diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM13372diaendo-13507Research ArticleОБЗОРЫREVIEWSРазличные стратегии снижения массы тела и их влияние на жировую и мышечную тканьDifferent weight loss strategies and their impact on fat and muscle tissuehttps://orcid.org/0000-0001-8838-8908ВознесенскаяА. А.VoznesenskayaA. A.

Вознесенская Анастасия Александровна – аспирант

117292, Москва, ул. Дм. Ульянова, д. 11

Anastasia A. Voznesenskaya - MD, PhD student.

11 Dm. Ulyanova street, 117292 Moscow

voznesenskaya.a.a@yandex.ruhttps://orcid.org/0009-0008-6199-7699РожевскаяЕ. Е.RozhevskayaE. E.

Рожевская Екатерина Евгеньевна - клинический ординатор.

Москва

Ekaterina E. Rozhevskaya - clinical resident.

Moscow

kopylova.catherine@mail.ruhttps://orcid.org/0000-0002-5057-127XШестаковаМ. В.ShestakovaM. V.

Шестакова Марина Владимировна - д.м.н., профессор, академик РАН.

Москва

Marina V. Shestakova - MD, PhD, Professor, Academician of the RAS.

Moscow

shestakova.marina@endocrincentr.ruГНЦ ФГБУ РФ «Национальный медицинский исследовательский центр эндокринологии им. академика И.И. Дедова»РоссияEndocrinology Research CentreRussian Federation202618052026292203214Copyright © Вознесенская А.А., Рожевская Е.Е., Шестакова М.В., 20262026Вознесенская А.А., Рожевская Е.Е., Шестакова М.В.Voznesenskaya A.A., Rozhevskaya E.E., Shestakova M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/13507

Во всем мире распространенность ожирения и ассоциированных с ним заболеваний продолжает неуклонно расти, несмотря на значительное совершенствование подходов к его лечению. Появление препаратов инкретинового ряда и развитие бариатрической хирургии существенно расширило врачебный арсенал в борьбе с ожирением, дополнив диетические вмешательства, физические упражнения и ряд длительно использующихся в клинической практике препаратов. При этом отмечено, что различные стратегии в снижении массы тела оказывают неодинаковое влияние на жировые депо и мышечную ткань. Хорошо известно, что подкожная (ПЖТ) и висцеральная (ВЖТ) жировые ткани вносят неравнозначный вклад в метаболические нарушения при ожирении, и уменьшение содержания ВЖТ представляет наиболее важную цель при снижении массы тела. Не менее значимой задачей при этом является сохранение метаболически активной мышечной ткани и профилактика саркопении. В последнее время вопрос о степени воздействия различных подходов в лечении ожирения на жировую и мышечную ткань вызывает все больший интерес среди исследователей и клиницистов, в связи с чем мы подробно рассмотрели его в рамках данного обзора.

The prevalence of obesity and its associated diseases continues to grow steadily worldwide, despite significant improvements in various treatment approaches. The advent of GLP-1 and GIP agonists and the development of bariatric surgery have significantly improved obesity treatment options, complementing dietary interventions, physical exercise, and a number of drugs that have long been used in clinical practice. At the same time weight loss strategies differ in their effects on fat and muscle tissue. It is well known that subcutaneous (SAT) and visceral (VAT) adipose tissues make unequal contributions to metabolic disorders in obesity, and reducing visceral adipose tissue is the most important goal during weight loss. Maintaining metabolically active muscle tissue and prevention of sarcopenia is also a very important issue. The question of different obesity treatment strategies impact on adipose and muscle tissue has attracted interest among researchers and clinicians, and therefore we have considered it in this review.

