Abstract: Bariatric surgery is the most effective intervention for severe obesity, yet signi-ficant individual variability exists in postoperative outcomes. Recent research has increasingly high-lighted the pivotal role of genetic factors as key mechanism influencing the efficacy of bariatric procedures. The authors systematically elaborate on the genetic basis of obesity, with a specific focus on how genetic polymorphisms and epigenetic modifications regulate surgical responses. They further explore the potential applications of multi‑omics technologies in this field, aiming to provide novel insights for predicting surgical outcomes through genetic screening and evaluation, thereby facilita-ting personalized postoperative management strategies for improved long‑term prognosis and preci-sion medicine.