Patient adherence to prescribed behavioral changes can result in positive weight loss and health outcomes following bariatric surgery. The purpose of this study was to analyze patients’ self-reported adherence to twelve bariatric recommendations among an ethnically diverse sample.


A cross sectional design was used to collect data from 136 predominantly Hispanic patients between 6 to 24 months post-surgery in an outpatient community bariatric clinic. All patients received preoperative nutrition education and counseling by a registered dietitian and continued postoperative care with the dietitian and other bariatric providers. A questionnaire was developed to assess patient adherence by identifying the frequency with which patients followed the bariatric guidelines.


Participants self-reported daily adherence to the following bariatric recommendations: starting a meal with protein (42.6%), consuming 3-5 servings of fruits and vegetables (27.2%), spacing meals every four hours (29.4%), taking 11-20 minutes to eat a meal (38.2%), avoiding eating and drinking at the same time (69.9%), ceasing eating when satiated (77.9%), and taking a vitamin supplement (76%). Most participants self-reported committing to the following undesirable behaviors 0 to 2 times per week: drinking alcoholic beverages (91.2%), drinking sugar sweetened beverages (81.6%), eating salty snack foods (76.5%), and eating concentrated sweets (77.2%). One third of participants (35%) self-reported adequate exercise according to the recommended goal of 150 minutes of moderate to vigorous physical activity per week.


Counseling by a registered dietitian can improve adherence to postoperative nutrition and lifestyle recommendations and improve long-term bariatric clinical outcomes.