ожирениеподкожная жировая тканьвисцеральная жировая тканьмышечная тканьфармакотерапия ожирениябариатрическая хирургияobesitysubcutaneous adipose tissuevisceral adipose tissuemuscle tissuepharmacotherapy of obesitybariatric surgeryИсследование выполнено за счет средств гранта РНФ № 22-15-00365-П (продление) от 10.06.2025 г.ReferencesWorld Obesity Federation. World Obesity Atlas 2024. London: World Obesity Federation, 2024. Available from: https://data.worldobesity.org/publications/?cat=22World Obesity Federation. World Obesity Atlas 2024. London: World Obesity Federation, 2024. Available from: https://data.worldobesity.org/publications/?cat=22Ibrahim MM. Subcutaneous and visceral adipose tissue: structural and functional differences. Obes Rev. 2010;11(1):11-18. doi: https://doi.org/10.1111/j.1467-789X.2009.00623.xIbrahim MM. Subcutaneous and visceral adipose tissue: structural and functional differences. Obes Rev. 2010;11(1):11-18. doi: https://doi.org/10.1111/j.1467-789X.2009.00623.xOliver CJ, Climstein M, Rosic N, Bosy-Westphal A, Tinsley G, Myers S. Fat-Free Mass: Friend or Foe to Metabolic Health?. J Cachexia Sarcopenia Muscle. 2025;16(1):e13714. doi: https://doi.org/10.1002/jcsm.13714Oliver CJ, Climstein M, Rosic N, Bosy-Westphal A, Tinsley G, Myers S. Fat-Free Mass: Friend or Foe to Metabolic Health?. J Cachexia Sarcopenia Muscle. 2025;16(1):e13714. doi: https://doi.org/10.1002/jcsm.13714Johnson VR, Washington TB, Chhabria S, et al. Food as Medicine for Obesity Treatment and Management. Clin Ther. 2022;44(5):671-681. doi: https://doi.org/10.1016/j.clinthera.2022.05.001Johnson VR, Washington TB, Chhabria S, et al. Food as Medicine for Obesity Treatment and Management. Clin Ther. 2022;44(5):671-681. doi: https://doi.org/10.1016/j.clinthera.2022.05.001McCarthy D, Berg A. Weight Loss Strategies and the Risk of Skeletal Muscle Mass Loss. Nutrients. 2021;13(7):2473. doi: https://doi.org/10.3390/nu13072473McCarthy D, Berg A. Weight Loss Strategies and the Risk of Skeletal Muscle Mass Loss. Nutrients. 2021;13(7):2473. doi: https://doi.org/10.3390/nu13072473Smith ES, Smith HA, Betts JA, et al. A Systematic Review and Meta-Analysis Comparing Heterogeneity in Body Mass Responses Between Low-Carbohydrate and Low-Fat Diets. Obesity (Silver Spring). 2020;28(10):1833-1842. doi: https://doi.org/10.1002/oby.22968Smith ES, Smith HA, Betts JA, et al. A Systematic Review and Meta-Analysis Comparing Heterogeneity in Body Mass Responses Between Low-Carbohydrate and Low-Fat Diets. Obesity (Silver Spring). 2020;28(10):1833-1842. doi: https://doi.org/10.1002/oby.22968Tobias DK, Chen M, Manson JE, et al. Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2015;3(12):968-979. doi: https://doi.org/10.1016/S2213-8587(15)00367-8Tobias DK, Chen M, Manson JE, et al. Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2015;3(12):968-979. doi: https://doi.org/10.1016/S2213-8587(15)00367-8Goss AM, Gower B, Soleymani T, et al. Effects of weight loss during a very low carbohydrate diet on specific adipose tissue depots and insulin sensitivity in older adults with obesity: a randomized clinical trial. Nutr Metab (Lond). 2020;17:64. doi: https://doi.org/10.1186/s12986-020-00481-9Goss AM, Gower B, Soleymani T, et al. Effects of weight loss during a very low carbohydrate diet on specific adipose tissue depots and insulin sensitivity in older adults with obesity: a randomized clinical trial. Nutr Metab (Lond). 2020;17:64. doi: https://doi.org/10.1186/s12986-020-00481-9Garr Barry V, Stewart M, Soleymani T, et al. Greater Loss of Central Adiposity from Low-Carbohydrate versus Low-Fat Diet in Middle-Aged Adults with Overweight and Obesity. Nutrients. 2021;13(2):475. doi: https://doi.org/10.3390/nu13020475Garr Barry V, Stewart M, Soleymani T, et al. Greater Loss of Central Adiposity from Low-Carbohydrate versus Low-Fat Diet in Middle-Aged Adults with Overweight and Obesity. Nutrients. 2021;13(2):475. doi: https://doi.org/10.3390/nu13020475Veum VL, Laupsa-Borge J, Eng Ø, et al. Visceral adiposity and metabolic syndrome after very high-fat and low-fat isocaloric diets: a randomized controlled trial. Am J Clin Nutr. 2017;105(1):85-99. doi: https://doi.org/10.3945/ajcn.115.123463Veum VL, Laupsa-Borge J, Eng Ø, et al. Visceral adiposity and metabolic syndrome after very high-fat and low-fat isocaloric diets: a randomized controlled trial. Am J Clin Nutr. 2017;105(1):85-99. doi: https://doi.org/10.3945/ajcn.115.123463Meckling KA, O’Sullivan C, Saari D. Comparison of a low-fat diet to a low-carbohydrate diet on weight loss, body composition, and risk factors for diabetes and cardiovascular disease in free-living, overweight men and women. J Clin Endocrinol Metab. 2004;89(6):2717-2723. doi: https://doi.org/10.1210/jc.2003-031606Meckling KA, O’Sullivan C, Saari D. Comparison of a low-fat diet to a low-carbohydrate diet on weight loss, body composition, and risk factors for diabetes and cardiovascular disease in free-living, overweight men and women. J Clin Endocrinol Metab. 