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Background <p>Sarcopenia is a common complication following metabolic and bariatric surgery (MBS) and may adversely affect postoperative outcomes. This review aimed to investigate the effects of structured exercise interventions (SEI) on sarcopenia-related outcomes in patients undergoing bariatric surgery.</p> Methods <p>Randomized and non-randomized trials were included if they used a control group that did not engage in structured exercise, reported at least one relevant outcome, and used SEI either before or after MBS in adults aged over 18 with a BMI ≥ 35&#xa0;kg/m². Scopus, PubMed, Cochrane Library, Web of Science, and Google Scholar were searched on April 3, 2025. The ROB and ROBINS-I tools were used to evaluate the risk of bias. Quantitative data synthesis was conducted using the random-effects model. The review protocol was registered in the PROSPERO database (ID: CRD420251020805).</p> Results <p>A total of 4,618 records were screened, of which thirty-three studies (<i>n</i> = 1,545 participants; mean age = 41.3 years; mean BMI = 42.1&#xa0;kg/m²; 82.2% female) were included. SEI significantly reduced body weight (WMD=-1.96 [-3.37,-0.54] kg) and BMI (WMD=-0.67 [-1.04,-0.29] kg/m<sup>2</sup>) following bariatric surgery, particularly through aerobic training. SEI was also effective in preserving fat-free mass, with the largest effect size observed for combined exercise interventions (WMD = 1.87 [0.91,2.83] kg). Muscle strength improved significantly following SEI, especially in response to resistance training (SMD = 0.74 [0.03,1.45]). Functional and aerobic capacity improved as reflected in the 6-minute walk test, sit-to-stand test, and VO₂ peak. Overall physical activity improved (SMD = 0.54 [0.02,1.06]), but step count and resting metabolic rate did not change significantly.</p> Conclusions <p>Supervised combined exercise programs should be considered in the early postoperative period and sustained for a minimum of six months. Aerobic training should be considered for continuation and may be appropriately transitioned to unsupervised formats without compromising effectiveness.</p> Graphical Abstract <p></p>

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Enhancing Sarcopenia-Related Outcomes After Bariatric Surgery: A Systematic Review and Meta-Analysis of Exercise Interventions

  • 期刊论文

  • 发表日期：

    2026年5月11日

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  • Mohammadmahdi Abbasi,
  • Fezzeh Elyasinia,
  • Ali Jahromi,
  • Farima Farsi,
  • Roham Jebeli Fard,
  • Niloofar Jahromi,
  • Anahita Pirisedigh,
  • Ahmadreza Soroush,
  • Shirin Hasani-Ranjbar

摘要

Background

Sarcopenia is a common complication following metabolic and bariatric surgery (MBS) and may adversely affect postoperative outcomes. This review aimed to investigate the effects of structured exercise interventions (SEI) on sarcopenia-related outcomes in patients undergoing bariatric surgery.

Methods

Randomized and non-randomized trials were included if they used a control group that did not engage in structured exercise, reported at least one relevant outcome, and used SEI either before or after MBS in adults aged over 18 with a BMI ≥ 35 kg/m². Scopus, PubMed, Cochrane Library, Web of Science, and Google Scholar were searched on April 3, 2025. The ROB and ROBINS-I tools were used to evaluate the risk of bias. Quantitative data synthesis was conducted using the random-effects model. The review protocol was registered in the PROSPERO database (ID: CRD420251020805).

Results

A total of 4,618 records were screened, of which thirty-three studies (n = 1,545 participants; mean age = 41.3 years; mean BMI = 42.1 kg/m²; 82.2% female) were included. SEI significantly reduced body weight (WMD=-1.96 [-3.37,-0.54] kg) and BMI (WMD=-0.67 [-1.04,-0.29] kg/m2) following bariatric surgery, particularly through aerobic training. SEI was also effective in preserving fat-free mass, with the largest effect size observed for combined exercise interventions (WMD = 1.87 [0.91,2.83] kg). Muscle strength improved significantly following SEI, especially in response to resistance training (SMD = 0.74 [0.03,1.45]). Functional and aerobic capacity improved as reflected in the 6-minute walk test, sit-to-stand test, and VO₂ peak. Overall physical activity improved (SMD = 0.54 [0.02,1.06]), but step count and resting metabolic rate did not change significantly.

Conclusions

Supervised combined exercise programs should be considered in the early postoperative period and sustained for a minimum of six months. Aerobic training should be considered for continuation and may be appropriately transitioned to unsupervised formats without compromising effectiveness.

Graphical Abstract