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Exercise & Bone Health Post-Op Bariatric Surgery

If you feel like getting into the nitty gritty details: here’s the link to the research paper where I got this information:

Title of this article:

Bone Health after Bariatric Surgery: Consequences, Prevention, and Treatment

I read through and wrote some bullet points of the important facts I wanted to share!


BS (Bariatric Surgery)

BMD (Bone Mineral Density)


  • Turns out, one of the most critical complications of BS → an adverse effect on the health of the bones & skeletal system.

  • Studies show that BMD (bone mineral density) decreases significantly in the early years after bariatric surgery.

  • 2 main reasons: nutritional deficiencies & hormonal changes

  • Just one example: calcium absorption will significantly reduce post-op...and we all know calcium is good for our bones!

  • The overall risk of fractures is also increased post-op BS

  • Varies surgery-to-surgery

  • The risk of fracture in people who had bariatric surgery is 2.3X higher than for those who did not have bariatric surgery.

Studies show that exercise and dietary intervention with calcium, vitamin D, and protein consumption are the most critical strategies for maintaining this complication.

  • The rate of bone loss during the 1st year after BS was higher than in subsequent years. The main reasons are nutritional deficiencies & hormonal changes.

  • Nutritional deficiencies are a common complication of BS

  • Most common deficiencies (which all play a role in bone health)

  • Protein

  • Iron

  • B12

  • Folate

  • Calcium

  • Fat-soluble vitamins (Vit D, K, E)

Did you know our skeletal system & bones are a part of the endocrine system? Which plays a major role in hormonal function.

  • Gut hormones are also changed post-op. Specifically:

  • Peptide YY

  • Ghrelin

  • Changes in these hormones, specifically post-op BS, may involve changes in the skeletal system.

  • Endocrine Factors (estrogen/testosterone) 

  • Estrogen → LOW estrogen is one of the top reasons for an increased risk of osteoporosis during menopause (BS or not)

  • Estrogen has a stimulating effect on the skeletal system

  • Testosterone → Studies show an increase in blood testosterone levels post-op BS

  • Leptin → hormone secreted by fat cells

    • Studies show that leptin DECREASES rapidly after bariatric surgery.

  • Roles: regulates nerves, endocrine glands, and bone metabolism

    • Also plays a major role in feeling hungry / feeling full.

  • Leptin regulates BMD by directly affecting bone cells and indirectly affecting the hypothalamus.

Bariatric surgery never eliminates unhealthy habits. Changing your lifestyle (having a healthy eating pattern & participating in daily physical activity) will undoubtedly improve the outcome of your operation.

  • According to studies, ~4 hours a week of exercise is associated with higher BMD.

  • The research suggests exercise as a treatment for bone loss from bariatric surgery.

  • Researchers studied two groups (All participants were post-op bariatric surgery)

  • Aerobic exercise ONLY

  • Aerobic & resistance exercise

  • After 12 weeks, they found that the group who did BOTH aerobic & resistance exercises showed:

  • Increased weight loss

  • Increased muscle mass

  • Increased functional capacity

  • Increased upper-body strength


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