Adherencia al seguimiento nutricional en pacientes sometidos a manga gástrica y su relación con los resultados metabólicos al año del procedimiento.

Abstract

Introduction: Sleeve gastrectomy is one of the most widely used strategies in the management of obesity and its associated comorbidities. However, postoperative metabolic outcomes depend not only on the surgical procedure itself but also on sustained nutritional follow-up. Objective: To relate adherence to postoperative nutritional follow-up and changes in metabolic parameters one year after sleeve gastrectomy in patients treated at Clínica Santamaría in Guayaquil between 2024 and 2025. Methods: An observational, retrospective, and analytical study was conducted in 78 patients. Preoperative and 12-month clinical and metabolic variables were analyzed. Nutritional adherence was classified as low, moderate, or high. Descriptive and inferential statistics were applied, considering p < 0.05 as statistically significant. Results: Male sex predominated (64.1%, n=50), and dyslipidemia was the most frequent comorbidity (66.7%, n=52). Low adherence was observed in 41.0% (n=32), followed by moderate adherence in 35.9% (n=28) and high adherence in 23.1% (n=18). At 12 months, weight decreased from 128 kg to 101 kg (−27.1 kg), and BMI from 46.3 to 36.6 kg/m². Glucose levels declined from 125 to 98.8 mg/dL, and HbA1c from 7.99% to 6.14%. LDL decreased by 37.8 mg/dL and triglycerides by 74.5 mg/dL, while HDL increased by 11.3 mg/dL. Weight loss and BMI reduction showed a significant association with adherence (p < 0.001). Conclusion: Sleeve gastrectomy is associated with a significant improvement in metabolic parameters at one year of follow-up. Furthermore, higher levels of adherence to nutritional follow-up are linked to greater weight reduction, establishing adherence as a key factor in optimizing postoperative outcomes.