Abstract:Metabolic bariatric surgery is an effective intervention for obesity and related metabolic disorders. Beyond substantial weight reduction, it modulates orexigenic and anorexigenic neuropeptides and their signaling pathways to improve energy homeostasis and metabolic function. This review summarizes the regulatory effects of various bariatric procedures (such as Roux-en-Y gastric bypass and sleeve gastrectomy) on orexigenic neuropeptides and anorexigenic factors, highlighting the involvement of key signaling pathways including mTOR and AMPK. These mechanisms contribute to weight control, enhanced insulin sensitivity, and remission of metabolic diseases. By integrating central and peripheral regulatory processes, metabolic surgery provides new biological insights into individualized obesity management. Future research should focus on interindividual variability and long-term neuro-metabolic adaptations to optimize surgical outcomes and improve metabolic health.