Epidemiological studies suggest that physical inactivity is a major cause of obesity. There is little agreement that a sedentary lifestyle is the cause of obesity or that physical activity prevents weight gain through improved metabolic management. The evidence to support a more active lifestyle as the key to weight loss and improved health is weak  so a modest approach to increased walking, biking, or swimming could help improve weight loss potential with a 30-minute per day recommendation. A combination of s urgery-induced diet restrictions and modest daily exercise may be the key to future success but more research is needed on this.
Clinicians can fail to recognize the importance of drug-nutrient interactions when assessing the nutrition status of bariatric surgery patients but health-care professionals need to be aware of the malnutrition factors that drugs may cause. Medications may modify nutrient absorption, metabolism, and excretion of nutrients in the following ways:
Drugs and nutrients interact metabolically because they use the same enzyme systems in the small intestines and liver. Drugs may enhance or inhibit the activity of enzymes needed for normal nutrient metabolism or dietary components may enhance or inhibit enzymes that break down drugs. Select examples include  the following:
• Monoamine oxidase (MAO) inhibitors—medications used to treat depression block an enzyme that inactivates tyramine, epinephrine, and norepinephine
The enzyme system responsible for the metabolism of most nutrients and drugs is the cytochrome P450 (CYP) enzyme family located in the endoplasmic reticulum of the hepatocytes and enterocytes . Vitamins and dietary factors are known to modify CYP activity. Dietary factors that increase CYP activity are
Dietary factors that reduce CYP activity are
Failure to identify and manage drug-nutrient interactions can cause serious consequences like compromised immune function, treatment failure, or morbidity .
Drugs that are recommended to be taken with food to maximize absorption are [7,8]
Drugs that should not be taken with food to allow optimal absorption are [7,9,10]
The reason for not consuming drugs with food include: acid liability, chelation, or binding with food content.