2004;89(6):2717-2723. doi: https://doi.org/10.1210/jc.2003-031606Apekey TA, Maynard MJ, Kittana M, Kunutsor SK. Comparison of the Effectiveness of Low Carbohydrate Versus Low Fat Diets, in Type 2 Diabetes: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2022;14(20):4391. doi: https://doi.org/10.3390/nu14204391Apekey TA, Maynard MJ, Kittana M, Kunutsor SK. Comparison of the Effectiveness of Low Carbohydrate Versus Low Fat Diets, in Type 2 Diabetes: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2022;14(20):4391. doi: https://doi.org/10.3390/nu14204391Waters DL, Aguirre L, Gurney B, et al. Effect of Aerobic or Resistance Exercise, or Both, on Intermuscular and Visceral Fat and Physical and Metabolic Function in Older Adults With Obesity While Dieting. J Gerontol A Biol Sci Med Sci. 2022;77(1):131-139. doi: https://doi.org/10.1093/gerona/glab111Waters DL, Aguirre L, Gurney B, et al. Effect of Aerobic or Resistance Exercise, or Both, on Intermuscular and Visceral Fat and Physical and Metabolic Function in Older Adults With Obesity While Dieting. J Gerontol A Biol Sci Med Sci. 2022;77(1):131-139. doi: https://doi.org/10.1093/gerona/glab111O’Donoghue G, Blake C, Cunningham C, et al. What exercise prescription is optimal to improve body composition and cardiorespiratory fitness in adults living with obesity? A network meta-analysis. Obes Rev. 2021;22(2):e13137. doi: https://doi.org/10.1111/obr.13137O’Donoghue G, Blake C, Cunningham C, et al. What exercise prescription is optimal to improve body composition and cardiorespiratory fitness in adults living with obesity? A network meta-analysis. Obes Rev. 2021;22(2):e13137. doi: https://doi.org/10.1111/obr.13137Yarizadeh H, Eftekhar R, Anjom-Shoae J, Speakman JR, Djafarian K. The Effect of Aerobic and Resistance Training and Combined Exercise Modalities on Subcutaneous Abdominal Fat: A Systematic Review and Meta-analysis of Randomized Clinical Trials. Adv Nutr. 2021;12(1):179-196. doi: https://doi.org/10.1093/advances/nmaa090Yarizadeh H, Eftekhar R, Anjom-Shoae J, Speakman JR, Djafarian K. The Effect of Aerobic and Resistance Training and Combined Exercise Modalities on Subcutaneous Abdominal Fat: A Systematic Review and Meta-analysis of Randomized Clinical Trials. Adv Nutr. 2021;12(1):179-196. doi: https://doi.org/10.1093/advances/nmaa090Sabag A, Way KL, Keating SE, et al. Exercise and ectopic fat in type 2 diabetes: A systematic review and meta-analysis. Diabetes Metab. 2017;43(3):195-210. doi: https://doi.org/10.1016/j.diabet.2016.12.006Sabag A, Way KL, Keating SE, et al. Exercise and ectopic fat in type 2 diabetes: A systematic review and meta-analysis. Diabetes Metab. 2017;43(3):195-210. doi: https://doi.org/10.1016/j.diabet.2016.12.006An J, Su Z, Meng S. Effect of aerobic training versus resistance training for improving cardiorespiratory fitness and body composition in middle-aged to older adults: A systematic review and meta-analysis of randomized controlled trials. Arch Gerontol Geriatr. 2024;126:105530. doi: https://doi.org/10.1016/j.archger.2024.105530An J, Su Z, Meng S. Effect of aerobic training versus resistance training for improving cardiorespiratory fitness and body composition in middle-aged to older adults: A systematic review and meta-analysis of randomized controlled trials. Arch Gerontol Geriatr. 2024;126:105530. doi: https://doi.org/10.1016/j.archger.2024.105530Bellicha A, van Baak MA, Battista F, et al. Effect of exercise training on weight loss, body composition changes, and weight maintenance in adults with overweight or obesity: An overview of 12 systematic reviews and 149 studies. Obes Rev. 2021;22(Suppl 4):e13256. doi: https://doi.org/10.1111/obr.13256Bellicha A, van Baak MA, Battista F, et al. Effect of exercise training on weight loss, body composition changes, and weight maintenance in adults with overweight or obesity: An overview of 12 systematic reviews and 149 studies. Obes Rev. 2021;22(Suppl 4):e13256. doi: https://doi.org/10.1111/obr.13256Dedov II, Melnichenko GA, Troshina EA, Mazurina NV, Galieva MO. Body Weight Reduction Associated with the Sibutramine Treatment: Overall Results of the PRIMAVERA Primary Health Care Trial. Obes Facts. 2018;11(4):335-343. doi: https://doi.org/10.1159/000488880Dedov II, Melnichenko GA, Troshina EA, Mazurina NV, Galieva MO. Body Weight Reduction Associated with the Sibutramine Treatment: Overall Results of the PRIMAVERA Primary Health Care Trial. Obes Facts. 2018;11(4):335-343. doi: https://doi.org/10.1159/000488880Аметов АС. Эффективное лечение ожирения – путь борьбы с эпидемией diabetus mellitus // Медицинский Совет. — 2013. — Т. 2-2. — С. 78-83. [Ametov AS. Effective treatment of obesity: ways to fight epidemic of diabetes mellitus. Meditsinskiy sovet = Medical Council. 2013;(2-2):78-83. (In Russ.) doi: https://doi.org/10.21518/2079-701X-2013-2-2-78-83Ametov AS. Effective treatment of obesity: ways to fight epidemic of diabetes mellitus. Meditsinskiy sovet = Medical Council. 2013;(2-2):78-83. (In Russ.) doi: https://doi.org/10.21518/2079-701X-2013-2-2-78-83Hauner H, Meier M, Wendland G, et al. Weight reduction by sibutramine in obese subjects in primary care medicine: the SAT Study. Exp Clin Endocrinol Diabetes. 2004;112(4):201-207. doi: https://doi.org/10.1055/s-2004-817934Hauner H, Meier M, Wendland G, et al. Weight reduction by sibutramine in obese subjects in primary care medicine: the SAT Study. Exp Clin Endocrinol Diabetes. 2004;112(4):201-207. doi: https://doi.org/10.1055/s-2004-817934Grudell AB, Sweetser S, Camilleri M, et al. A controlled pharmacogenetic trial of sibutramine on weight loss and body composition in obese or overweight adults. Gastroenterology. 2008;135(4):1142-54. doi: https://doi.org/10.1053/j.gastro.2008.07.009Grudell AB, Sweetser S, Camilleri M, et al. A controlled pharmacogenetic trial of sibutramine on weight loss and body composition in obese or overweight adults. Gastroenterology. 2008;135(4):1142-54. doi: https://doi.org/10.1053/j.gastro.2008.07.009Van Gaal LF, Wauters MA, Peiffer FW, De Leeuw IH. Sibutramine and fat distribution: is there a role for pharmacotherapy in abdominal/visceral fat reduction?. Int J Obes Relat Metab Disord. 1998;22 Suppl 1:S38-S42Van Gaal LF, Wauters MA, Peiffer FW, De Leeuw IH. Sibutramine and fat distribution: is there a role for pharmacotherapy in abdominal/visceral fat reduction?. Int J Obes Relat Metab Disord. 