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Oral nutritional supplements significantly attenuate body weight loss after gastrectomy for gastric cancerOral nutritional supplements may slow weight loss after stomach surgery

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Key Takeaway
Consider ONS post-discharge to reduce weight loss after gastrectomy, though evidence is limited by high heterogeneity.

This meta-analysis evaluated the impact of oral nutritional supplementation (ONS) on patients undergoing gastrectomy for gastric cancer. The study included a total population of 1736 patients. The primary focus was on the efficacy of ONS provided after hospital discharge compared to standard control care. The follow-up period for these patients ranged from 8 weeks to 3 months post-discharge.

The intervention involved oral nutritional supplementation administered following the surgical procedure. The control group received standard care. The primary outcome measured was changes in body weight. The analysis found that ONS significantly attenuated absolute body weight loss, with a weighted mean difference (WMD) of 0.75 kg (95% CI: 0.11 to 1.40). Additionally, the percentage of body weight loss was significantly attenuated in the ONS group, showing a WMD of 1.42 (95% CI: 0.78 to 2.07).

Secondary outcomes were assessed to provide a broader view of nutritional status and physiological impact. These included laboratory indices, body composition, and handgrip strength. For all three of these secondary outcomes, the analysis found no significant inter-group differences between the ONS and control groups. These results suggest that while ONS may impact weight maintenance, it did not significantly alter other markers of muscle mass or laboratory values within the study timeframe.

Safety and tolerability were also evaluated. The analysis found that adverse events were not significantly different between the ONS and control groups (RR: 1.17; 95% CI: 0.92 to 1.49). No specific data regarding serious adverse events, treatment discontinuations, or specific tolerability metrics were reported. This suggests that ONS is generally well-tolerated in the immediate post-discharge period following gastrectomy.

The findings regarding weight maintenance provide a specific point of intervention in the postoperative period. However, the evidence is tempered by several methodological limitations. The analysis noted a small number of trials and substantial heterogeneity in the primary weight outcome. Furthermore, no formal GRADE assessment was performed, and the durability of the observed benefits beyond the 3-month follow-up period remains unknown.

Clinically, these results suggest that post-discharge ONS may be a viable strategy to reduce early to intermediate postoperative weight loss in patients following gastrectomy for gastric cancer. This intervention does not appear to carry a significant safety penalty based on the reported data. However, clinicians should note that the evidence is limited by the quality of the underlying trials and the heterogeneity of the data. Questions remain regarding the long-term durability of weight maintenance beyond 3 months and the impact of ONS on other physiological markers beyond simple weight metrics.

How this fits prior evidence

How this fits prior evidence: This finding addresses a gap in the management of postoperative nutritional status in gastric cancer patients. While previous evidence has focused on diagnostic tools like multi-protein panels, treatment selection via biomarkers like HER2 and PD-L1, and the efficacy of perioperative immune checkpoint inhibitors, this study specifically addresses the nutritional management of patients following surgical intervention. It provides evidence on the role of ONS in mitigating weight loss, a common complication after gastrectomy.

When a person undergoes surgery for gastric cancer, the road to recovery is often physically and emotionally demanding. One of the biggest challenges during this time is maintaining weight and nutrition. After a gastrectomy, which is the surgical removal of part of the stomach, patients often struggle to keep weight on as they adjust to their new routine. This makes the role of nutrition a vital part of the healing process.

To better understand how to support these patients, researchers looked at data from 1,736 people who underwent gastrectomy for gastric cancer. They compared two groups: one group received standard care, while the other group received oral nutritional supplements (ONS) after they were discharged from the hospital. These supplements are designed to provide extra nutrients and calories to help patients maintain their health during recovery.

The results showed that patients who took the oral nutritional supplements had a significantly lower amount of weight loss compared to those who did not. Specifically, the group taking supplements saw a reduction in the amount of weight lost by about 0.75 kilograms on average. While the supplements helped slow down weight loss in the weeks following surgery, the study did not find significant differences in other areas. These other areas included body composition, handgrip strength, and various laboratory markers. This means that while the supplements helped with weight, they did not necessarily change muscle mass or other physical strength markers in the short term.

In terms of safety, the study found no significant difference in adverse events between the two groups. This suggests that the supplements were well-tolerated by the patients during the follow-up period of up to three months. However, there are important reasons to be cautious before making big changes. The study was based on a small number of trials, and there was a lot of variation in how weight was measured across those trials. Additionally, the researchers did not know if the benefits of these supplements lasted longer than three months.

For patients right now, this means that oral nutritional supplements could be a helpful tool to help manage weight loss in the months immediately following a gastrectomy. While it is not a guaranteed fix for every health metric, it shows a promising way to support patients during a difficult recovery period. Patients should always talk to their medical team to see if these specific supplements are right for their individual recovery plan.

What this means for you:
Oral supplements may help slow weight loss after stomach surgery, but long-term benefits are not yet known.

Study Details

Study typeMeta analysis
Sample sizen = 1,736
EvidenceLevel 1
Follow-up1.8 mo
PublishedSep 2026
View Original Abstract ↓
Nutritional intervention after gastrectomy is central to postoperative recovery, but the optimal outpatient supplementation strategy remains uncertain. This systematic review assessed the efficacy and safety of oral nutritional supplementation (ONS) after hospital discharge in patients undergoing gastrectomy for gastric cancer. Eligible randomized controlled trials (RCTs) were identified from five databases through September 2025. Extracted outcomes included adverse events, laboratory indices, body composition, handgrip strength, and body-weight change. Seven RCTs involving 1,736 participants met the review criteria, although the number of trials contributing to each pooled outcome varied. ONS significantly attenuated absolute body-weight loss (WMD: 0.75 kg; 95% CI: 0.11 to 1.40) and percentage body-weight loss (WMD: 1.42; 95% CI: 0.78 to 2.07) compared with control care. Risk-of-bias assessment identified generally adequate randomization and allocation reporting in most trials, but certainty remains limited by the small number of trials, substantial heterogeneity in the primary weight outcome, and the absence of a formal GRADE assessment. No significant inter-group differences were found for body composition, handgrip strength, or laboratory markers. Adverse-event incidence was not significantly different between groups when analyzed with the fixed-effect model selected for minimal heterogeneity (RR: 1.17; 95% CI: 0.92 to 1.49). These findings suggest that post-discharge ONS may help reduce early to intermediate postoperative weight loss after gastrectomy without a clear safety penalty. Because most endpoints were assessed between 8 weeks and 3 months, the durability of benefit beyond this period remains unclear.
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