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Beyond Sarcopenia: A Systematic Review and Meta-Analysis on Muscle Outcomes After Bariatric Surgery.
Gabriël Eksteen1, Lore Dubois1, Bart Van der Schueren1,2
1Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium.
Summary
Metabolic and bariatric surgery (MBS) leads to adaptive muscle loss proportional to weight loss, generally preserving functional capacity. Standardized measures are needed to differentiate adaptive changes from sarcopenia post-MBS.
Area of Science:
- Endocrinology and Metabolism
- Surgical Sciences
- Gerontology
Background:
- Metabolic and bariatric surgery (MBS) is effective for sustained weight loss.
- Concerns exist regarding potential skeletal muscle loss and sarcopenia following MBS.
Purpose of the Study:
- To systematically review muscle quantity, strength, and physical performance changes after MBS.
- To assess if muscle loss post-MBS is adaptive or leads to clinically significant impairments.
Main Methods:
- Systematic review of longitudinal and cross-sectional studies.
- Searches across multiple databases (PubMed, EMBASE, etc.).
- Meta-analyses using standardized mean differences (SMDs) with random-effects models.
Main Results:
- Absolute muscle quantity declined, but relative muscle mass increased.
- Greater weight loss correlated with greater absolute muscle loss.
- Lower-body strength improved, while upper body strength remained stable or declined modestly; physical performance generally improved.
Conclusions:
- Muscle loss after MBS appears adaptive and proportional to weight reduction.
- Functional capacity is generally preserved or enhanced.
- Standardized outcome measures and obesity-specific normative data are crucial for early sarcopenia detection.
