Cross-Sectional Differences in BMI, Sarcopenia Risk, and Quality of Life During the First Postoperative Year Following Sleeve Gastrectomy: An Exploratory Study.

Abstract

Introduction: Sleeve gastrectomy (SG) effectively reduces body mass index (BMI); however, rapid postoperative weight loss may result in skeletal muscle loss and transiently impair health-related quality of life (QoL). Concurrent data on these three outcomes across the first postoperative year remain limited, particularly in the southern United States.

Methods: This exploratory cross-sectional study enrolled 55 patients (aged 30-50 years; preoperative BMI 30-45 kg/m²) who underwent SG at healthcare facilities across Texas and were stratified by postoperative interval: 3-6, 6-9, and 9-12 months. Sarcopenia risk was assessed using the SARC-F questionnaire (threshold ≥ 4), and QoL was measured using the EQ-5D-5 L with the United States value set. Nonparametric methods included the Kruskal-Wallis H test with Dunn post-hoc correction.

Results: Median BMI decreased significantly from 40.8 to 29.2 kg/m² (Wilcoxon Z = - 6.45, r = .87, p < .001). Sarcopenia risk was markedly lower in patients assessed at 9-12 months (35.3%) than in those assessed at 3-6 months (90.5%) (p < .001). The QoL index was higher in the 9-12-month group (0.90) than in the 3-6-month group (0.84) (p < .001). Moderate to extreme pain and discomfort was reported by 38.1% of patients in the 3-6-month group versus 0.0% in the 9-12-month group. Middle-aged patients demonstrated significantly higher sarcopenia burden (r = .591) and lower QoL (r = .446) compared with early adults.

Conclusion: BMI, sarcopenia risk, and QoL differed favorably across groups assessed later in the first postoperative year. The high sarcopenia risk observed in patients early in the postoperative course supports routine SARC-F screening from 3 months postoperatively and phase-specific rehabilitation. Future longitudinal studies with objective body composition assessments are warranted.