1998;22 Suppl 1:S38-S42Porter JA, Raebel MA, Conner DA, et al. The Long-term Outcomes of Sibutramine Effectiveness on Weight (LOSE Weight) study: evaluating the role of drug therapy within a weight management program in a group-model health maintenance organization. Am J Manag Care. 2004;10(6):369-376Porter JA, Raebel MA, Conner DA, et al. The Long-term Outcomes of Sibutramine Effectiveness on Weight (LOSE Weight) study: evaluating the role of drug therapy within a weight management program in a group-model health maintenance organization. Am J Manag Care. 2004;10(6):369-376Российская ассоциация эндокринологов. Клинические рекомендации. Ожирение, взрослые. — M.: МЗ РФ; 2024 [Rossijskaja associacija endokrinologov. Klinicheskie rekomendacii. Ozhirenie, vzroslye. Moscow: MZ RF; 2024. (In Russ.)Российская ассоциация эндокринологов. Клинические рекомендации. Ожирение, взрослые. — M.: МЗ РФ; 2024 [Rossijskaja associacija endokrinologov. Klinicheskie rekomendacii. Ozhirenie, vzroslye. Moscow: MZ RF; 2024. (In Russ.)Torgerson JS, Hauptman J, Boldrin MN, Sjöström L. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care. 2004;27(1):155-161. doi: https://doi.org/10.2337/diacare.27.1.155Torgerson JS, Hauptman J, Boldrin MN, Sjöström L. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care. 2004;27(1):155-161. doi: https://doi.org/10.2337/diacare.27.1.155Smith SR, Stenlof KS, Greenway FL, et al. Orlistat 60 mg reduces visceral adipose tissue: a 24-week randomized, placebo-controlled, multicenter trial. Obesity (Silver Spring). 2011;19(9):1796-1803. doi: https://doi.org/10.1038/oby.2011.143Smith SR, Stenlof KS, Greenway FL, et al. Orlistat 60 mg reduces visceral adipose tissue: a 24-week randomized, placebo-controlled, multicenter trial. Obesity (Silver Spring). 2011;19(9):1796-1803. doi: https://doi.org/10.1038/oby.2011.143Shirai K, Tanaka M, Fujita T, et al. Reduction of Excessive Visceral Fat and Safety with 52-Week Administration of Lipase Inhibitor Orlistat in Japanese: Long-Term Clinical Study. Adv Ther. 2019;36(1):217-231. doi: https://doi.org/10.1007/s12325-018-0822-xShirai K, Tanaka M, Fujita T, et al. Reduction of Excessive Visceral Fat and Safety with 52-Week Administration of Lipase Inhibitor Orlistat in Japanese: Long-Term Clinical Study. Adv Ther. 2019;36(1):217-231. doi: https://doi.org/10.1007/s12325-018-0822-xKarhunen L, Franssila-Kallunki A, Rissanen P, et al. Effect of orlistat treatment on body composition and resting energy expenditure during a two-year weight-reduction programme in obese Finns. Int J Obes Relat Metab Disord. 2000;24(12):1567-1572. doi: https://doi.org/10.1038/sj.ijo.0801443Karhunen L, Franssila-Kallunki A, Rissanen P, et al. Effect of orlistat treatment on body composition and resting energy expenditure during a two-year weight-reduction programme in obese Finns. Int J Obes Relat Metab Disord. 2000;24(12):1567-1572. doi: https://doi.org/10.1038/sj.ijo.0801443Chanoine JP, Hampl S, Jensen C, Boldrin M, Hauptman J. Effect of orlistat on weight and body composition in obese adolescents: a randomized controlled trial. JAMA. 2005;293(23):2873-2883. doi: https://doi.org/10.1001/jama.293.23.2873Chanoine JP, Hampl S, Jensen C, Boldrin M, Hauptman J. Effect of orlistat on weight and body composition in obese adolescents: a randomized controlled trial. JAMA. 2005;293(23):2873-2883. doi: https://doi.org/10.1001/jama.293.23.2873Pillai AA, Melo L, Frishman WH, Aronow WS. The Effects of Metformin on Weight Loss, Cardiovascular Health, and Longevity. Cardiol Rev. doi: https://doi.org/10.1097/CRD.0000000000000832Pillai AA, Melo L, Frishman WH, Aronow WS. The Effects of Metformin on Weight Loss, Cardiovascular Health, and Longevity. Cardiol Rev. doi: https://doi.org/10.1097/CRD.0000000000000832Apolzan JW, Venditti EM, Edelstein SL, et al. Long-Term Weight Loss With Metformin or Lifestyle Intervention in the Diabetes Prevention Program Outcomes Study. Ann Intern Med. 2019;170(10):682-690. doi: https://doi.org/10.7326/M18-1605Apolzan JW, Venditti EM, Edelstein SL, et al. Long-Term Weight Loss With Metformin or Lifestyle Intervention in the Diabetes Prevention Program Outcomes Study. Ann Intern Med. 2019;170(10):682-690. doi: https://doi.org/10.7326/M18-1605Pu R, Shi D, Gan T, et al. Effects of metformin in obesity treatment in different populations: a meta-analysis. Ther Adv Endocrinol Metab. 2020;11:2042018820926000. doi: https://doi.org/10.1177/2042018820926000Pu R, Shi D, Gan T, et al. Effects of metformin in obesity treatment in different populations: a meta-analysis. Ther Adv Endocrinol Metab. 2020;11:2042018820926000. doi: https://doi.org/10.1177/2042018820926000Kusaka I, Nagasaka S, Horie H, и др. Метформин, но не пиоглитазон, снижает уровень грелина в плазме после нагрузки глюкозой у пациентов с сахарным диабетом 2 типа: возможная роль в стабилизации массы тела? // Ожирение и метаболизм. — 2009. — Т. 6. — №2. — С. 50-51. doi: https://doi.org/10.14341/2071-8713-5321Kusaka I, Nagasaka S, Horie H, Ishibashi S. Metformin, but not pioglitazone, decreases postchallenge plasma ghrelin levels in type 2 diabetic patients: a possible role in weight stability? Obesity and metabolism. 2009;6(2):50-51. (In Russ.) doi: https://doi.org/10.14341/2071-8713-5321Соколова А.В., Климова А.В., Драгунов Д.О., Арутюнов Г.П. Оценка влияния терапии метформином на величину мышечной массы и мышечной силы у больных с и без сахарного диабета. Метаанализ 15 исследований // Российский кардиологический журнал. — 2021. — Т. 26. — №3. — С. 433. doi: https://doi.org/10.15829/1560-4071-2021-4331Sokolova AV, Klimova AV, Dragunov DO, Arutyunov GP. Effect of metformin therapy on muscle mass and strength in patients with and without diabetes. Meta-analysis of 15 studies. Russ J Cardiol. 