TITLE:
Bariatric Surgery and Postoperative Endocrine-Metabolic Dysfunction: Main Clinical Syndromes and Complications
AUTHORS:
Gustavo Alberto Gutiérrez-Barros, Emanuel David Hernández Riascos, María Victoria Morales-Morales, Ambar Valentina Pulido Moreno, Juan Sebastián Llanes Villalba, Luis David Mulford Granados, Adriana de Jesús Novoa Doria, María Graciela Novoa Doria, Leidy Pamela Peralta Villalba, Juan Carlos Camargo Cadena, Marilyn Antequera, Gustavo Adolfo Albor Castillejo
KEYWORDS:
Bariatric Surgery, Metabolic Surgery, Endocrine-Metabolic Complications, Post-Bariatric Hypoglycemia, Nutritional Deficiencies, Sarcopenia, Metabolic Bone Disease, Weight Regain
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.9,
September
2,
2026
ABSTRACT: Bariatric surgery is a highly effective intervention for the treatment of severe obesity and its cardiometabolic comorbidities; however, its effects are not limited to weight loss. The anatomical and functional reconfiguration of the gastrointestinal tract modifies nutrient transit, enteroendocrine secretion, macro- and micronutrient absorption, body composition, bone metabolism, and several hormonal axes. This review analyzes the main endocrine-metabolic complications following bariatric surgery, with emphasis on their pathophysiology, clinical expression, risk factors, and follow-up strategies. The most relevant entities include post-bariatric hypoglycemia, dumping syndrome, protein-energy malnutrition, sarcopenia, micronutrient deficiencies, metabolic bone disease, gonadal and thyroid alterations, weight regain, and recurrence of metabolic comorbidities. These complications may appear early or late, even years after initial weight-loss success, and require clinical, biochemical, nutritional, muscular, skeletal, metabolic, and psychosocial surveillance. The optimal approach requires a longitudinal, multidisciplinary model stratified by surgical technique, aimed at preventing irreversible damage, preserving the metabolic benefits of surgery, and promptly identifying the need for nutritional, pharmacological, endoscopic, or revisional surgical intervention.