Despite showing better adherence to healthy eating behaviors and physical activity recommendations, new research suggests more emphasis is needed on optimizing lifestyle changes after bariatric surgery in people with severe obesity and metabolic disease. .
An analysis of data from more than 4,500 patients comparing lifestyle patterns among those who underwent bariatric surgery with those who were deemed eligible for surgery, study results demonstrate that undergoing surgery is associated with improvements in lifestyle patterns, but have not yet reached the levels of adherence to healthy eating and physical activity among their normal-weight counterparts.
“Obesity is a chronic disease process and should be managed as such, like hypertension or diabetes,” said study investigator Crystal Johnson-Mann, MD, MPH, assistant professor and a minimally invasive/bariatric surgeon in the division of surgery. gastrointestinal at the University of Florida College of Medicine, in a statement. “Patients get the best results from bariatric surgery when it is fully used in conjunction with lifestyle/behavior changes, such as changes in physical activity and diet. Not all post-surgery patients may be as physically active as desired due to ongoing neurological, musculoskeletal, or other factors, but physical activity should be strongly encouraged in those who are able to participate to maximize the benefits of their metabolic surgery.”
Although the acceptance of bariatric surgery has increased in recent years, few studies have explored how bariatric surgery might influence patient behavior. To do so, the researchers designed their study as a cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) data from survey cycles that were conducted between 2015 and 2018 to characterize differences in the behaviors of lifestyle among people with normal weight, those who received bariatric surgery, and those who were considered clinically eligible for bariatric surgery.
The researchers’ initial search of the NHANES data returned a sample of 11,848 participants age 18 and older. After categorizing patients into groups based on weight and whether or not they had undergone bariatric surgery, as well as those with missing data, a cohort of 4659 participants was identified for inclusion. This cohort had a mean age of 46.1 (SD, 18.6) years, 58.8% were female, 12.7% were black, and 3.7% reported having had bariatric surgery. Among those who underwent bariatric surgery, the median time since surgery was 7 (IQR, 3-10) years.
The primary outcomes of interest for the study were self-report measures to assess physical activity and eating behaviors. Physical activity measurements included moderate-to-vigorous physical activity (MVPA), sedentary activity, and whether physical activity guidelines were met, and eating behaviors were measured as total energy intake and Healthy Eating Index (HEI) diet scores. )-2015.
In propensity score-weighted analyses, those who underwent bariatric surgery reported more time spent in MVPA than those eligible for surgery, with a reported total MVPA per week of 147.9 minutes per week compared with 97.4 minutes per week, respectively. Compared with those of normal weight (45.6%; 95% CI, 13.8-32.4%), the percentage of patients who achieved physical activity guidelines was almost 2 times higher than those of bariatric surgery (23, 1%, 95% CI, 13.8-32.4%). %) and group eligible for surgery (20.3%; 95% CI, 15.6-25.1%).
Further analysis of HEI-2015 scores showed that HEI scores were higher for people with normal weight (54.4; 95% CI, 53.0-55.9) than for those who had surgery bariatric surgery (50.0; 95% CI, 47.2-52.9) or eligible for surgery (48.0; 95% CI, 46.0-50.0). Furthermore, when evaluating the components of the HEI, the mean scores were similar between those who received bariatric surgery and those who were considered clinically eligible for surgery. The researchers also found that total daily energy intake was lowest among those who underwent bariatric surgery (1,746 kcal; 95% CI, 1,554-1,937), followed by those with normal weight (1,943 kcal; 95% CI, 1,873 -2013) and those eligible for bariatric surgery (2040 kcal; 1953-2128).
“The provision of nutritional counseling and support to help patients make and maintain post-surgical changes in their dietary intake and physical activity is key to supporting long-term weight loss maintenance,” said lead investigator Kathryn Ross, PhD. , MPH, associate professor of clinical research. and health psychology at the College of Public Health and Health Professions, in the aforementioned statement. “Offering nonjudgmental, positive support while helping patients set realistic and achievable goals can also benefit postoperative patients trying to make changes to their eating and activity patterns.”
This study, “Assessment of Physical Activity and Healthy Eating Behaviors Among US Adults Receiving Bariatric Surgery,” was published in JAMA Network Open.
Source: www.endocrinologynetwork.com