2021;26(3):4331. (In Russ.) doi: https://doi.org/10.15829/1560-4071-2021-4331Wang H, Ni Y, Yang S, et al. The effects of gliclazide, metformin, and acarbose on body composition in patients with newly diagnosed type 2 diabetes mellitus. Curr Ther Res Clin Exp. 2013;75:88-92. doi: https://doi.org/10.1016/j.curtheres.2013.10.002Wang H, Ni Y, Yang S, et al. The effects of gliclazide, metformin, and acarbose on body composition in patients with newly diagnosed type 2 diabetes mellitus. Curr Ther Res Clin Exp. 2013;75:88-92. doi: https://doi.org/10.1016/j.curtheres.2013.10.002van der Aa MP, Elst MA, van de Garde EM, et al. Long-term treatment with metformin in obese, insulin-resistant adolescents: results of a randomized double-blinded placebo-controlled trial. Nutr Diabetes. 2016;6(8):e228. doi: https://doi.org/10.1038/nutd.2016.37van der Aa MP, Elst MA, van de Garde EM, et al. Long-term treatment with metformin in obese, insulin-resistant adolescents: results of a randomized double-blinded placebo-controlled trial. Nutr Diabetes. 2016;6(8):e228. doi: https://doi.org/10.1038/nutd.2016.37Feng WH, Bi Y, Li P, et al. Effects of liraglutide, metformin and gliclazide on body composition in patients with both type 2 diabetes and non-alcoholic fatty liver disease: A randomized trial. J Diabetes Investig. 2019;10(2):399-407. doi: https://doi.org/10.1111/jdi.12888Feng WH, Bi Y, Li P, et al. Effects of liraglutide, metformin and gliclazide on body composition in patients with both type 2 diabetes and non-alcoholic fatty liver disease: A randomized trial. J Diabetes Investig. 2019;10(2):399-407. doi: https://doi.org/10.1111/jdi.12888Lee CG, Boyko EJ, Barrett-Connor E, et al. Insulin sensitizers may attenuate lean mass loss in older men with diabetes. Diabetes Care. 2011;34(11):2381-2386. doi: https://doi.org/10.2337/dc11-1032Lee CG, Boyko EJ, Barrett-Connor E, et al. Insulin sensitizers may attenuate lean mass loss in older men with diabetes. Diabetes Care. 2011;34(11):2381-2386. doi: https://doi.org/10.2337/dc11-1032Rodríguez-Moctezuma JR, Robles-López G, López-Carmona JM, Gutiérrez-Rosas MJ. Effects of metformin on the body composition in subjects with risk factors for type 2 diabetes. Diabetes Obes Metab. 2005;7(2):189-192. doi: https://doi.org/10.1111/j.1463-1326.2004.00385.xRodríguez-Moctezuma JR, Robles-López G, López-Carmona JM, Gutiérrez-Rosas MJ. Effects of metformin on the body composition in subjects with risk factors for type 2 diabetes. Diabetes Obes Metab. 2005;7(2):189-192. doi: https://doi.org/10.1111/j.1463-1326.2004.00385.xPereira MJ, Eriksson JW. Emerging Role of SGLT-2 Inhibitors for the Treatment of Obesity. Drugs. 2019;79(3):219-230. doi: https://doi.org/10.1007/s40265-019-1057-0Pereira MJ, Eriksson JW. Emerging Role of SGLT-2 Inhibitors for the Treatment of Obesity. Drugs. 2019;79(3):219-230. doi: https://doi.org/10.1007/s40265-019-1057-0Ohkuma T, Van Gaal L, Shaw W, et al. Clinical outcomes with canagliflozin according to baseline body mass index: results from post hoc analyses of the CANVAS Program. Diabetes Obes Metab. 2020;22(4):530-539. doi: https://doi.org/10.1111/dom.13920Ohkuma T, Van Gaal L, Shaw W, et al. Clinical outcomes with canagliflozin according to baseline body mass index: results from post hoc analyses of the CANVAS Program. Diabetes Obes Metab. 2020;22(4):530-539. doi: https://doi.org/10.1111/dom.13920Heymsfield SB, Raji A, Gallo S, et al. Efficacy and Safety of Ertugliflozin in Patients with Overweight and Obesity with Type 2 Diabetes Mellitus. Obesity (Silver Spring). 2020;28(4):724-732. doi: https://doi.org/10.1002/oby.22748Heymsfield SB, Raji A, Gallo S, et al. Efficacy and Safety of Ertugliflozin in Patients with Overweight and Obesity with Type 2 Diabetes Mellitus. Obesity (Silver Spring). 2020;28(4):724-732. doi: https://doi.org/10.1002/oby.22748Анциферов М.Б., Демидов Н.А. Эффективность дапаглифлозина в отношении улучшения клинических исходов у пациентов с сахарным диабетом 2 типа (продолжение исследования CARDIA-MOS, Москва) // Сахарный диабет. — 2025. — Т. 28. — №1. — C. 80-90. doi: https://doi.org/10.14341/DM13262Antsiferov MB, Demidov NA. Dapagliflozin effectiveness in improvement of clinical outcomes in diabetic patients (extention of CARDIA-MOS study, Moscow). Diabetes Mellitus. 2025;28(1):80-90. (In Russ.) doi: https://doi.org/10.14341/DM13262Tosaki T, Kamiya H, Himeno T, et al. Sodium-glucose Co-transporter 2 Inhibitors Reduce the Abdominal Visceral Fat Area and May Influence the Renal Function in Patients with Type 2 Diabetes. Intern Med. 2017;56(6):597-604. doi: https://doi.org/10.2169/internalmedicine.56.7196Tosaki T, Kamiya H, Himeno T, et al. Sodium-glucose Co-transporter 2 Inhibitors Reduce the Abdominal Visceral Fat Area and May Influence the Renal Function in Patients with Type 2 Diabetes. Intern Med. 2017;56(6):597-604. doi: https://doi.org/10.2169/internalmedicine.56.7196Liu X, Chen Y, Liu T, et al. The effects of Sodium-glucose cotransporter 2 inhibitors on adipose tissue in patients with type 2 diabetes: A meta-analysis of randomized controlled trials. Front Endocrinol (Lausanne). 2023;14:1115321. doi: https://doi.org/10.3389/fendo.2023.1115321Liu X, Chen Y, Liu T, et al. The effects of Sodium-glucose cotransporter 2 inhibitors on adipose tissue in patients with type 2 diabetes: A meta-analysis of randomized controlled trials. Front Endocrinol (Lausanne). 