Bariatric surgery has established itself as an effective intervention for the management of morbid obesity and its associated comorbidities. This procedure not only promotes significant and sustained weight loss, but also positively impacts metabolic and gastrointestinal health. From a metabolic perspective, bariatric surgery has been shown to contribute significantly to the improvement of conditions such as type 2 diabetes, with remission rates that can reach up to 80% in some cases, as well as high blood pressure, with reductions observed in up to 70% of patients. In addition, an improvement in dyslipidemia has been evidenced in more than 60% of cases. These benefits are not limited only to weight loss, but are also related to physiological mechanisms such as hormonal modifications, including increases in GLP-1 (glucagon-like peptide-1) concentrations, and alterations in the gut-brain axis that optimize metabolic regulation. On the other hand, in the gastrointestinal field, although it can generate benefits such as reducing the risk of non-alcoholic fatty liver disease, it can also be associated with complications such as dumping syndrome or nutritional deficiencies. This narrative review explores the multifaceted effects of bariatric surgery, highlighting both its benefits and the challenges it poses in the long-term follow-up of patients. Thus, the importance of a multidisciplinary approach is emphasized to maximize positive results and minimize risks, guaranteeing comprehensive and personalized care in this population.

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