{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T18:31:56Z","timestamp":1780684316746,"version":"3.54.1"},"reference-count":56,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"national funds through the Foundation for Science and Technology","award":["UIDB\/04923\/2020"],"award-info":[{"award-number":["UIDB\/04923\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Introduction: Leptin and ghrelin are two hormones that play a role in weight homeostasis. Leptin, which is produced primarily by adipocytes and is dependent on body fat mass, suppresses appetite and increases energy expenditure. Conversely, ghrelin is the \u201chunger hormone\u201d, it stimulates appetite and promotes fat storage. Bariatric surgery significantly alters the levels and activity of these hormones, contributing to weight loss and metabolic improvements. Clarifying the interplay between bariatric surgery, weight loss, physical exercise, leptin, and ghrelin is essential in developing comprehensive strategies for optimizing the long-term outcomes for candidates who have undergone bariatric surgery, especially for sarcopenic patients. Methods: This was a randomized controlled study with two groups (n = 22). The patients in both groups had obesity and sarcopenia. A Roux-en-Y-gastric bypass (RYGB) procedure was performed on all patients. The intervention group participated in a structured exercise program three times per week, beginning one month after surgery and lasting 16 weeks. Patient assessment was performed before surgery (baseline) and after the completion of the exercise program. The control group received the usual standard of care and was assessed similarly. Results: After surgery, weight, BMI, and lean mass decreased significantly in both groups between the baseline and the second assessment. Leptin levels were not significantly different between baseline and the second assessment in the physical exercise group, but were significantly lower in the control group (p = 0.05). Ghrelin levels increased over time in both groups, but the differences were not significant. When we associated leptin (the dependent variable) with weight (the independent variable), we found that lower weight was associated with lower leptin levels. A similar relationship was also observed between the leptin and sarcopenia parameters (muscle strength and mass), as well as in the bone health parameters (bone mineral density and t-score). Higher ghrelin levels were significantly associated with higher t-scores and z-scores (p &lt; 0.05). Conclusion: Exercise has been shown to have a significant effect on leptin and ghrelin levels after bariatric surgery. By incorporating regular physical activity into their lifestyle, bariatric patients can optimize their weight loss outcomes and improve their overall health. After the physical exercise protocol, patients in the intervention group revealed more established leptin levels, which may indicate a protected pattern concerning decreased leptin levels. An unfavorable profile was evidenced, according to which greater weight loss, sarcopenia, and osteoporosis were associated with lower leptin levels.<\/jats:p>","DOI":"10.3390\/nu16223913","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T06:06:54Z","timestamp":1731996414000},"page":"3913","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Possible Interaction Between Physical Exercise and Leptin and Ghrelin Changes Following Roux-en-Y Gastric Bypass in Sarcopenic Obesity Patients\u2014A Pilot Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7873-5558","authenticated-orcid":false,"given":"Cl\u00e1udia","family":"Mendes","sequence":"first","affiliation":[{"name":"Unidade Local Sa\u00fade Alentejo Central, EPE\u2014Hospital Esp\u00edrito Santo de \u00c9vora, 7000-811 \u00c9vora, Portugal"},{"name":"CRI.COM\u2014Centro Responsabilidade Integrada de Cirurgia da Obesidade e Metab\u00f3lica, 7000-811 \u00c9vora, Portugal"},{"name":"CHRC\u2014Comprehensive Health Research Centre, Universidade de \u00c9vora, 7004-516 \u00c9vora, Portugal"},{"name":"Departamento de Desporto e Sa\u00fade, Escola de Sa\u00fade e Desenvolvimento Humano, Universidade de \u00c9vora, 7004-516 \u00c9vora, Portugal"},{"name":"CBIOS\u2014Research Center for Biosciences & Health Technologie, Universidade Lus\u00f3fona, 1749-024 Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3939-5065","authenticated-orcid":false,"given":"Manuel","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Unidade Local Sa\u00fade Alentejo Central, EPE\u2014Hospital Esp\u00edrito Santo de \u00c9vora, 7000-811 \u00c9vora, Portugal"},{"name":"CRI.COM\u2014Centro Responsabilidade Integrada de Cirurgia da Obesidade e Metab\u00f3lica, 7000-811 \u00c9vora, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9009-5693","authenticated-orcid":false,"given":"Jorge","family":"Bravo","sequence":"additional","affiliation":[{"name":"CHRC\u2014Comprehensive Health Research Centre, Universidade de \u00c9vora, 7004-516 \u00c9vora, Portugal"},{"name":"Departamento de Desporto e Sa\u00fade, Escola de Sa\u00fade e Desenvolvimento Humano, Universidade de \u00c9vora, 7004-516 \u00c9vora, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Martins","sequence":"additional","affiliation":[{"name":"Research Center in Sports Sciences, Health and Human Development (CIDESD), 5000-801 Vila Real, Portugal"},{"name":"Departamento de Desporto, Universidade Europeia, 1500-210 Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9753-8381","authenticated-orcid":false,"given":"Armando","family":"Raimundo","sequence":"additional","affiliation":[{"name":"CHRC\u2014Comprehensive Health Research Centre, Universidade de \u00c9vora, 7004-516 \u00c9vora, Portugal"},{"name":"Departamento de Desporto e Sa\u00fade, Escola de Sa\u00fade e Desenvolvimento Humano, Universidade de \u00c9vora, 7004-516 \u00c9vora, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2627","DOI":"10.1016\/S0140-6736(17)32129-3","article-title":"Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: A pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults","volume":"390","author":"Bentham","year":"2017","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1136\/bjsports-2020-103531","article-title":"New global physical activity guidelines for a more active and healthier world: The WHO Regional Offices perspective","volume":"54","author":"Breda","year":"2020","journal-title":"Br. 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