2023;14:1115321. doi: https://doi.org/10.3389/fendo.2023.1115321Post A, Groothof D, Eisenga MF, Bakker SJL. Sodium-Glucose Cotransporter 2 Inhibitors and Kidney Outcomes: True Renoprotection, Loss of Muscle Mass or Both?. J Clin Med. 2020;9(5):1603. doi: https://doi.org/10.3390/jcm9051603Post A, Groothof D, Eisenga MF, Bakker SJL. Sodium-Glucose Cotransporter 2 Inhibitors and Kidney Outcomes: True Renoprotection, Loss of Muscle Mass or Both?. J Clin Med. 2020;9(5):1603. doi: https://doi.org/10.3390/jcm9051603Tucker ME. Womens weight gain higher on thiazolidinedione. Fam Pract News. 2005;35(13):22. doi: https://doi.org/10.1016/s0300-7073(05)70935-xTucker ME. Womens weight gain higher on thiazolidinedione. Fam Pract News. 2005;35(13):22. doi: https://doi.org/10.1016/s0300-7073(05)70935-xStefan N. Causes, consequences, and treatment of metabolically unhealthy fat distribution. Lancet Diabetes Endocrinol. 2020;8(7):616-627. doi: https://doi.org/10.1016/S2213-8587(20)30110-8Stefan N. Causes, consequences, and treatment of metabolically unhealthy fat distribution. Lancet Diabetes Endocrinol. 2020;8(7):616-627. doi: https://doi.org/10.1016/S2213-8587(20)30110-8Yokota T, Kinugawa S, Hirabayashi K, et al. Pioglitazone improves whole-body aerobic capacity and skeletal muscle energy metabolism in patients with metabolic syndrome. J Diabetes Investig. 2017;8(4):535-541. doi: https://doi.org/10.1111/jdi.12606Yokota T, Kinugawa S, Hirabayashi K, et al. Pioglitazone improves whole-body aerobic capacity and skeletal muscle energy metabolism in patients with metabolic syndrome. J Diabetes Investig. 2017;8(4):535-541. doi: https://doi.org/10.1111/jdi.12606Bastien M, Poirier P, Brassard P, et al. Effect of PPARγ agonist on aerobic exercise capacity in relation to body fat distribution in men with type 2 diabetes mellitus and coronary artery disease: a 1-yr randomized study. Am J Physiol Endocrinol Metab. 2019;317(1):E65-E73. doi: https://doi.org/10.1152/ajpendo.00505.2018Bastien M, Poirier P, Brassard P, et al. Effect of PPARγ agonist on aerobic exercise capacity in relation to body fat distribution in men with type 2 diabetes mellitus and coronary artery disease: a 1-yr randomized study. Am J Physiol Endocrinol Metab. 2019;317(1):E65-E73. doi: https://doi.org/10.1152/ajpendo.00505.2018Massimino E, Izzo A, Riccardi G, Della Pepa G. The Impact of Glucose-Lowering Drugs on Sarcopenia in Type 2 Diabetes: Current Evidence and Underlying Mechanisms. Cells. 2021;10(8):1958. doi: https://doi.org/10.3390/cells10081958Massimino E, Izzo A, Riccardi G, Della Pepa G. The Impact of Glucose-Lowering Drugs on Sarcopenia in Type 2 Diabetes: Current Evidence and Underlying Mechanisms. Cells. 2021;10(8):1958. doi: https://doi.org/10.3390/cells10081958Phua WWT, Wong MXY, Liao Z, Tan NS. An aPPARent Functional Consequence in Skeletal Muscle Physiology via Peroxisome Proliferator-Activated Receptors. Int J Mol Sci. 2018;19(5):1425. doi: https://doi.org/10.3390/ijms19051425Phua WWT, Wong MXY, Liao Z, Tan NS. An aPPARent Functional Consequence in Skeletal Muscle Physiology via Peroxisome Proliferator-Activated Receptors. Int J Mol Sci. 2018;19(5):1425. doi: https://doi.org/10.3390/ijms19051425Гаврилова А.О., Шестакова Е.А., Шестакова М.В., и др. Сравнение сахароснижающего эффекта и влияния на массу тела семаглутида 1,0 мг и лираглутида 3,0 мг у пациентов с ожирением и сахарным диабетом 2 типа // Фундаментальная и клиническая диабетология в 21 веке: от теории к практике : Сборник тезисов III Конференции по лечению и диагностике сахарного диабета, Москва, 25–26 мая 2023 года. – Москва: Общество с ограниченной ответственностью «Типография «Печатных Дел Мастер», 2023. doi: https://doi.org/10.14341/DIAConfIII25-26.05.23-30Gavrilova AO, Shestakova EA, Shestakova MV, et al. Sravnenie sakharosnizhayushchego effekta i vliyaniya na massu tela semaglutida 1,0 mg i liraglutida 3,0 mg u patsientov s ozhireniem i sakharnym diabetom 2 tipa // Fundamental’naya i klinicheskaya diabetologiya v 21 veke: ot teorii k praktike : Sbornik tezisov III Konferentsii po lecheniyu i diagnostike sakharnogo diabeta, Moskva, 25–26 maya 2023 goda. – Moskva: Obshchestvo s ogranichennoi otvetstvennost’yu «Tipografiya «Pechatnykh Del Master», 2023. (In Russ.) doi: https://doi.org/10.14341/DIAConfIII25-26.05.23-30Pi-Sunyer X, Astrup A, Fujioka K, et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med. 2015;373(1):11-22. doi: https://doi.org/10.1056/NEJMoa1411892Pi-Sunyer X, Astrup A, Fujioka K, et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med. 2015;373(1):11-22. doi: https://doi.org/10.1056/NEJMoa1411892Neeland IJ, Marso SP, Ayers CR, et al. Effects of liraglutide on visceral and ectopic fat in adults with overweight and obesity at high cardiovascular risk: a randomised, double-blind, placebo-controlled, clinical trial. Lancet Diabetes Endocrinol. 2021;9(9):595-605. doi: https://doi.org/10.1016/S2213-8587(21)00179-0Neeland IJ, Marso SP, Ayers CR, et al. Effects of liraglutide on visceral and ectopic fat in adults with overweight and obesity at high cardiovascular risk: a randomised, double-blind, placebo-controlled, clinical trial. Lancet Diabetes Endocrinol. 2021;9(9):595-605. doi: https://doi.org/10.1016/S2213-8587(21)00179-0Astrup A, Carraro R, Finer N, et al. Safety, tolerability and sustained weight loss over 2 years with the once-daily human GLP-1 analog, liraglutide. Int J Obes (Lond). 2012;36(6):843-854. doi: https://doi.org/10.1038/ijo.2011.158Astrup A, Carraro R, Finer N, et al. Safety, tolerability and sustained weight loss over 2 years with the once-daily human GLP-1 analog, liraglutide. Int J Obes (Lond). 2012;36(6):843-854. doi: https://doi.org/10.1038/ijo.2011.158Frøssing S, Nylander M, Chabanova E, et al. Effect of liraglutide on ectopic fat in polycystic ovary syndrome: A randomized clinical trial. Diabetes Obes Metab. 2018;20(1):215-218. doi: https://doi.org/10.1111/dom.13053Frøssing S, Nylander M, Chabanova E, et al. Effect of liraglutide on ectopic fat in polycystic ovary syndrome: A randomized clinical trial. Diabetes Obes Metab. 