payments from Red Pen Reviews as a contributor, consultancy work for Consensus and Androlabs, and travel fees from a USDA National Institute of Food and Agriculture grant. R.L.B. reports honoraria from Novo Nordisk, Eli Lilly, Medscape, ViiV Healthcare and International Medical Press, and advisory board and consultancy work for Novo Nordisk, Eli Lilly, Pfizer, Gila Therapeutics, Epitomee Medical and ViiV Healthcare; from May 2023, they are an employee and shareholder of Eli Lilly. J.L. received an honorarium from Eli Lilly to deliver a talk at the 2025 BOMSS scientific meeting. B.N. has received research support from Aqua Medical unrelated to this work. C.S., T.R., A.B., J. Makaronidis and R.M. are supported by the UCLH NIHR BRC. J. Makaronidis has received institutional funding from Novo Nordisk and Rhythm Pharmaceuticals, and research funding from the NIHR, the Sir Jules Thorne Charitable Trust and the Society for Endocrinology (UK). J. Makaronidis was funded to attend the 2024 UKCO conference by Novo Nordisk. J. Makaronidis obtained funding from commercial organizations for the purpose of organizing conferences and educational events on behalf of the Association for the Study of Obesity (UK) in a voluntary role as the organization\u2019s sponsorship lead in 2025. The other authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}}]}}