Cardiorespiratory and Metabolic Responses After Sleeve Gastrectomy in Adults With Obesity: Systematic Review.
Thanakorn Kaewnin, Sirapitch Manakhantikul, Jirawat Wattanapanyawech
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In 30 seconds
This systematic review examined cardiorespiratory and metabolic responses after sleeve gastrectomy in adults with obesity. It included seven observational reports involving 162 participants from two independent cohorts, all using cardiopulmonary exercise testing with direct gas analysis. Relative VO₂peak improved after surgery, but absolute VO₂peak declined at every reported time point, indicating that relative measures may not reflect actual aerobic capacity. Oxygen uptake kinetics worsened at 1 and 6 months, then trended toward baseline by 16 months; walking economy improved.
Key findings
- Relative VO₂peak improved, while absolute VO₂peak declined at all reported time points after sleeve gastrectomy.
- Oxygen uptake kinetics (τ) worsened at 1 and 6 months, then trended toward baseline by 16 months.
- Walking economy improved through biomechanical adaptations.
Why it matters
The divergence between relative and absolute VO₂peak cautions against interpreting improvement in weight-adjusted aerobic capacity as evidence that overall aerobic capacity has increased. The reported early worsening in oxygen uptake kinetics also raises the possibility of a period when high-intensity exercise tolerance is reduced, although the review describes this as a hypothesis requiring prospective validation.
What to keep in mind
Evidence was very limited: seven observational reports represented only two independent cohorts, and the proposed early period of metabolic vulnerability requires prospective validation.