2018;20(1):215-218. doi: https://doi.org/10.1111/dom.13053Томилова А.О. Динамика гормонально-метаболических факторов и воспалительного потенциала жировой ткани на фоне медикаментозного и хирургического методов лечения лиц с ожирением и сахарным диабетом 2 типа: Дис. … канд. мед. Наук. — Москва; 2025. Доступно по: http://endocrincentr.ru/specialists/science/dissertacionnyy-sovet/dissertacii/dinamika-gormonalno-metabolicheskih-faktorov-i-vospalitelnogo-potenciala Ссылка активна на 06.04.2025Tomilova AO. Dinamika gormonal’no-metabolicheskih faktorov i vospalitel’nogo potenciala zhirovoj tkani na fone medikamentoznogo i hirurgicheskogo metodov lecheniya lic s ozhireniem i saharnym diabetom 2 tipa. [dissertation] Moscow; 2025. (In Russ.) Доступно по: http://endocrincentr.ru/specialists/science/dissertacionnyy-sovet/dissertacii/dinamika-gormonalno-metabolicheskih-faktorov-i-vospalitelnogo-potenciala Ссылка активна на 06.04.2025Bergmann NC, Davies MJ, Lingvay I, Knop FK. Semaglutide for the treatment of overweight and obesity: A review. Diabetes Obes Metab. 2023;25(1):18-35. doi: https://doi.org/10.1111/dom.14863Bergmann NC, Davies MJ, Lingvay I, Knop FK. Semaglutide for the treatment of overweight and obesity: A review. Diabetes Obes Metab. 2023;25(1):18-35. doi: https://doi.org/10.1111/dom.14863Wilding JPH, Batterham RL, Calanna S, et al. Impact of Semaglutide on Body Composition in Adults With Overweight or Obesity: Exploratory Analysis of the STEP 1 Study. J Endocr Soc. 2021;5(Suppl 1):A16-A17. doi: https://doi.org/10.1210/jendso/bvab048.030Wilding JPH, Batterham RL, Calanna S, et al. Impact of Semaglutide on Body Composition in Adults With Overweight or Obesity: Exploratory Analysis of the STEP 1 Study. J Endocr Soc. 2021;5(Suppl 1):A16-A17. doi: https://doi.org/10.1210/jendso/bvab048.030Kadowaki T, Isendahl J, Khalid U, et al. Semaglutide once a week in adults with overweight or obesity, with or without type 2 diabetes in an east Asian population (STEP 6): a randomised, double-blind, double-dummy, placebo-controlled, phase 3a trial. Lancet Diabetes Endocrinol. 2022;10(3):193-206. doi: https://doi.org/10.1016/S2213-8587(22)00008-0Kadowaki T, Isendahl J, Khalid U, et al. Semaglutide once a week in adults with overweight or obesity, with or without type 2 diabetes in an east Asian population (STEP 6): a randomised, double-blind, double-dummy, placebo-controlled, phase 3a trial. Lancet Diabetes Endocrinol. 2022;10(3):193-206. doi: https://doi.org/10.1016/S2213-8587(22)00008-0Nelson LW, Lee MH, Garrett JW, et al. Intrapatient Changes in CT-Based Body Composition After Initiation of Semaglutide (Glucagon-Like Peptide-1 Receptor Agonist) Therapy. AJR Am J Roentgenol. 2024;223(6):e2431805. doi: https://doi.org/10.2214/AJR.24.31805Nelson LW, Lee MH, Garrett JW, et al. Intrapatient Changes in CT-Based Body Composition After Initiation of Semaglutide (Glucagon-Like Peptide-1 Receptor Agonist) Therapy. AJR Am J Roentgenol. 2024;223(6):e2431805. doi: https://doi.org/10.2214/AJR.24.31805Look M, Dunn JP, Kushner RF, et al. Body composition changes during weight reduction with tirzepatide in the SURMOUNT-1 study of adults with obesity or overweight. Diabetes Obes Metab. 2025;27(5):2720-2729. doi: https://doi.org/10.1111/dom.16275Look M, Dunn JP, Kushner RF, et al. Body composition changes during weight reduction with tirzepatide in the SURMOUNT-1 study of adults with obesity or overweight. Diabetes Obes Metab. 2025;27(5):2720-2729. doi: https://doi.org/10.1111/dom.16275Gastaldelli A, Cusi K, Fernández Landó L, Bray R, Brouwers B, Rodríguez Á. Effect of tirzepatide versus insulin degludec on liver fat content and abdominal adipose tissue in people with type 2 diabetes (SURPASS-3 MRI): a substudy of the randomised, open-label, parallel-group, phase 3 SURPASS-3 trial. Lancet Diabetes Endocrinol. 2022;10(6):393-406. doi: https://doi.org/10.1016/S2213-8587(22)00070-5Gastaldelli A, Cusi K, Fernández Landó L, Bray R, Brouwers B, Rodríguez Á. Effect of tirzepatide versus insulin degludec on liver fat content and abdominal adipose tissue in people with type 2 diabetes (SURPASS-3 MRI): a substudy of the randomised, open-label, parallel-group, phase 3 SURPASS-3 trial. Lancet Diabetes Endocrinol. 2022;10(6):393-406. doi: https://doi.org/10.1016/S2213-8587(22)00070-5Cariou B, Linge J, Neeland IJ, et al. Effect of tirzepatide on body fat distribution pattern in people with type 2 diabetes. Diabetes Obes Metab. 2024;26(6):2446-2455. doi: https://doi.org/10.1111/dom.15566Cariou B, Linge J, Neeland IJ, et al. Effect of tirzepatide on body fat distribution pattern in people with type 2 diabetes. Diabetes Obes Metab. 2024;26(6):2446-2455. doi: https://doi.org/10.1111/dom.15566Angrisani L, Santonicola A, Iovino P, et al. Bariatric Surgery and Endoluminal Procedures: IFSO Worldwide Survey 2014. Obes Surg. 2017;27(9):2279-2289. doi: https://doi.org/10.1007/s11695-017-2666-xAngrisani L, Santonicola A, Iovino P, et al. Bariatric Surgery and Endoluminal Procedures: IFSO Worldwide Survey 2014. Obes Surg. 2017;27(9):2279-2289. doi: https://doi.org/10.1007/s11695-017-2666-xTałałaj M, Bogołowska-Stieblich A, Wąsowski M, et al. The Influence of Laparoscopic Sleeve Gastrectomy on Body Composition and Fat Distribution in Obese Caucasian Men and Women. Obes Surg. 2020;30(10):3974-3981. doi: https://doi.org/10.1007/s11695-020-04766-zTałałaj M, Bogołowska-Stieblich A, Wąsowski M, et al. The Influence of Laparoscopic Sleeve Gastrectomy on Body Composition and Fat Distribution in Obese Caucasian Men and Women. Obes Surg. 2020;30(10):3974-3981. doi: https://doi.org/10.1007/s11695-020-04766-zHaghighat N, Kazemi A, Asbaghi O, et al. Long-term effect of bariatric surgery on body composition in patients