The application of artificial intelligence (AI) in the field of metabolic and bariatric surgery (MBS) holds significant potential but faces practical challenges, necessitating standardized guidance. Against this backdrop, the international expert consensus titled "The Current Status and Future Prospects of Artificial Intelligence in Metabolic and Bariatric Surgery," released in 2025, has reached important agreements regarding the core value and development prospects of AI in MBS. This article aims to provide an in-depth interpretation of this consensus: Based on relevant literature evidence from 2017 to 2025, it conducts an empirical analysis of the key issues covered in the consensus, including research progress and application status of AI in surgical training and standardization, optimization of referral processes, development of prognostic prediction models, and improvement of complication risk stratification. Additionally, it delves into the challenges of AI application highlighted by the consensus, such as the risk of over-reliance, ethical concerns, and technical limitations. Through an evidence-based interpretation of the consensus statement, this article seeks to assist healthcare professionals in more accurately understanding the current application status, core value, potential risks, and future directions of AI in the field of MBS. It aims to promote the clinical comprehension and practical implementation of the consensus, advance metabolic and bariatric surgery toward precision and personalization, and ultimately benefit patients.

This study aimed to compare the differences between single-port laparoscopic sleeve gastrectomy (LSG) and multi-port LSG in terms of short-term postoperative weight loss, psychological status improvement, and patient satisfaction with incisions. It further explored the clinical advantages and potential mechanisms of single-port LSG to provide a scientific basis for individualized surgical options for obese patients.

This retrospective analysis included 341 female patients who underwent sleeve gastrectomy at Shanghai Sixth People's Hospital from September 2023 to December 2024 (100 in the single-port group and 241 in the multi-port group). Inclusion criteria were age≥18 years, meeting IFSO surgical indications, and completion of baseline data collection. Exclusion criteria included severe mental illness, history of abdominal surgery, or severe postoperative complications. Surgical procedures followed guidelines, with the single-port group using a single-port access platform and the multi-port group following standard laparoscopic procedures. Observation indicators included preoperative and 3-month postoperative weight, BMI, BAI, BDI, PSQI, and SCAR scores, with calculations of ΔBMI, %TWL, %EWL, and changes in psychological scores. Statistical analysis was performed using R 4.4.3 software. Continuous data were expressed as mean ± standard deviation, and intergroup comparisons were conducted using independent samples t-tests. Categorical data were analyzed using Fisher's exact test, and propensity score matching was performed using a 1:1 nearest-neighbor matching method. P<0.05 was considered statistically significant.

Baseline data comparison showed that the single-port group had significantly lower age, weight, BMI, BAI score, BDI score, and PSQI score than the multi-port group (P<0.05), while waist circumference, hip circumference, and waist-to-hip ratio showed no significant difference (P>0.05). Three-month postoperative follow-up results revealed that the single-port group performed significantly better in weight, BMI, BAI score, ΔBAI, BDI score, PSQI score, ΔPSQI, and SCAR score (P<0.05), but no significant differences were observed between the two groups in ΔBMI, %TWL, %EWL, or ΔBDI (P>0.05). After propensity score matching, baseline characteristics showed no significant differences (P>0.05). At three months postoperatively, the single-port group still demonstrated superior BAI score, BDI score, PSQI score, SCAR score, and changes in psychological scores (ΔBAI, ΔBDI, ΔPSQI) compared to the multi-port group (P<0.05). Mediation analysis indicated that the surgical approach had significant direct and total effects on postoperative psychological changes, but the indirect effect through SCAR score was not significant. No significant difference was observed in postoperative complication rates (P>0.05), which mainly included incision fat liquefaction, incision hematoma, pulmonary infection, and postoperative bleeding, all of which resolved after treatment.

Single-port LSG outperforms multi-port LSG in postoperative psychological improvement and incision aesthetics, but weight loss efficacy and safety are comparable. Further validation of its long-term advantages and mechanisms is warranted.

To compare the clinical efficacy of Single-Anastomosis Sleeve Jejunal Bypass (SASJ) and One-Anastomosis Gastric Bypass (OAGB) for the treatment of obesity.

