Alyafei Anees A, AlMukhaini Said K, Ma Hussein Aysha, Al Abdulla Sara Tariq
Preventive Medicine/Wellness Programs, Primary Health Care Corporation, Doha, QAT.
Health Services and Programs, Ministry of Health, Muscat, OMN.
Cureus. 2025 Jun 9;17(6):e85587. doi: 10.7759/cureus.85587. eCollection 2025 Jun.
Weight loss from obesity is a global health concern associated with increased risk of chronic illness and significant healthcare costs. Sleeve gastrectomy is an increasingly popular bariatric surgery option for substantial weight reduction; however, sustained success depends on lifestyle modification. Integrating food, exercise, behavioral, and technology-based interventions into surgery can potentially enhance outcomes and promote weight maintenance. A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) 2020 guidelines, encompassing randomized controlled trials published between 2014 and 2025. Databases like PubMed, Cochrane Library, Embase, Web of Science, and Scopus were searched. Studies included adults (age ≥18 years) with obesity undergoing sleeve gastrectomy and subjected to post-operative lifestyle interventions. The primary outcomes were weight changes, BMI, and body composition, while the secondary outcomes included comorbidities and quality of life. Risk of bias was assessed using the ROB-2 tool (www.cochrane.org). Thirty-one studies with varying follow-up durations (1-60 months) were included. The combined intervention resulted in greater weight loss (5%-30% decrease), improvement in fat mass, BMI, and cardiometabolic profiles compared to usual care. The meta-analysis revealed a high overall effect size for weight reduction, with a value of 2.56 (2.15-2.88) for the high weight reduction group and 1.88 (1.76-1.91) for the low weight reduction group. Heterogeneity among studies was moderate, with I² values ranging from 18% to 46%, indicating some variation in study populations and intervention effects. Technology-augmented interventions, such as wearable devices and mobile apps, provided additional gains in adherence and long-term efficacy. Long-term weight loss maintenance remained a difficulty. Sleeve gastrectomy combined with structured lifestyle interventions significantly improves anthropometric and health outcomes in adults. Technology-derived interventions and behavioral therapy have the potential for improving long-term weight management, but additional studies are required to optimize intervention approaches.
肥胖导致的体重减轻是一个全球性的健康问题，与慢性病风险增加和高昂的医疗成本相关。袖状胃切除术是一种越来越受欢迎的减肥手术选择，可实现显著的体重减轻；然而，持续的成功取决于生活方式的改变。将食物、运动、行为和基于技术的干预措施融入手术中，可能会改善手术效果并促进体重维持。按照系统评价和Meta分析的首选报告项目（PRISMA）2020指南进行了一项系统评价和Meta分析，涵盖2014年至2025年发表的随机对照试验。检索了PubMed、Cochrane图书馆、Embase、科学网和Scopus等数据库。研究纳入了年龄≥18岁、接受袖状胃切除术并进行术后生活方式干预的肥胖成年人。主要结局是体重变化、体重指数（BMI）和身体成分，次要结局包括合并症和生活质量。使用ROB-2工具（www.cochrane.org）评估偏倚风险。纳入了31项随访时间不同（1 - 60个月）的研究。与常规护理相比，联合干预导致更大程度的体重减轻（减少5% - 30%），体脂、BMI和心脏代谢指标得到改善。Meta分析显示体重减轻的总体效应大小较高，高体重减轻组的值为2.56（2.15 - 2.88），低体重减轻组的值为1.88（1.76 - 1.91）。研究之间的异质性为中等，I²值范围为18%至46%，表明研究人群和干预效果存在一些差异。技术增强型干预措施，如可穿戴设备和移动应用程序，在依从性和长期疗效方面提供了额外的益处。长期维持体重减轻仍然是一个难题。袖状胃切除术联合结构化生活方式干预可显著改善成年人的人体测量指标和健康结局。技术衍生的干预措施和行为疗法有改善长期体重管理的潜力，但需要更多研究来优化干预方法。
