减重代谢手术（MBS）是重度肥胖及相关代谢性疾病的重要治疗手段，但其长期疗效在很大程度上依赖术后依从性与全程管理质量。术后依从性具有多维特征，主要涵盖随访依从性、饮食与药物依从性以及运动依从性，并受个体社会人口学特征、心理行为问题、家庭与社会支持、医疗可及性及随访流程设计等多因素共同影响。个案管理强调以患者为中心的连续评估、跨学科协同与结构化随访支持，现有研究总体提示其可能通过提高随访参与度、强化自我监测与行为支持，促进体重维持及相关临床指标改善，但证据仍存在研究设计与干预要素异质性较大、结局指标不统一及因果推断不足等局限。基于现有证据与临床需求，建议构建分阶段、标准化、个体化并与信息化工具融合的术后管理路径，形成"评估—干预—反馈纠偏"的闭环体系；未来仍需在统一核心指标与管理规范的基础上开展高质量前瞻性研究，以明确个案管理的有效成分及其成本效益，为规范化推广提供循证依据。

Bariatric metabolic surgery (MBS) is an important therapeutic option for severe obesity and obesity-related metabolic disorders; however, its long-term effectiveness largely depends on postoperative adherence and the quality of longitudinal, comprehensive care. Postoperative adherence is multidimensional, encompassing follow-up adherence, dietary and medication adherence, and exercise adherence, and is influenced by a range of factors including sociodemographic characteristics, psychological and behavioral problems, family and social support, healthcare accessibility, and the design of follow-up workflows. Case management emphasizes patient-centered continuous assessment, multidisciplinary coordination, and structured follow-up support. The existing literature generally suggests that case management may improve weight maintenance and related clinical outcomes by increasing follow-up participation and strengthening self-monitoring and behavioral support; nevertheless, the evidence is limited by substantial heterogeneity in study designs and intervention components, non-uniform outcome measures, and insufficient basis for causal inference. Based on current evidence and clinical needs, a postoperative care pathway integrating stage-based, standardized, individualized, and digital approaches is recommended to establish a closed-loop system of "assessment-intervention-feedback and correction." Future high-quality prospective studies, grounded in unified core outcome sets and standardized management frameworks, are warranted to identify the active components and cost-effectiveness of case management and to provide robust evidence for its wider implementation.