Retrospective clinical data were collected from patients who underwent SASJ and OAGB from January 2023 to January 2024 at the Department of Weight Loss and Metabolic Surgery, Drum Tower Hospital, School of Medicine, Nanjing University, China, and the main indexes included the patients' preoperative and postoperative weights, BMI, and glycemic-lipid metabolism indexes from 6 to 12 months after surgery, and the remission of comorbidities was also recorded. The data were statistically analyzed using chi-square test and independent sample t-test.

Total 152 patients were included in this study and were categorized into SASJ group (n=82) and OAGB group (n=70) according to the type of surgery they underwent. Significant weight loss as well as remission of complications were recorded at 6 and 12 months after both procedures. The weights at 6 and 12 months postoperatively were (93.1±15.7) kg and (84.2±16.6) kg in the SASJ group and (94.1±26.2) kg and (85.3±22.7) kg in the OAGB group, respectively.The remission rates for T2DM were 91.7% in the SASJ group and 91.7% in the OAGB group. and OAGB showed remission rates of 91.7% and 90% for T2DM and 81.3% and 80% for GERD, respectively. In addition, a relatively high risk of postoperative malnutrition in OAGB was documented at 12 months postoperatively. This was manifested by low postoperative nutritional markers such as albumin, serum calcium, and 25 hydroxyvitamin D, which were still within the normal range. Postoperative gastroscopic findings revealed anastomotic ulcers in 6 patients after OAGB, whereas SASJ had fewer abnormal postoperative gastroscopic findings, with only 1 anastomotic ulcer as well as 2 cases of reflux esophagitis.

SASJ and OAGB have similar efficacy in weight loss and relief of complications, while the risk of malnutrition after SASJ is lower than that after OAGB, and the probability of anastomotic ulcer after SASJ is lower.

To explore the relationship between carotid artery abnormalities and blood lipids, pulse pressure index (PPI), and ankle-brachial index (ABI) in newly diagnosed type 2 diabetes mellitus (T2DM) patients.

A total of 219 newly diagnosed T2DM patients from the Department of Endocrinology of the First Affiliated Hospital of Jinan University from January to December 2023 were selected for carotid artery ultrasound examination, blood sample testing, and other examinations. The correlation between carotid artery lesions and blood lipids, pulse pressure, and ankle-brachial index in newly diagnosed T2DM patients was analyzed.

The age, SBP, PP, PPI, Cys C, HDL-C, and the prevalence of hypertension in the carotid artery abnormal group were significantly higher than those in the carotid artery normal group (P<0.05), while the TG level was lower than that in the carotid artery normal group (P<0.05). Spearman correlation analysis showed that the carotid intima-media thickness (CIMT) in newly diagnosed T2DM patients was positively correlated with age, PPI, HDL-C, onset type, and history of hypertension (P<0.05). Logistic regression analysis showed that HDL-C was an influencing factor for carotid plaque formation in newly diagnosed T2DM patients.

Reduced HDL-C levels are a risk factor for carotid artery lesions in newly diagnosed T2DM patients. Therefore, initiating management of lipid indicators as early as possible is particularly important for this patient population. Young patients, in particular, require stricter monitoring and regulation of their lipid levels.

This paper employs bibliometric analysis to deeply explore the evolution of the knowledge structure and its visual representation in the integration of obesity management and artificial intelligence (AI), identify key research topics, development trajectories, and frontier directions, and provide evidence-based support for the clinical application of endocrinology and interdisciplinary integration.

Using the Web of Science core database as the data source, the search strategy of "Obesity" OR "Weight Loss" AND "Artificial Intelligence" OR "Machine Learning" was adopted, covering Article and Review types from 2011 to 2025. CiteSpace was utilized for analysis, with annual time slices set and the Top 50 per slice screening criterion applied to construct co-occurrence networks of terms, cluster lineage diagrams, temporal evolution diagrams, and author-institution collaboration maps.

