Endocrine Effects of Bariatric Surgery: Benefits, Risks, and the Need for Comprehensive Care

Bariatric surgery (BS) is a highly effective treatment for obesity and related metabolic issues, significantly enhancing metabolic health and correcting hormonal imbalances. However, it also triggers complex hormonal changes that can disrupt various endocrine systems, including the somatotropic, gonadal, thyroid, pancreatic, and adrenal axes. This review examined the dual impact of BS on the endocrine system through a thorough evaluation of peer-reviewed studies, adhering to PRISMA guidelines, focusing on human research assessing endocrine parameters before and after surgery. Selected studies were chosen for their relevance and quality in clarifying the endocrine effects of BS.

While BS can restore growth hormone levels and improve fertility, it may also disrupt the recovery of insulin-like growth factor-1 and sex hormone balance, potentially leading to bone loss and catabolic conditions. Additionally, excessive post-meal insulin secretion can cause hyperinsulinemic hypoglycemia, coupled with impaired hormone responses that regulate blood sugar. There are further risks, such as secondary hyperparathyroidism and decreased bone density. Changes in thyroid hormone levels are also significant for both hypothyroid and euthyroid patients.

These findings emphasized the relationship between enhanced metabolic control and possible endocrine dysfunctions. Most existing evidence consists of associative studies that may not be robust enough for safe clinical guidelines, indicating a need for higher-quality research to establish causation and improve treatment strategies. Addressing the gaps in understanding the mechanisms behind these hormonal changes is crucial for optimizing BS results. Thus, a comprehensive approach that includes thorough preoperative assessments, personalized postoperative care, and targeted treatments is vital for minimizing complications while maximizing the benefits of BS.

Source: Shahid Tanweer A, Shaheen MH, Alshamsi BA, Almazrouei MA, Almasri RM, Shahid Tanveer A, Rajeh JM. Endocrine Dysfunction Following Bariatric Surgery: A Systematic Review of Postoperative Changes in Major Endocrine Hormones. Cureus. 2025 Jan 21;17(1):e77756. doi: 10.7759/cureus.77756. PMID: 39981480; PMCID: PMC11842000.

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