Zheng Shuwen, Li Aihua, Yang Yuxian, Zhao Dong, Ke Jing
Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital Capital Medical University Beijing China.
Laboratory for Clinical Medicine Capital Medical University Beijing China.
Food Sci Nutr. 2025 Sep 12;13(9):e70834. doi: 10.1002/fsn3.70834. eCollection 2025 Sep.
Obesity has emerged as a significant global public health challenge. Sleeve gastrectomy (SG), currently the most widely performed bariatric procedure worldwide, has demonstrated substantial efficacy in achieving significant weight loss and improving metabolic health. However, notable postoperative complications-particularly malnutrition and weight regain-require heightened clinical attention and the implementation of effective long-term management strategies. These adverse outcomes result from a variety of factors, including anatomical changes that trigger complex hormonal, metabolic, and immune adaptations. These issues are often compounded by suboptimal lifestyle behaviors and poor adherence to postoperative recommendations. Emerging evidence highlights that sustained dietary counseling provides significant long-term benefits for the majority of patients undergoing SG. Therefore, this review aimed to synthesize the current understanding of the pathophysiological mechanisms that drive digestive adaptations, malnutrition, and weight regain following SG. Further, it evaluates the efficacy, feasibility, and tolerability of targeted dietary management strategies aimed at mitigating these complications.
肥胖已成为一项重大的全球公共卫生挑战。袖状胃切除术(SG)是目前全球开展最为广泛的减肥手术,已在实现显著体重减轻和改善代谢健康方面展现出显著疗效。然而,值得注意的术后并发症——尤其是营养不良和体重反弹——需要临床给予更多关注并实施有效的长期管理策略。这些不良后果由多种因素导致,包括引发复杂激素、代谢和免疫适应的解剖学变化。这些问题常常因不良生活方式行为以及对术后建议的依从性差而更加复杂。新出现的证据表明,持续的饮食咨询对大多数接受SG手术的患者具有显著的长期益处。因此,本综述旨在综合目前对SG术后驱动消化适应、营养不良和体重反弹的病理生理机制的理解。此外,它还评估了旨在减轻这些并发症的针对性饮食管理策略的疗效、可行性和耐受性。