Exercise after bariatric surgery can yield better postoperative outcomes

Nov 17 2008

A new study by researchers from The Miriam Hospital's Centers for Behavioral and Preventive Medicine suggests increased physical activity after bariatric surgery can yield better postoperative outcomes.

According to the study, published online by the journal Obesity, previously inactive patients who became physically active after bariatric surgery lost more weight and achieved greater improvements in quality of life than those patients who remained inactive.

"Bariatric surgery is quickly emerging as a standard treatment for severe obesity, although weight loss outcomes vary. These results suggest that patient behavior, particularly physical activity, may promote both enhanced weight loss and greater improvements in health-related quality of life following bariatric surgery," says lead author Dale Bond, PhD, of The Miriam Hospital's Centers for Behavioral and Preventive Medicine.

Approximately 190 patients who underwent gastric bypass surgery at Virginia Commonwealth University participated in the study. A validated, self-administered questionnaire was used to assess physical activity levels of participants both before surgery and one year after surgery. Researchers set a benchmark of 200 minutes of weekly physical activity (defined as walking and participating in activities of a moderate or vigorous intensity) to differentiate between inactive vs. active individuals.

Participants also completed a standardized self-reported questionnaire designed to measure health-related quality of life, focusing on areas such as physical functioning, limitations because of physical or emotional problems, bodily pain, general health, energy levels (vitality), social functioning and mental health.

Overall, researchers observed a positive relationship between changes in physical activity and improved bariatric outcomes. More than two-thirds (68 percent) of those individuals who went from being inactive before surgery to highly active one year afterward lost an additional 13.2 lbs, reduced their BMI by two more units and lost eight percent more of their excess weight compared to those who remained inactive after surgery. This group also increased their daily physical activity duration from an average of less than 10 minutes before surgery to approximately two hours postoperatively.

Nearly a third (32 percent) of participants who engaged in less frequent physical activity did not change their activity levels postoperatively, accumulating fewer than 10 minutes of daily exercise both before and after surgery.

When researchers looked at health-related quality of life, they discovered that individuals who became active following bariatric surgery, as well as those who were already physically active, reported greater improvements in areas such as general health, vitality, depression and anxiety symptoms compared with those who remained inactive.

"Future studies should focus on identifying factors that can target those individuals who are likely to remain inactive after surgery and might require additional interventions to increase their level of physical activity," says Bond, who's also a research fellow in psychiatry (weight control) at the Warren Alpert Medical School of Brown University.

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