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Introduction <p>Telemedicine provides outcomes comparable to in-person follow-up after Metabolic Bariatric Surgery (MBS), but evidence on multicomponent online interventions in the late postoperative period remains scarce. This study evaluated the effects of a supervised online multicomponent program on sarcopenia risk and related components in adults 2–7 years after MBS.</p> Methods <p>In this randomized controlled trial, participants were assigned to either the multicomponent online group (<i>n</i> = 79) or control group (<i>n</i> = 60). The intervention combined nutritional counseling, delivered through synchronous group sessions and pre-recorded videos addressing behavioral strategies; and supervised exercise training including aerobic and resistance components. Assessments included body composition, phase angle, handgrip strength, sit-to-stand test, functional performance, resting energy expenditure, and biochemical analyses. Sarcopenia risk was assessed based on phase angle. Analyses used generalized estimating equations (intention-to-treat, <i>p</i> &lt; 0.05).</p> Results <p>After 12 weeks, the multicomponent online group (mean age 40.1 ± 7.5 years; BMI 29.6 ± 5.1&#xa0;kg/m²; 3.9 ± 1.7 years post-surgery), compared with controls (mean age 40.6 ± 8.1 years; BMI 29.2 ± 5.0&#xa0;kg/m²; 3.9 ± 1.6 years post-surgery) showed improvements in phase angle (β = 0.15; 95% CI: 0.02; 0.29; <i>p</i> = 0.025), handgrip strength/body weight (β = 0.03; 95% CI: 0.001; 0.06; <i>p</i> = 0.043), sit-to-stand time test (β = − 1.22; 95% CI: − 2.30; − 0.14; <i>p</i> = 0.027). Regarding biochemical outcomes, C-reactive protein and HOMA-β levels decreased, while serum creatinine and glucose increased within clinical reference ranges (<i>p</i> &lt; 0.05). Compared to controls, the intervention group had a significantly lower likelihood of sarcopenia risk after 12 weeks (OR = 0.41; 95% CI: 0.19; 0.87; <i>p</i> = 0.020).</p> Conclusion <p>A supervised online multicomponent intervention improved muscle strength and lowered sarcopenia risk after MBS, highlighting the potential of remote multicomponent strategies as a feasible approach to preserve muscle health and prevent sarcopenia in long-term bariatric care.</p>

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Multicomponent Online Intervention Improves Sarcopenia-Related Traits Following Long-Term Metabolic Bariatric Surgery: A Randomized Clinical Trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月22日

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  • Gabriela Sousa de Oliveira,
  • Ariene Silva do Carmo,
  • Simone Gonzaga do Carmo,
  • Patrícia Borges Botelho,
  • Ricardo Moreno Lima,
  • Kenia Mara Baiocchi de Carvalho

摘要

Introduction

Telemedicine provides outcomes comparable to in-person follow-up after Metabolic Bariatric Surgery (MBS), but evidence on multicomponent online interventions in the late postoperative period remains scarce. This study evaluated the effects of a supervised online multicomponent program on sarcopenia risk and related components in adults 2–7 years after MBS.

Methods

In this randomized controlled trial, participants were assigned to either the multicomponent online group (n = 79) or control group (n = 60). The intervention combined nutritional counseling, delivered through synchronous group sessions and pre-recorded videos addressing behavioral strategies; and supervised exercise training including aerobic and resistance components. Assessments included body composition, phase angle, handgrip strength, sit-to-stand test, functional performance, resting energy expenditure, and biochemical analyses. Sarcopenia risk was assessed based on phase angle. Analyses used generalized estimating equations (intention-to-treat, p < 0.05).

Results

After 12 weeks, the multicomponent online group (mean age 40.1 ± 7.5 years; BMI 29.6 ± 5.1 kg/m²; 3.9 ± 1.7 years post-surgery), compared with controls (mean age 40.6 ± 8.1 years; BMI 29.2 ± 5.0 kg/m²; 3.9 ± 1.6 years post-surgery) showed improvements in phase angle (β = 0.15; 95% CI: 0.02; 0.29; p = 0.025), handgrip strength/body weight (β = 0.03; 95% CI: 0.001; 0.06; p = 0.043), sit-to-stand time test (β = − 1.22; 95% CI: − 2.30; − 0.14; p = 0.027). Regarding biochemical outcomes, C-reactive protein and HOMA-β levels decreased, while serum creatinine and glucose increased within clinical reference ranges (p < 0.05). Compared to controls, the intervention group had a significantly lower likelihood of sarcopenia risk after 12 weeks (OR = 0.41; 95% CI: 0.19; 0.87; p = 0.020).

Conclusion

A supervised online multicomponent intervention improved muscle strength and lowered sarcopenia risk after MBS, highlighting the potential of remote multicomponent strategies as a feasible approach to preserve muscle health and prevent sarcopenia in long-term bariatric care.