with morbid obesity: A systematic review and meta-analysis. Clin Nutr. 2021;40(4):1755-1766. doi: https://doi.org/10.1016/j.clnu.2020.10.001Haghighat N, Kazemi A, Asbaghi O, et al. Long-term effect of bariatric surgery on body composition in patients with morbid obesity: A systematic review and meta-analysis. Clin Nutr. 2021;40(4):1755-1766. doi: https://doi.org/10.1016/j.clnu.2020.10.001Ito MK, Gonçalves VSS, Faria SLCM, et al. Effect of Protein Intake on the Protein Status and Lean Mass of Post-Bariatric Surgery Patients: a Systematic Review. Obes Surg. 2017;27(2):502-512. doi: https://doi.org/10.1007/s11695-016-2453-0Ito MK, Gonçalves VSS, Faria SLCM, et al. Effect of Protein Intake on the Protein Status and Lean Mass of Post-Bariatric Surgery Patients: a Systematic Review. Obes Surg. 2017;27(2):502-512. doi: https://doi.org/10.1007/s11695-016-2453-0Jassil FC, Papageorgiou M, Mackay E, et al. One Year Changes in Body Composition and Musculoskeletal Health Following Metabolic/Bariatric Surgery. J Clin Endocrinol Metab. 2025;110(5):e1598-e1608. doi: https://doi.org/10.1210/clinem/dgae496Jassil FC, Papageorgiou M, Mackay E, et al. One Year Changes in Body Composition and Musculoskeletal Health Following Metabolic/Bariatric Surgery. J Clin Endocrinol Metab. 2025;110(5):e1598-e1608. doi: https://doi.org/10.1210/clinem/dgae496Kenngott HG, Nickel F, Wise PA, et al. Weight Loss and Changes in Adipose Tissue and Skeletal Muscle Volume after Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypass: a Prospective Study with 12-Month Follow-Up. Obes Surg. 2019;29(12):4018-4028. doi: https://doi.org/10.1007/s11695-019-04087-wKenngott HG, Nickel F, Wise PA, et al. Weight Loss and Changes in Adipose Tissue and Skeletal Muscle Volume after Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypass: a Prospective Study with 12-Month Follow-Up. Obes Surg. 2019;29(12):4018-4028. doi: https://doi.org/10.1007/s11695-019-04087-wЯшков Ю.И., Бордан Н.С., Малыхина А.И., Бекузаров Д.К. Cравнительная оценка пятилетних результатов билиопанкреатического шунтирования в модификациях SADI-S и Duodenal Switch (Hess-Marceau) // Московский хирургический журнал. — 2020. — №1. — С. 111-119. doi: https://doi.org/10.17238/issn2072-3180.2020.1.111-119Yashkov YI, Bordan NS, Malykhina AI, Bekuzarov DK. A comparative evaluation of five-year results of SADI-S and biliopancreatic diversion/Duodenal Switch (Hess-Marceau). Moscow Surgical Journal. 2020;(1):111-119. (In Russ.) doi: https://doi.org/10.17238/issn2072-3180.2020.1.111-119Zhang Z, Wang L, Wei Z, Zhang Z, Cui L, Jiang T. Analysis of the 1-year efficacy of four different surgical methods for treating Chinese super obese (BMI ≥ 50 kg/m2) patients. Sci Rep. 2024;14(1):10451. doi: https://doi.org/10.1038/s41598-024-60983-xZhang Z, Wang L, Wei Z, Zhang Z, Cui L, Jiang T. Analysis of the 1-year efficacy of four different surgical methods for treating Chinese super obese (BMI ≥ 50 kg/m2) patients. Sci Rep. 2024;14(1):10451. doi: https://doi.org/10.1038/s41598-024-60983-xAuclair A, Piché ME, Biertho L, et al. Changes in fat-free mass and muscle mass at 6 and 12 months after biliopancreatic diversion with duodenal switch surgery. Surg Obes Relat Dis. 2020;16(7):878-885. doi: https://doi.org/10.1016/j.soard.2020.03.012Auclair A, Piché ME, Biertho L, et al. Changes in fat-free mass and muscle mass at 6 and 12 months after biliopancreatic diversion with duodenal switch surgery. Surg Obes Relat Dis. 2020;16(7):878-885. doi: https://doi.org/10.1016/j.soard.2020.03.012Shestakova E, Stafeev I, Yashkov Y, et al. Comparative Effect of Insulin Resistance Reduction and Hormonal Alterations on Type 2 Diabetes Remission After Bariatric Surgery. J Clin Med. 2024;13(22):6998. doi: https://doi.org/10.3390/jcm13226998Shestakova E, Stafeev I, Yashkov Y, et al. Comparative Effect of Insulin Resistance Reduction and Hormonal Alterations on Type 2 Diabetes Remission After Bariatric Surgery. J Clin Med. 2024;13(22):6998. doi: https://doi.org/10.3390/jcm13226998Nuijten MAH, Eijsvogels TMH, Monpellier VM, et al. The magnitude and progress of lean body mass, fat-free mass, and skeletal muscle mass loss following bariatric surgery: A systematic review and meta-analysis. Obes Rev. 2022;23(1):e13370. doi: https://doi.org/10.1111/obr.13370Nuijten MAH, Eijsvogels TMH, Monpellier VM, et al. The magnitude and progress of lean body mass, fat-free mass, and skeletal muscle mass loss following bariatric surgery: A systematic review and meta-analysis. Obes Rev. 2022;23(1):e13370. doi: https://doi.org/10.1111/obr.13370Fischer L, Hildebrandt C, Bruckner T, et al. Excessive weight loss after sleeve gastrectomy: a systematic review. Obes Surg. 2012;22(5):721-731. doi: https://doi.org/10.1007/s11695-012-0616-1Fischer L, Hildebrandt C, Bruckner T, et al. Excessive weight loss after sleeve gastrectomy: a systematic review. Obes Surg. 2012;22(5):721-731. doi: https://doi.org/10.1007/s11695-012-0616-1O’Brien PE, Hindle A, Brennan L, et al. Long-Term Outcomes After Bariatric Surgery: a Systematic Review and Meta-analysis of Weight Loss at 10 or More Years for All Bariatric Procedures and a Single-Centre Review of 20-Year Outcomes After Adjustable Gastric Banding. Obes Surg. 2019;29(1):3-14. doi: https://doi.org/10.1007/s11695-018-3525-0O’Brien PE, Hindle A, Brennan L, et al. Long-Term Outcomes After Bariatric Surgery: a Systematic Review and Meta-analysis of Weight Loss at 10 or More Years for All Bariatric Procedures and a Single-Centre Review of 20-Year Outcomes After Adjustable Gastric Banding. Obes Surg. 2019;29(1):3-14. doi: https://doi.org/10.1007/s11695-018-3525-0Сахарный диабет. 2026;29(2):203-214

The authors declare that there are no conflicts of interest present.