Fat reduction and muscle gain integrated strategies for long-term management after metabolic and bariatric surgery
1Huang Linya,1Yang Yi,1,2Chen Yanming
1Department of Endocrinology and Metabolic Diseases The Third Affiliated Hospital of Sun Yat-sen University Guangdong Provincial
Key Laboratory of Diabetology & Guangzhou Municipal Key Laboratory of Mechanistic and Translational Obesity Research Medical
Center for Comprehensive Weight Control Guangzhou 510630 Guangdong China
2Department of Endocrinology and Metabolic
Diseases The Eighth Affiliated Hospital of Sun Yat-sen University Shenzhen 518033 Guangdong China
Abstract：Metabolic and bariatric surgery MBS is a pivotal intervention for severe obesity and its comorbidities. However the
significant loss of lean body mass and the associated risk of sarcopenia following surgery present major challenges to long-term patient
health. The review aims to systematically summarize the dynamic changes in body composition following MBS and to discuss scientific
management strategies focused on optimizing body composition. Ideal postoperative management should go beyond short - term
improvements in weight and metabolic parameters it should be based on scientific principles striving to minimize fat mass
particularly visceral adipose tissue while preserving or even increasing lean body mass. Achieving this goal hinges on implementing a
multidimensional personalized and sustained comprehensive intervention strategy. The core components of this strategy include
phased and adequate protein supplementation to stimulate muscle protein synthesis and mitigate lean tissue loss personalized exercise
prescriptions combining resistance and aerobic training to synergistically promote muscle anabolism improve insulin sensitivity and
prevent weight regain and a long - term multidisciplinary follow - up model that integrates expertise from nutrition physical
rehabilitation endocrinology and surgical team to provide continuous patient support and education thereby ensuring long - term
adherence. In conclusion implementing this body composition-focused management framework is critical for consolidating the lasting
benefits of surgery and enhancing overall metabolic health and quality of life.
