Effect of Dietary Patterns on Long-Term Weight Maintenance of Patients After Sleeve Gastrectomy

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.