The Important Role of Protein and Physical Activity in Preventing Muscle Mass Loss While Losing Weight
March 3, 2025Categories: Bariatric, Blog, Health & Wellness
Individuals undergoing bariatric surgery are at a higher risk of losing lean body mass (muscle tissue) which makes the chance of developing sarcopenia higher. Sarcopenia is a condition characterized by a progressive loss of muscle mass, strength, and physical function that is common as we age and become less active. Having sarcopenia is associated with a higher all cause morbidity and mortality. Most people have bariatric surgery because they want to improve their health and longevity, not to become weaker and develop more health issues. This is why adequate protein intake and physical activity are so important post-operatively, or for anyone losing weight through any method.
In the initial months following bariatric surgery, patients consume a very low-calorie, low carbohydrate diet, which leads to rapid weight loss. This initial loss can feel fairly effortless at first, meaning patients are losing weight without much increase in physical activity. Unfortunately, this can create a false sense of security for patients that start thinking they don’t need to exercise to continue losing weight, or that exercise isn’t important. This could not be further from the truth. Losing muscle mass can lead to weight regain because it causes a decrease in basal metabolic rate (AKA how many calories a person burns a day).
This lack of physical activity, especially resistance training, combined with not consuming the recommended amount of protein is a recipe for disaster that leads to muscle loss. Protein is also essential for many other bodily functions besides just maintaining muscle mass.
Protein also helps with:
- Hormone regulation
- Building and repairing hair, nails, and skin tissue
- Metabolism and nutrient transport
- Producing antibodies to fight infections/illnesses
- Balancing the acid/base environment within our body
- Satiation after eating
How Much Protein is Enough?
The amount of protein each person needs varies and depends on age, height, weight, gender, and level of physical activity. Most people need about 30% of their total daily calories to come from protein (ex. 30% of 1800 calories = 135 grams of protein/day). In the initial stages post-op, the goal is to consume 60-80 grams of protein a day as calorie intake is low.
Our bodies do not store protein, so it must be consumed in adequate amounts on a regular basis, or our bodies will begin to break down muscle tissue to get what it needs to function properly. You will not be able to build new muscle tissue without eating enough protein. If you are exercising and not eating adequate amounts of high-quality protein, you won’t make much progress in the gym. When it comes to protein, the food source also matters. Processed meats like hot dogs and fast-food high-fat burgers do contain protein; but they are also high in unhealthy saturated fat, calories, and sodium.
High Quality Complete Protein Choices:
- Skinless chicken and turkey
- Lean cuts of beef and pork
- Seafood
- Eggs
- Greek yogurt, milk, cottage cheese
- Whey protein powder or protein shakes
- Tofu, soy beans, soy milk
What Kind of Exercise Should I Do?
Whatever kind of exercise you actually enjoy doing is what you will stick with! There are tons of ways to be physically active, build strength, and burn calories, so trying different things to find what you like is key. Get out of your comfort zone and give yoga, Zumba, spinning, hiking, biking, or country line dancing a try! You never know what you might like if you never try it. It’s ideal to do both a combination of cardio and strength exercises for overall health and fitness. Many people find typical gyms to be intimidating because they don’t know how to use the equipment or what to do, or they fear getting hurt. If you have specific mobility limitations like back, knee, or other joint issues, then seek out a personal trainer who has knowledge on how to modify exercises to prevent injuries. Working with a personal trainer if you are new to weight lifting can be very educational and can give you the confidence you need to work out on your own after a few sessions. In addition, there are tons of free exercise Apps and videos available on YouTube.
How Much Exercise Should I Get?
The American Heart Association recommends the following for cardiovascular health based on the Physical Activity Guidelines for Americans, 2nd ed., published by the U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion:
- Moderate-intensity cardio: At least 150 minutes per week (e.g., brisk walking, cycling) OR
- Vigorous-intensity cardio: At least 75 minutes per week (e.g., running, high-intensity interval training) OR
- A combination of both moderate and vigorous activities spread throughout the week.
For additional health benefits or weight loss, increasing the duration to 300 minutes of moderate-intensity or 150 minutes of vigorous-intensity exercise per week is suggested. It’s also recommended to spread the activity throughout the week, such as 30 minutes a day, five days a week. 1
The American Heart Association and the CDC recommend strength training at least two days per week. These sessions should target all major muscle groups, including:
- Legs (quadriceps, hamstrings, calves)
- Hips (glutes)
- Back (upper and lower)
- Chest
- Abdomen (core)
- Shoulders
- Arms (biceps and triceps)
Each session should include:
- 8-12 repetitions per exercise
- 1-3 sets per muscle group, depending on fitness level and goals
Strength training can include bodyweight exercises (like push-ups and squats), free weights, resistance bands, or weight machines. Resting at least 48 hours between sessions for the same muscle group is recommended for recovery and muscle growth. Don’t forget to also include exercises to improve your endurance, balance, and flexibility. 2
Seem overwhelming at first? Start out slow and work your way up to that amount. Everyone has to start somewhere! Exercise can be split up into smaller increments spread throughout the day and still be effective. See if you can fit in 3 ten minute bouts of exercise throughout your day. Maybe you park as far away from your work entrance as possible and take the stairs in your office instead of the elevator. Save the last 10 minutes of your lunch break to walk, do squats, calf raises, or balance exercises before going back to work. Take your dog for a 10 minute walk instead of letting it out in your back yard. Do some core exercises in between commercial breaks when watching TV in the evening. Have a 10 minute dance party with your kids after dinner! All of these things can add up to a full 30-45 minutes of exercise.
Create Your Own at Home Circuit Style Workout*
Choose 2-4 exercises from each category alternating between a cardio move and a strength move. Perform each move for 30 seconds, then start the next move. Take a 1-2 minute break and then repeat the circuit 2-3 times! As your stamina and strength improves, you can increase the time per move or increase the amount of moves or rounds.
Cardio Exercises:
- Jumping Jacks or foot taps
- Squat jumps or body weight squats
- Jogging in place or marching in place
- High knee run or knee raises
- Burpees
- Jumping rope or calf raises
- Mountain climbers
- Step ups or stair climbing
- Dancing
Strength and Stability Exercises:
- Alternating lunges
- Side lunges
- Push ups
- Sit ups or crunches
- Wall sit
- Tricep dips using a bench or chair
- Hip Lift/Glute Bridge
- Inchworm walk outs
- Plank (holding top of push up position)
If you are unfamiliar with how to do any of these exercises, search online for a visual instruction of proper form, or ask a personal trainer.
*Before beginning any new exercise regimen, especially if you have existing health conditions, consult with a healthcare professional or certified fitness trainer to ensure the activities are safe and appropriate for your individual needs.
References:
- www.heart.org. American Heart Association Recommendations for Physical Activity in Adults and Kids – 1/18/24
- www.heart.org. Strength and Resistance Training Exercise – 1/18/24