The number of documents showed an exponential growth trend, going through three stages: initial accumulation, rapid development in the middle period, and explosive growth in the recent period. The co-occurrence network of terms included 651 nodes and 2,935 connections, with a network density of 0.0139. High-frequency terms included "obesity" (1 241 times) and "machine learning" (403 times). The clustering results revealed 10 research modules (Q = 0.4151, S = 0.6977), with the main research dimensions focusing on the application of AI technology (deep learning), mechanism explanation (metabolic syndrome), and treatment intervention (weight loss surgery). The temporal evolution showed that the research focus shifted from the early epidemiological foundation to the budding of clinical application in the middle period, and then to the recent precise integration and development, such as the combination of gut microbiota and AI prediction models. In the institutional collaboration network, Harvard University held a core position, while Chinese research institutions demonstrated a catching-up development trend.

The knowledge evolution in this research field reflects the model innovation of AI technology from risk assessment to personalized treatment. Current hotspots have shifted to explainable AI and multimodal data fusion. Future research should strengthen international collaboration, promote clinical randomized controlled trials for validation, pay attention to ethical norms and algorithm bias issues, and enhance the global effectiveness of obesity prevention and treatment and the development of precision medicine.

To systematically evaluate the clinical application effect of enhanced recovery after surgery (ERAS) protocols in patients undergoing bariatric and metabolic surgery.

A systematic search was performed across multiple Chinese and English-language databases, including the Joanna Briggs Institute (JBI) Database of Evidence-Based Healthcare, Embase, the Cochrane Library, Web of Science, PubMed, CNKI, CINAHL, Wanfang Data, VIP Database, and the Chinese Biomedical Literature Database. The search period spanned from the inception of each database through December 25, 2024. Two investigators, both rigorously trained in systematic review methodologies, independently conducted the screening, quality assessment, and data extraction processes. Meta-analyses were conducted using RevMan version 5.3. For dichotomous variables, odds ratios (OR) with 95% confidence intervals (CI) were calculated, whereas continuous variables were summarized using mean differences (MD) with corresponding 95%CI.

A total of 16 studies involving 3,576 patients were included. Meta-analysis results demonstrated that, compared with conventional perioperative management, ERAS protocols significantly reduced length of hospital stay [MD= -1.40, 95%CI (-1.82, -0.99), P<0.00001], decreased the incidence of postoperative nausea and vomiting (PONV) [OR= 0.44, 95%CI (0.21, 0.92), P= 0.03], and lowered hospitalization costs [MD= -8061.24, 95%CI (-12925.10, -3197.38), P= 0.001]. No statistically significant differences were observed between ERAS and conventional care in terms of overall postoperative complications [OR= 1.00, 95%CI (0.75, 1.32), P= 0.98], 30-day readmission rate [OR= 0.87, 95%CI (0.60, 1.26), P= 0.46], reoperation rate [OR= 0.73, 95%CI (0.34, 1.59), P= 0.43], or postoperative analgesic use [OR= 0.47, 95%CI (0.21, 1.04), P= 0.06].

ERAS protocols can effectively optimize perioperative management for bariatric and metabolic surgery patients by shortening hospital stay, reducing PONV incidence, and lowering healthcare costs without increasing the risk of adverse postoperative events. The clinical benefits of ERAS are not derived from a single intervention but from the synergistic effects of multiple core components. Given the heterogeneity and methodological limitations of existing studies, future research should expand sample sizes, include more high-quality trials, and conduct rigorously designed randomized controlled trials to clarify the independent contributions and synergistic effects of individual ERAS elements, thereby further validating the clinical effectiveness of ERAS in bariatric and metabolic surgery.

