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Enjoyment of healthy behaviors tied to long-term weight loss after bariatric surgery
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In adults who underwent Roux-en-Y gastric bypass or sleeve gastrectomy, adopting healthier eating and physical activity habits were not associated with improved weight loss at 2 years, but those who maintained such habits in the long term were more likely to maintain their weight loss, according to survey data.
“Perhaps unsurprisingly, the majority of the participants, regardless of follow-up time since surgery, reported that they enjoyed healthy behaviors more than they did before surgery,” Anna-Leena Vuorinen, MSc, of VTT Technical Research Center of Finland, and colleagues wrote. “However, it was only after 2 years that greater enjoyment of healthy behaviors appeared to be associated with weight-loss success. Among participants whose follow-up time since surgery was the shortest (12-24 months), changes in enjoyment of healthy behaviors did not show correlation with weight-loss success.”
Vuorinen and colleagues analyzed data from 475 patients who underwent bariatric surgery recruited from an online support group to complete a cross-sectional, online survey about their lifestyle and behavior (95% women; mean age, 53 years; mean current BMI, 34.2 kg/m²; 78% underwent Roux-en-Y). Participants answered 89 questions regarding the enjoyment of healthy and unhealthy behaviors, and their engagement with support services (meeting with a nutritionist, counselor or therapist) after surgery. Researchers stratified responders into three follow-up groups: 12 to 24 months since surgery, 24 to 60 months since surgery and more than 60 months since surgery.
The mean percentage of BMI loss after surgery was 64.9%, with 70% of responders having lost at least 50% of their excess weight. Within the cohort, 63% reported that they enjoyed healthy foods more since surgery, 34% the same and 3% less; 95% reported less enjoyment in overeating.
Researchers found that the enjoyment of eating behaviors and exercise among responders who experienced successful vs. unsuccessful weight loss varied across follow-up groups. Among those who were 12 to 24 months since surgery, increased enjoyment of healthy eating was not associated with weight-loss outcomes (adjusted OR = 1.33; 95% CI, 0.45-3.9). However, those who were 24 to 60 months since surgery and reported increased enjoyment of healthy eating were more likely to experience successful weight loss (adjusted OR = 2.81; 95% CI, 1.33-5.96), with an even greater likelihood for those at more than 60 months since surgery (adjusted OR = 3.02; 95% CI, 1.61-5.65). Results were similar for increased enjoyment of exercise, according to researchers. Weight-loss success was associated with decreased enjoyment of consuming junk food only among responders who were 24 to 60 months since surgery (OR = 2.33; 95% CI, 1.11-4.89).
Among all responders, 38% reported obtaining post-bariatric support at some point since surgery. Obtaining support was associated with enjoying healthy food, exercise and less overeating only among responders who had more than 60 months since surgery. Among those who were 24 to 60 months since surgery, obtaining support was associated only with increased enjoyment of exercise. There were no associations between obtaining support and healthy eating or exercise for those 12 to 24 months since surgery, according to researchers.
“It is likely that participants soon after surgery do not need to enjoy their new behavioral patterns to adhere to them, since returning to old eating patterns is much more anatomically difficult and painful,” the researchers wrote. “Research confirms that almost all participants who undergo bariatric surgery experience rapid weight loss during the first 2 years.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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