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December 10, 2020

Exercise may counteract negative impact of weight loss surgery, study finds

Bariatric surgery helps people lose weight, but it leaves them more vulnerable to bone fractures

Fitness Exercise
Bariatric surgery exercise Steve Buissinne/Pixabay

Routine exercise helps stimulate bone formation and prevents bone loss after weight loss surgery, researchers say.

Regular exercise may help improve bone mineral density levels in people who have undergone bariatric surgery for weight loss, researchers say.

Previous research has shown that bariatric surgery has a negative effect on the skeleton, causing bone loss and a higher risk of fracture.

The severity of the impact can vary depending on the type of procedure, mechanical unloading, nutritional deficiencies and hormonal changes. Mechanical loading through routine exercise helps stimulate bone formation and prevents bone loss.

Despite these risks, bariatric surgery can be a highly effective way for obese patients to lose weight and manage health co-morbidities, such as type 2 diabetes and heart disease.

The two most common types of bariatric surgery are Roux-en-Y gastric bypass and sleeve gastrectomy.

Rouxen-en-Y gastric bypass surgery involves shrinking the stomach and reducing the amount of calories and fat the body absorbs. Most food is redirected to the small intestine.

Sleeve gastrectomy surgery is performed solely in the stomach and is much less invasive. About 80% of the stomach is removed in this type of procedure.

The new study, published in the Journal of Bone and Mineral Researchsuggests regular exercise may be able to help reverse some of this bone loss. 

Researchers had a group of patients perform high impact, balance and resistance exercise three times per week for 11 months after bariatric surgery. Another group of patients served as a control. 

One year after surgery, the exercise group had higher bone mineral density measurements at the lumbar spine and forearm than those in the control group. The participants who attended at least half of the exercise sessions also had higher bone mineral density at the femoral neck.

"These findings showed that a structured exercise program may be a valid treatment option to minimize weight loss surgery-induced bone loss, which may be particularly important since many patients undergo surgery in early adulthood or even at pediatric ages," Florêncio Diniz-Sousa, of the University of Porto in Portugal, said in a statement.

The findings dovetail nicely with a recent University Pittsburgh study that found higher physical activity levels after bariatric surgery can improve mental and physical quality of life, regardless of how much weight is lost.

"As stated in recently released World Health Organization physical activity guidelines, regular exercise should be a priority for everyone, including patients who have undergone weight loss surgery," added Diniz-Sousa.

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