healthy eating

Healthier Lifestyle Maintained After Bariatric Surgery

Bariatric surgery patients tended to maintain healthier lifestyle habits compared with peers who were eligible but had not received this treatment, according to data from the National Health and Nutrition Examination Survey (NHANES).

People approximately 7 years out of bariatric surgery reported more moderate-to-vigorous physical activity (MVPA) than those who were eligible but did not undergo the operation (average 147.9 minutes per week vs 97.4 minutes per week), as well as lower total energy intake (1,746 calories per day vs 2,040 calories per day).

Yet they did not significantly perform better in meeting physical activity requirements (23.1% vs 20.3%) or eating healthy (Healthy Eating Index score 50.0 vs 48.0), according to propensity-matched analyses by Young-Rock Hong, PhD, MPH, of the University of Florida in Gainesville, and colleagues. Their report was published in JAMA Network Open.

The surgical group also fared worse than a nonsurgical group at normal weight in healthy eating and meeting physical activity requirements, the latter defined as engaging in at least 150 minutes a week of moderate-intensity or 75 minutes a week of vigorous-intensity aerobic physical activity.

There was still room for improvement in postbariatric lifestyle, study authors concluded. "Taken together, our findings suggest that postsurgical patients may need more continual support for engaging in healthy lifestyle behaviors to maintain the effects of the surgery," they wrote.

Strong support from physicians of those patients may be needed to ensure more success following bariatric surgery. The authors also highlighted issues such as stigma faced by those experiencing obesity while exercising, as well as both physical and mental health challenges following such a major operation.

Hong's group said that over 200,000 people get bariatric surgery per year, and about half gain back about 17-22 lbs within the first 2 years following their surgery.

"While regaining lost weight is not necessarily harmful, a deeper understanding of postoperative lifestyle patterns is needed to help inform preoperative education programs and postsurgical interventions to maximize the clinical benefits of bariatric surgery," the authors noted.

For their cross-sectional study, the investigators relied on nationally representative NHANES data from 2015 to 2018 including validated measures of diet and physical activity-related assessments.

Of the 4,659 participants, the average age was 46.1 years old, 58.8% were women, 12.7% were Black, and 68.6% were white.

Just 132 participants had undergone bariatric surgery. As a group, these individuals were older and more likely female or white compared with their 1,621 peers eligible for bariatric surgery, according to the American Society for Metabolic and Bariatric Surgery guidelines, who did not get the procedure.

The study left room for confounding and recall bias. Another limitation was the authors' inability to adjust for time since surgery and the exact surgery undergone.


Hong had no disclosures.

Co-authors reported personal relationships with WW International and Novo Nordisk and grants from the National Institutes of Health.

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