Analysis of the efficacy of metabolic and bariatric surgery on sarcopenic obesity: a systematic review and meta-analysis.

BACKGROUND

The efficacy of metabolic and bariatric surgery (MBS) in the treatment of sarcopenic obesity (SO) remains unclear.

OBJECTIVES

The purpose of this systematic review and meta-analysis was to evaluate the efficacy of MBS in the SO population to provide some reference value for the implementation of reasonable intervention in this population.

SETTING

All over the world.

METHODS

PubMed, Embase, Web of Science, and ClinicalTrials.gov were searched for relevant articles up to September 2025. The standard mean difference (SMD) and its 95% confidence interval (CI) were used for the quantitative synthesis of continuous variables, and the risk ratio (RR) and its 95% CI were used for the quantitative analysis of categorical variables. The primary outcomes were the variations of body weight and body mass index from initial to follow-up, the proportion of total weight loss, the proportion of excess weight loss, and the remission of comorbidities.

RESULTS

After screening, 7 studies involving 1704 patients were included in our final meta-analysis. The results of our analysis showed that the SO group had more significant variations in body weight (SMD = .89, 95% CI: .32-1.46, P = .002) and body mass index (SMD = 1.08, 95% CI: .41-1.76, P = .0016). There was a trend toward higher percentage of total weight loss and percentage of excess weight loss in the SO versus non-SO groups (SMD = .30, 95% CI: .06-.66, P = .09; SMD = .57, 95% CI: .28-1.42, P = .08). In terms of the remission of comorbidities, the 2 groups were similar (all P values > .05). In addition, the incidence of postoperative complications was similar between the 2 groups (RR = 1.78, 95% CI: .93-3.41, P > .05).

CONCLUSIONS

In the SO population, MBS was associated with comparable efficacy and safety outcomes, including moderate weight loss, improvement in comorbidities, and no significant increase in postoperative complications.