Physical activity, healthy diet necessary to maintain benefits of sleeve gastrectomy in women

Women who underwent sleeve gastrectomy (SG) should adhere to a healthy diet and engage in physical activities to sustain the benefits of weight-loss surgery and improve their overall wellbeing, suggests a recent study.

“[T]he study revealed high success rates in terms of weight reduction and improvement in several obesity-related health conditions,” the investigators said. “However, it also highlighted the potential disadvantages, such as the increased prevalence of certain vitamin and mineral deficiencies and the need for continued monitoring and management.”

Some 352 women aged 20 to 50 years who had undergone SG were included in the study. The investigators used surveys to ascertain the participants’ physical activity levels and dietary behaviours. They also used a food frequency questionnaire and calculated the BMI of each participant.

Nearly all women (98.9 percent) were diagnosed as having obesity or morbid obesity prior to the surgery. The main reason for undergoing SG was failed dietary regimens (26.4 percent). [Asia Pac J Clin Nutr 2025;34:363-372]

Weight significantly improved post-SG, but a significant proportion of women continued taking dietary supplements after the surgery and frequently consumed juices and sweets. Most of them also fell short of meeting the WHO recommendations for regular physical activity.

In addition, further analysis revealed a significant association between BMI and the consumption of healthy foods post-SG.

“Regularly consuming sugary drinks and sweets in excess can contribute to various health problems, including weight regain and obesity, type 2 diabetes, dental problems, and other health issues,” the investigators said. [Obesity Surg 2022;32:3722-3731; Endocrinol Diabetes Metab J 2021;4:e00282]

However, other studies reported a reduction in sweet food consumption following Roux-en-Y gastric bypass compared with presurgery procedures. This difference in dietary intake could have been driven by the type of gastric sleeve surgery. [Proc Nutr Soc 2015;74:419-425]

Long-term outcomes

“Data on the prevalence of several obesity-related diseases among the study population, prior to undergoing SG, revealed postoperative improvements in 29.58 percent of the women,” according to the investigators. 

Furthermore, SG resulted in a significant reduction in the incidence of sleep apnoea (50 percent), elevated liver fat (42.13 percent), type 2 diabetes (36.8 percent), total cholesterol, and blood fat elevation (34.0 percent).

These results support those of a previous systematic review, which showed a significant improvement in diabetes in 77.8 percent of patients 5 years after SG. [Saudi Med 2019;39:100-103]

Improvements were also observed in arterial hypertension (68.0 percent), dyslipidaemia (65.9 percent), obstructive sleep apnoea (75.8 percent), gastroesophageal reflux disease (30.6 percent), and degenerative joint diseases (55.7 percent).

“Therefore, this systematic review indicates that SG can result in substantial and enduring loss of excess weight and notable enhancement in obesity-related comorbidities,” the investigators said.

Interestingly, SG was associated with some negative outcomes, such as menstrual disorders, hair loss, anxiety, and depression. This finding was consistent with those of an earlier study, which reported preoperative depression in 30.2 percent of participants and postoperative depression in 37.7 percent (p=0.025). [Obes Surg 2018;28:649-655]

"This result suggests that undergoing bariatric surgery might be associated with increased anxiety and depression in some women,” the investigators said. “The reasons for this could be complex and may involve various factors such as stress about the surgery and its aftermath, body image changes, or the emotional challenges associated with weight loss.”