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Increasing evidence indicates that biological sex influences not only the development and distribution of adipose tissue but also responses to obesity treatments, including metabolic-bariatric surgery. This narrative review synthesizes current evidence on sex-related differences in metabolic outcomes after bariatric surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Recent findings<\/jats:title>\n                    <jats:p>Bariatric surgery induces substantial weight loss and marked improvement of obesity-related complications in both men and women along sex-specific differences in body composition changes, adipose tissue remodeling, adipokine secretion, inflammatory responses, and thermogenic adaptations. Estrogen signaling contributes to a more favorable adipose tissue phenotype through anti-inflammatory effects, enhanced adipokine profiles, preservation of lean mass, and stimulation of white adipose tissue beiging, a process by which an inducible form of thermogenic adipocytes within white adipose tissue (beige adipocytes) acquire thermogenic characteristics similar to brown adipose tissue. In women, menopausal status represents a key biological modifier of these responses. In contrast, androgen excess is associated with visceral fat accumulation and insulin resistance. Despite largely comparable rates of remission of major obesity-related complications between sexes, variances in adiposity, hormonal milieu, and postoperative metabolic outcomes suggest different underlying mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Although remission rates of obesity-related complications appear broadly comparable between sexes, the underlying metabolic and endocrine adaptations differ. Biological sex represents a determinant of post-bariatric metabolic remodeling. This review highlights the relevance of biological sex in obesity and its treatment, emphasizing the need for sex-stratified studies to elucidate underlying mechanisms and support the development of more precise, personalized strategies in obesity management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s13679-026-00740-5","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T06:45:29Z","timestamp":1784702729000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of Biological Sex on Metabolic and Adipokine Responses after Metabolic-Bariatric Surgery: A Narrative Review"],"prefix":"10.1007","volume":"15","author":[{"given":"Gonzalo","family":"Rivero","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaia","family":"Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Catal\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Ram\u00edrez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Carbone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Montecucco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"G\u00f3mez-Ambrosi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gema","family":"Fr\u00fchbeck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Becerril","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"issue":"9","key":"740_CR1","doi-asserted-by":"publisher","first-page":"2395","DOI":"10.1038\/s41591-024-03095-3","volume":"30","author":"L Busetto","year":"2024","unstructured":"Busetto L, Dicker D, Fr\u00fchbeck G, Halford JCG, Sbraccia P, Yumuk V, et al. 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