When to Use Probiotics With Weight Loss Surgery

Everyone’s gastrointestinal tract has a natural balance of “good” and “bad” bacteria. This mixture of bacteria contributes to the system by aiding in digestion and immune support, among other things. During some weight loss surgery procedures, the digestive tract undergoes a large change, but no matter what procedure you choose, it is likely your gut health will shift. From research we know that the gut flora of obese individuals tends to be different from those with a healthy body mass index, or BMI. Research studies have also been exploring the weight loss effects of altering the gut bacteria using methods like introducing probiotics to the system with some encouraging results, both in studies of patients who have had bariatric surgery and those who have not. So, should you be taking a probiotic supplement?

What affects your gut balance?

There are several factors that play into your gut flora. With bariatric surgery, changes in intestinal motility and acid secretion in the stomach both impact your gut health. These changes can impact important functions like vitamin absorption, namely that of vitamin b12.

What and how you eat has a large impact on the strains of bacteria that occur in your GI tract. High sugar and high fat diets feed what we call “bad” bacteria in the gut that is known to contribute to increased absorption of calories and crowd out the growth of “good” bacteria. Foods that are high in fiber benefit the “good” bacteria that aid in controlling fungus development and slow or prevent the growth of harmful bacteria and can also aid in reducing inflammation and protecting the intestinal barrier.

Some high fiber foods are known as prebiotics as they encourage the healthy strains of bacteria and help them to thrive. These prebiotic foods include beans, garlic, onions, barley, oats and apples. Probiotics also naturally exist in some foods, including yogurt with active cultures and fermented foods like kimchi, pickled vegetables, and sauerkraut. An important note, check if your fermented foods are pasteurized, as this process kills the bacteria you are hoping to consume.

A few things other than food affect you gut microbiome as well. Antibiotics, commonly used to knock out an infection, also take a harsh toll on your gut bacteria, both the good and the bad. Other factors like if produce was treated with certain pesticides can harm the healthy gut bacteria.

How to get started with probiotics

For most everyone, probiotic supplements are considered safe. It is always recommended to discuss any supplements you are considering adding to your diet with your doctor or healthcare team. Most people can benefit from increasing the amount of healthy bacteria in the gut. This can be done by introducing pre and probiotic foods into your regular diet and limiting fat and sugar, which feed the “bad” bacteria.

Altering your gut balance can also be achieved with a well-chosen probiotic supplement. If you choose to go the supplementation route, after discussing with your doctor, be sure to do your research and choose carefully. There are countless strains of bacteria and it is better to take advantage of formulas with multiple types. Basic recommendations are to look for a supplement with at least 1 billion colony forming units, or CFUs, but it appears that probiotics with at least 5 billion CFUs per dose that contain at least seven strains of probiotics may be most effective. You should look for a supplement that contains the genus Lactobacillus, Bifidobacterium or Saccharomyces boulardii. These are some of the most researched probiotics. If you are looking to address a specific concern, say weight loss, look for a supplement that includes strains that has been researched for the desired effect.

Are there downsides of probiotics?

For some people, existing conditions cause immune suppression. If your immune system is compromised, or you’re not sure if an existing condition you have may cause immune suppression, it is best to not start a new supplement on your own. Generally, the only side effect of adding a probiotic to your diet is a short adjustment period. Some people will experience a short-term increase in gas, bloating, or diarrhea. Because there are so many strains of bacteria and many brands to choose from, if you don’t notice any results within a month, it is recommended to try a different formula.

Can using probiotics mean greater weight loss?

Research has shown increased weight loss for bariatric patients using probiotics. A study at Stanford University School of Medicine¹ found that of the gastric bypass patients participating in the study, those using a probiotic supplement lost 10% more weight than those in the control group who had not been taking a probiotic. Knowing that gut flora varies between obese and non-obese individuals has lead to new studies using techniques including fecal transplant to determine how a change in one’s gut microbiome impacts weight. As researchers learn more, it seems that more support is found for improving the balance of “good” and “bad” bacteria specifically for weight loss. With bariatric patients, introducing a probiotic has shown increased weight loss, decrease in post-op GI distress, and increase in b12 levels. If you’re curious about adding a probiotic to your supplementation or how to make your diet more gut friendly, talk to your healthcare provider about how and when is best for you.

References:

¹Rogers, Diane. “Probiotics Help Gastric-Bypass Patients Lose Weight More Quickly, Stanford Study Shows.” Stanford Medicine News Center, Stanford Medicine, 13 June 2009, med.stanford.edu/news/all-news/2009/07/probiotics-help-gastric-bypass-patients-lose-weight-more-quickly-stanford-study-shows.html.