Increased post‐operative cardiopulmonary fitness in gastric bypass patients is explained by weight loss

Abstract

Roux-en-Y gastric bypass (RYGB) leads to a major weight loss in obese patients. However, given that most patients remain obese after the weight loss, regular exercise should be part of a healthier lifestyle. The primary aim of this study was to investigate the cardiopulmonary fitness in obese patients before and after RYGB. Thirty-four patients had body composition and cardiopulmonary fitness (VO ) assessed and completed questionnaires regarding physical activity and function twice before RYGB (time points A and B) and 4 and 18 months after surgery (time points C and D). Weight loss was 37 ± 2 kg during the study period. VO increased (A: 21 ± 1 vs D: 29 mL/min/kg, P < 0.001), but absolute VO decreased (A: 2713 ± 126 vs 2609 ± 187 mL/min, P = 0.02) and VO per kilogram fat free mass did not change. Self-perceived limitations to perform exercise decreased and self-perceived physical fitness increased after RYGB. Self-reported low- and high-intensity physical activity did not change. With weight loss, self-rated fitness level increased and the limitations to perform exercise decreased in RYGB patients. Nevertheless, as shown by the lower absolute VO , RYGB patients do not adopt new exercise habits following surgery.

Mitochondrial respiratory capacity remains stable despite a comprehensive and sustained increase in insulin sensitivity in obese patients undergoing gastric bypass surgery

“…It is known that insulin sensitivity, GLUT4 protein and mitochondrial content are highest in type I (red, oxidative) fibres, compared with type II (white, glycolytic) fibres and that insulin sensitivity increases with training status . Therefore, a change in fibre type composition or exercise habits could have influenced the data, but no change in fibre type composition (Figure ), GLUT 4 content or cardiorespiratory fitness per body weight was seen in this cohort.…”

“…The present study is part of a larger project investigating the metabolic and psychosocial effects of gastric bypass surgery. Design and methods of this study have been reported previously . The complete protocol was approved by the Copenhagen ethics committee (journal no.…”

Macrophage Area Content and Phenotype in Hepatic and Adipose Tissue in Patients with Obesity Undergoing Roux‐en‐Y Gastric Bypass

“…This study is part of a larger project investigating the metabolic and psychosocial effects of RYGB up to 18 months postoperatively . In the longitudinal part of the study, 18 patients with morbid obesity and a wide range of IS were included.…”

Obesity leads to impairments in the morphology and organization of human skeletal muscle lipid droplets and mitochondrial networks, which are resolved with gastric bypass surgery‐induced improvements in insulin sensitivity

“…[41][42][43][44][45][46][47] A full set of muscle biopsies from fifteen subjects with obesity (7 with (OB-DM2) and 8 without (OB) T2D) scheduled for laparoscopic RYGB were available at 4 time points: (i) at inclusion, (ii) after a voluntary diet-induced 8% body weight loss, (iii) 4 months and (iv) 1.5 years after RYGB surgery. [41][42][43][44][45][46][47] A full set of muscle biopsies from fifteen subjects with obesity (7 with (OB-DM2) and 8 without (OB) T2D) scheduled for laparoscopic RYGB were available at 4 time points: (i) at inclusion, (ii) after a voluntary diet-induced 8% body weight loss, (iii) 4 months and (iv) 1.5 years after RYGB surgery.…”

“…The present project is part of a larger project (GASMITO) investigating the metabolic and psycho-social effects of RYGB surgery. [41][42][43][44][45][46][47] A full set of muscle biopsies from fifteen subjects with obesity (7 with (OB-DM2) and 8 without (OB) T2D) scheduled for laparoscopic RYGB were available at 4 time points: (i) at inclusion, (ii) after a voluntary diet-induced 8% body weight loss, (iii) 4 months and (iv) 1.5 years after RYGB surgery. Muscle biopsies from five lean and sedentary male subjects, recruited as previously reported 48 under the MITOBOLISM project, were analysed as reference group (RG).…”