Background/Objectives: Bariatric surgery (BS) is considered one of the most effective interventions for the treatment of obesity. To achieve optimal long-term results, continuous follow-up (FU) within a multidisciplinary treatment team is essential to ensure patient compliance and maximize the benefits of BS. However, many patients find it difficult to maintain regular FU, which can affect the quality of care and lead to postoperative complications. This review aims to highlight factors that may hinder compliance with FU after BS, examine potential causes and consequences of inadequate FU, and identify strategies to improve patient participation in long-term FU. Methods: The literature search was conducted between October 2023 and June 2024 in Medline (PubMed) and the Cochrane Library datasets. Studies were selected for their relevance to adherence to FU, multidisciplinary approaches, and long-term bariatric outcomes. Results: The pre- and postoperative period is critical for educating patients and healthcare team members about the importance of FU, addressing potential barriers (e.g., logistical, psychological, and social challenges), and highlighting the risk of relapse to obesity after surgery. The lack of a standardized FU protocol leads to differences between medical centers, further impacting patient adherence. Conclusions: Tailored and regularly updated strategies are essential to address individual patient needs and improve adherence to FU. Further research is needed to identify the specific factors that influence variability in long-term BS outcomes, highlighting the need for a patient-centered approach to obesity treatment.

Overweight and obese individuals may have leaky intestinal barrier and microbiome dysbiosis. The aim of this study was to determine whether body mass reduction with diet and synbiotics in an adult person with excess body mass has an influence on the gut microbiota and zonulin concentration. The study was a single blinded trial. 60 persons with excess body mass were examined. Based on randomization, patients were qualified either to the intervention group (Synbiotic group) or to the control group (Placebo group). Anthropometric measurements, microbiological assessment of faecal samples and zonulin concentration in the stool were performed before and after observation. After 3-months, an increase in the variety of intestinal bacteria (increase in the Shannon-Weaver index and the Simpson index) and a decrease in concentration of zonulin in faecal samples were observed in the Synbiotic group. Also, statistically significant correlation between zonulin and Bifidobacterium spp. (Spearman test, R=–0.51; p=0.0040) was noticed. There were no significant relationships between the body mass, BMI and changes in the intestinal microbiota or zonulin concentrations. The use of diet and synbiotics improved the condition of the microbiota and intestinal barrier in patients in the Synbiotic group.

Reduction of total cholesterol (TC) and LDL fraction (LDL-C) may be beneficial towards decreasing the risk of development of cardiovascular diseases (CVD). First and foremost, before implementing or simultaneously with pharmacological treatment, patients should be informed about lifestyle changes that may be critical to achieving a better lipid profile. Recommendations from ACC/AHA (American College of Cardiology and American Heart Association) and EAS (European Atherosclerosis Society) mainly focus on limitation of saturated fatty acids (SFA) and trans fatty acids (TFA) consumption, but additional support could be considered. This review presents selected guidelines of European scientific societies concerning lipid metabolism disorders. The main aim of this manuscript was to present the guidelines how to provide simple and transparent schemes of management in dyslipidemia therapy. Encouraging patients for increasing the intake of soluble fiber (SF) and phytosterols (PS) may also be promoted for achieving therapeutic goals. In the clinical point of view, restoring an appropriate lipid profile is important because it directly reduces the risk of developing atherosclerotic cardiovascular disease (ASCVD). The EAS and ACC/AHA guidelines introduce several new demands, so far absent from previous recommendations. Mediterranean diet (MD) or vegetarian lifestyles are an example of diet patterns that are deliberated as healthy for cardio-vascular system, since both consist of fresh, unprocessed vegetables and fruits with addition of desirable fats.

The World Health Organization reports that the prevalent problem of excessive weight and obesity currently affects about 1.9 billion people worldwide and is the fifth most common death factor among patients. In view of the growing number of patients with obesity, attention is drawn to the insufficient effectiveness of behavioral treatment methods. In addition to genetic and environmental factors leading to the consumption of excess energy in the diet and the accumulation of adipose tissue, attention is paid to the role of intestinal microbiota in maintaining a normal body weight. Dysbiosis – a disorder in the composition of the gut microbiota – is mentioned as one of the contributing factors to the development of metabolic diseases, including obesity, type 2 diabetes, and cardiovascular disorders. The human gastrointestinal tract is colonized largely by a group of Gram-negative bacteria that are indicated to be a source of lipopolysaccharide (LPS), associated with inducing systemic inflammation and endotoxemia. Research suggests that disturbances in the gut microbiota, leading to damage to the intestinal barrier and an increase in circulating LPS, are implicated in obesity and other metabolic disorders. Plasma LPS and lipopolysaccharide-binding protein (LBP) levels have been shown to be elevated in individuals with excess body weight. Bariatric surgery has become a popular treatment option, leading to stable weight loss and an improvement in obesity-related conditions. The aim of this study was to characterize the factors that promote the induction of metabolic endotoxemia and its associated health consequences, along with the presentation of their changes after bariatric surgery.

Background: Plant-based dietary patterns are a source of different amounts and proportions of fatty acids (FAs) from those in traditional diets. Information about the full FAs profile provided by plant-based diets is widely lacking. The aim of this study was to present the exact serum profiles of FAs among people on a plant-based diet compared with omnivorous subjects. Methods: FAs compositions and inflammation statuses (based on serum C-reactive protein (CRP) levels) were studied in serum samples obtained from 102 female volunteers (divided into four groups: vegans, vegetarians, pescatarians, and omnivores). The quality of the volunteers’ diets was assessed based on seven-day dietary records. Results: Both vegans and vegetarians had lower total n-3 PUFAs, EPA, and DHA serum levels than omnivores. Decreased levels of these FAs presumably did not cause inflammation in vegetarians and vegans, as vegetarians had similar serum levels of CRP compared to omnivores, and vegans had even lower levels. Conclusion: The analysis of serum FAs and CRP levels in vegetarians and vegans suggests that factors other than diet alone influence inflammation and overall health status. Further research on long-term plant-based diet users is needed to better understand this issue, and supplementation with EPA and DHA is worth considering in vegans and vegetarians.