Nearby Food Stores Affect Weight Loss Surgery Results

According to new research, being able to quickly walk to a nearby grocery shop may be crucial for maintaining weight loss after bariatric surgery.
Nevertheless, the researchers discovered that simply being close to a grocery store—especially one that sells primarily highly processed convenience foods—doesn’t guarantee persistent weight loss.

In general, the examination of information from a large number of bariatric surgery patients in central Ohio revealed a link between being near a grocery store and better weight loss two years following the procedure.
Whether that proximity was advantageous was determined by a closer examination of the store’s goods, which revealed that being five minutes away from a store with a poor range of foods was associated with slower weight loss over time.

“Being in closer proximity to lower-quality stores predicted less weight loss, but being in closer proximity to higher-quality stores didn’t predict more weight loss,” said Keeley Pratt, associate professor of human sciences at The Ohio State University and the lead author of two studies detailing these findings. “So the lower-quality stores were driving poor outcomes.”

The research was released in the journals Obesity Surgery and Surgery for Obesity and Associated Disorders.

In the two years following bariatric surgery, the research team looked at neighborhood features and other socioeconomic determinants of health that may support or prevent continuing weight loss. Selected data from the electronic health records of all patients who underwent bariatric surgery at The Ohio State University Wexner Medical Center in Franklin County, Ohio, from 2015 to 2019 were included in the analysis. Race, insurance type, procedure, and the percentage of total weight loss from two to 24 months following surgery were all included in the data.

To count the number of grocery stores, parks, leisure areas, and fitness centers in the county as well as their exact locations of patients’ homes, researchers merged census, county, and health record data.
Following bariatric surgery, which shrinks the stomach and causes rapid weight reduction, patients must initially consume a soft diet in tiny amounts before gradually switching back to a more diverse diet while receiving coaching from a dietician and nurse practitioner for six months.

“What we see then is from six months to a year and after a year, if that volume of food increases because of not maintaining healthy behaviors or returning to previously eaten foods that weren’t as healthy, that weight can come back on,” said Pratt, who also has a faculty appointment in general surgery.

“That being said, that doesn’t mean that what patients can eat is readily available to them where they live—that’s the link we’re trying to figure out. Our patients know what to eat, so it’s not an education or a knowledge issue, but it could be an access issue.”

Living in healthier neighborhoods has been shown to help people control their weight in the past, but relatively few studies have examined how social determinants of health affect those who have undergone substantial surgery to lose weight, she said.

772 patients who had undergone one of two forms of stomach-reduction surgery made up the patient sample. 82% of them were women and 60% of them were white.

While Black surgery patients had higher rates of poverty and unemployment than White surgery patients, in line with earlier studies, those factors did not hurt the results of weight reduction. Neither did being close to recreational and exercise centers or green spaces.

All patients lost more weight on average when they had access to more grocery stores within a 10-minute walk. Yet there was a nuance: Black patients lost more weight over two years if they had access to more food stores within a 10-minute walk. For white patients, a five-minute walk from retailers was the ideal distance for long-term weight loss.

According to their product variety, researchers later classified food stores as having low, moderate, or high levels of diversity. These categories generally correspond to corner or convenience stores, specialized markets, and full-service supermarkets.

All patients lost weight regardless of whether they lived a five- or ten-minute walk from a moderate- or high-diversity store. However, having one low-diversity store within a five-minute walk or up to two low-diversity stores within a 10-minute drive was associated with less maintained weight loss.

Being close to these stores did not necessarily mean that patients made their grocery purchases at the stores that were most convenient for them, according to the researchers, but the characteristics of the nearest food stores might be a sign of more powerful economic factors at work.

“The real goal is to figure out how to make linkages from the clinic to the community and the community to the clinic,” Pratt said, suggesting Ohio State could partner with stores to upgrade their food selection and with fitness facilities to provide patient discounts.

“This is really a starting point to figuring out how we can aid patients in Franklin County and, eventually, beyond, to make sure post-operative weight loss is equitable, and the resources are equitable, for all patients following surgery.”

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