Undergoing bariatric (weight-loss) surgery is linked to healthier eating behaviors in the following years, according to a new study published in the journal JAMA Network Open.
Bariatric surgery is linked to a number of improved health outcomes in people with obesity, especially for those who also have diabetes. It can lead to remission of type 2 diabetes or prediabetes — meaning that blood glucose levels are normal without taking any glucose-lowering drugs. When bariatric surgery leads to diabetes remission, people are also at lower risk for cancer. People with type 2 diabetes who undergo bariatric surgery are at lower risk for diabetic retinopathy (eye disease), and also tend to have reduced liver fat — an important outcome because people with diabetes are at higher risk for nonalcoholic fatty liver disease (NAFLD). Bariatric surgery can also improve outcomes in people who undergo knee replacement, in addition to letting some people avoid the procedure altogether. And people who undergo bariatric surgery are at lower risk for death from all causes.
For the latest study, researchers were interested in whether people who undergo bariatric surgery also embrace healthier eating behaviors — something that might help explain better health outcomes in the years following the surgery. They looked at a nationally representative group of 4,659 U.S. adults who participated in the National Health and Nutrition Examination Survey (NHANES), with an average age of 46. As part of the survey, participants were asked questions related to their diet and exercise habits, as well as whether they had undergone bariatric surgery.
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Healthier behaviors linked to having had bariatric surgery
Overall, 132 participants (3.7%) reported having had bariatric surgery, with a median of about seven years before completing the survey. After adjusting for various differences between participants who underwent bariatric surgery and those who didn’t, the researchers found that compared with people who were eligible for the surgery but didn’t have it, those who had bariatric surgery spent more time each week engaged in moderate to vigorous physical activity — an average of 147.9 minutes, compared with 97.4 minutes.
Participants who had bariatric surgery also consumed 294 fewer calories each day, on average, than those who were eligible for the surgery but didn’t have it — 1,746 calories compared with 2,040 calories. This was not a surprising outcome, since many people aren’t able to eat as much following bariatric surgery.
But the researchers also found that people who underwent bariatric surgery were nowhere near as physically active as participants who never had obesity. While 45.6% of normal-weight participants reported meeting physical activity guidelines, only 23.1% of people who had bariatric surgery met these recommendations. What’s more, normal-weight participants scored higher on the Healthy Eating Index, with an average score of 54.4 (on a scale of 0 to 100) compared with 50.0 for people who had bariatric surgery and 48.0 for those who were eligible for bariatric surgery but didn’t have it.
“Individuals who underwent bariatric surgery had beneficial lifestyle patterns compared with those eligible for surgery,” the researchers concluded. “However, these improvements seemed suboptimal based on the current guidelines. Efforts are needed to incorporate benefits of physical activity and a healthy, balanced diet in postbariatric care.”
Want to learn more about bariatric surgery and type 2 diabetes? Read “Is Bariatric Surgery for You?” and “Bariatric Surgery and Diabetes: Questions and Answers.”