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Background and objectives To investigate the evolution of carbohydrate intake in respect to other macronutrient and the effect on glycemic status and body composition before and after laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods A cohort study prospectively collated data concerning dietary records, glycemic status and body composition of patients with planned LRYGB before 3, 6 and 12 months afterwards. The group was subdivided according to relative carbohydrate intake before surgery. Results At start, 30 patients had a moderate relative carbohydrate intake (M-CHO) (26-45%), a mean body mass index (BMI) of 40.4 ± 3.9 kg/m² and a mean glycated hemoglobin A1c (A1C) of 6.5 ± 1.2% compared to 20 patients with a high relative carbohydrate intake (H-CHO) (>45%) with a mean BMI of 40.9 ± 3.7 kg/m² (p 0.61) and a mean A1C of 6.2% (p 0.44). One year after surgery, mean BMI was 27 ± 3.2 kg/m² and mean A1C was 5.4 ± 0.4 % in the M-CHO group with 5 patients lost to follow-up compared to a mean BMI of 28 ± 3.4 kg/m² (p 0.45) and mean A1C of 5.5 ± 0.6 % (p 0.49) in the H-CHO group with 4 patients lost to follow-up. There was a similar evolution of relative total carbohydrate intake to 46% but the absolute intake of total carbohydrate (190 ±50 vs. 153 ±39g, p 0.02) and fat (65 ±20 vs. 48 ±14g, p<0.01) was significantly higher in the M-CHO group, resulting in a significant higher total energy intake (1646 ± 345 vs. 1317 ± 285 kcal, p<0.001). Conclusion The group with a high relative carbohydrate intake before LRYGB has a significant lower energy intake due to reduction of absolute carbohydrate and fat intake one year after surgery compared to the group with a moderate relative carbohydrate intake at baseline. The difference between relative carbohydrate intake before surgery didn’t influence the remission of diabetes nor the evolution of body composition.