Changes in Physical Activity in Relation to Body Composition, Fitness and Quality of Life after Primary Bariatric Surgery: a Two-Year Follow-Up Study

Abstract

Purpose The success of bariatric surgery varies largely, which may relate to variance in adopting a physically active lifestyle. This study aimed to determine whether two-year changes in physical activity (PA) were associated with weight loss, fat-free mass, cardiorespiratory fitness and quality of life up to two years after bariatric surgery. Materials and Methods In this retrospective study, 3879 post-bariatric patients were divided into three groups: 1) decreased PA (n = 388), 2) maintained PA (n = 2002) or 3) increased PA (n = 1498). Measurements regarding PA (Baecke questionnaire), body composition (bioelectrical impedance analysis), estimated cardiorespiratory fitness (Åstrand test) and health-related quality of life (RAND-36) were performed preoperatively and two years post-surgery. Results Bariatric patients with increased PA had greater excess weight loss (76.3% vs. 73.2% vs. 72.9%, P < 0.001), greater increases in %fat-free mass (Δ14.0% vs. 13.0% vs. 12.8%; P < 0.001), larger improvements in VO2max (Δ11.8 vs. 10.2 vs. 8.0 ml/kg/min, P < 0.001), and larger increases in health related quality of life subscale scores (P < 0.05) compared to patients with maintained- and decreased PA. Conclusions Bariatric patients who managed to induce improvements in habitual physical activity had better body composition, fitness and quality of life at 2 years post-surgery, compared to patients who maintained or even reduced their PA levels. These findings underscore the importance of perioperative-bariatric care programs to change lifestyle and achieve sustainable improvements in PA levels.

The General Self-Efficacy Scale in a population planned for bariatric surgery in Sweden: a psychometric evaluation study

“… 8 Changes in physical activity are also important and increased physical activity can improve outcomes after surgery. 9 …”

“…8 Changes in physical activity are also important and increased physical activity can improve outcomes after surgery. 9 One factor that can be important for lifestyle change is self-efficacy. Self-efficacy theory stems from social cognitive theory and concerns one's beliefs in one's capacity to organise and execute actions to achieve certain goals.…”

“…These include learning new eating habits, such as eating regularly, eating more vegetables, fruits and proteins,7 eating smaller portions, not eating quickly and not eating a high-carbohydrate diet, as it increases the risk of dumping syndrome 8. Changes in physical activity are also important and increased physical activity can improve outcomes after surgery 9…”

Effects of physical training on physical and functional fitness, physical activity level, endothelial function, hemodynamic variables, bone metabolism, and quality of life of post-bariatric patients: study protocol for a randomized controlled trial

“…This benefit is relevant, given the relationship between osteoporosis and sarcopenia vs. disability and mortality [19,58]. On the other hand, available evidence suggests that several surgical results are worsened by lack of physical exercise leading to the return of obesity-related comorbidities and regression in QoL [47,59]. In this context, defining which exercise strategy better suits this population and which one is more effective in improving these outcomes is relevant.…”

Asociación del fitness cardiorrespiratorio con marcadores de adiposidad corporal: estudio de corte transversal de la Encuesta Nacional de Salud Chile 2016-2017

“…También podríamos pensar que estos hallazgos se produjeron debido al carácter transversal de nuestra investigación por el fenómeno causa-efecto, sin embargo, estudios longitudinales han reportado evidencia que va en la misma línea sugiriendo que el mayor porcentaje de personas adultas que nunca habían fumado estuvieron clasificadas en el nivel más bajo de fitness en su línea de base 33 , que los efectos del ejercicio físico sobre el FCR fueron similares entre un grupo Fitness Cardiorrespiratorio y Marcadores de Adiposidad -J. Vásquez-Gómez et al de cardíacos fumadores y ex-fumadores comparado con los no fumadores 34 y que el "endurance" o resistencia aeróbica ha disminuido en adultos que indistintamente pasaron sentados < 4 o ≥ 4 horas al día 35 . Por el contrario, respecto a nuestros hallazgos sobre los más activos físicamente, pero con bajo nivel de fitness, personas con obesidad que siguieron programas de AF disminuyeron la adiposidad e incrementaron su FCR 36 y obesas mórbidas candidatas a cirugía bariátrica disminuyeron su adiposidad y mejoraron su aptitud cardiorrespiratoria para caminar debido al efecto de un programa de AF 37 , así mismo personas obesas que tuvieron un incremento en sus niveles de AF post-operatorio mostraron mayor FCR 38 .…”