The incidence of obesity continues to rise, becoming a major global public health problem. Bariatric surgery is currently the most effective means of treating moderate to severe obesity, and its procedures have expanded from traditional surgical procedures to endoscopic treatment gradually. Bariatric metabolic surgery (BMS) improves metabolic abnormalities and achieves long-term weight loss by reshaping anatomical structures and regulating neuroendocrine. Endoscopic bariatric and metabolic therapy (EBMT) simulates the mechanism of surgical operation, has the advantages of less trauma, faster recovery, and repeatable operation, providing a new option for obese patients. This article reviews the research progress of bariatric surgeries, aiming to promote the individualization of weight loss treatment.

has become a global public health issue, serving as both a cause and consequence of metabolic disorders and various chronic diseases, and is regulated by multiple biological processes. In recent years, protein lactylation, a novel post-translational modification (PTM), has been found to directly or indirectly participate in the pathophysiology of obesity through multiple physiological and pathological processes, including gene transcription, cell fate, inflammation, tumor development, and metabolism. It has gradually become a research hotspot. However, there is currently a lack of systematic reviews on the regulatory mechanisms of protein lactylation in obesity. This review begins with the production and function of lactate, systematically introduces the biochemical basis, detection methods, and biological functions of lactylation, and then explores its involvement in obesity by examining four key aspects: lactylation-mediated inflammatory signaling pathways, the induction of insulin resistance, its effects on glucose uptake and glycolysis, and its interference with lipid metabolism. The focus is placed on its potential roles and mechanisms in obesity regulation, and finally, potential future research directions and challenges are proposed.

Bariatric surgery, as an effective method for obesity and its metabolism-related complications, its impact on the risk of postoperative colorectal cancer (CRC) remains controversial. Although most clinical cohort studies have confirmed that bariatric surgery can significantly reduce the incidence of CRC, some studies have still observed a paradoxical increase. Therefore, it is necessary to further clarify the effect of bariatric surgery on the risk of CRC and its possible mechanism. This article presents a comprehensive systematic review and synthesis of current domestic and international research examining the impact of bariatric surgery on CRC incidence among obese patients, while also exploring potential underlying mechanisms for this observed effect.

Metabolic syndrome is a group of metabolic disorders characterized by obesity, hypertension, hyperglycemia and dyslipidemia, which seriously affects individual health. The nursing group is a high-risk group for this syndrome, and their health condition is directly related to the quality of care and patient safety. The occurrence of metabolic syndrome in nurses is closely related to factors such as age, gender, educational level, diet, physical activity, sleep and occupational factors. Therefore, it is of vital importance to carry out early prevention and intervention of metabolic syndrome among the nursing population. This article will review the epidemiological situation, influencing factors, prevention and intervention of metabolic syndrome in nurses, providing a reference for formulating intervention plans for metabolic syndrome in the nurse population.

Studies have confirmed that obesity is closely linked to the occurrence and development of breast cancer. Under obesity conditions, changes in the microenvironment of the tumor and surrounding breast tissues can promote the expansion of tumor cells and enhance tumor growth and invasiveness characteristics, leading to increased metastasis and deteriorated survival in breast cancer patients with obesity. This review focuses on the effects of cellular components and extracellular matrix in the tumor microenvironment on breast cancer growth in the presence of obesity.

Obesity is an established independent risk factor for gastroesophageal reflux disease (GERD) and hiatal hernia. Although the relationship between obesity and these conditions has been clarified from anatomical and physiological perspectives, the underlying molecular mechanisms require further elucidation. This review aims to systematically summarize current research progress on the molecular mechanisms driving obesity-induced GERD, with a focus on the interplay among inflammatory microenvironments, metabolic reprogramming, intestinal flora dysbiosis, and related signaling pathways. This integrated perspective seeks to enhance understanding of the pathophysiology and thereby inform novel clinical prevention and treatment strategies.

Bile reflux after one anastomotic gastric bypass (OAGB) is a major concern of bariatric metabolic surgeons, because bile reflux may lead to the increased risk of gastroesophageal reflux disease (GERD) and upper gastrointestinal cancer, and even revision surgery was completed due to severe bile reflux. However, there is no unified and ideal anti-bile reflux method in OAGB. In recent years, our center has also made a preliminary exploration in this respect, improved the method of gastrointestinal anastomosis and input loop fixation, and achieved satisfactory results in a short period of time.