Measurement and Intervention on Physical Activity and Sedentary Behaviours in Bariatric Surgery Patients: Emphasis on Mobile Technology

Abstract

Physical activity (PA) and sedentary behaviors (SB—i.e. activities involving low energy expenditure and a sitting/reclining posture) may each have significant implications for weight loss and other bariatric surgery outcomes. While early studies suggested that patients typically comply with clinical recommendations to adopt habitual PA, these data were based on retrospective questionnaires. Conversely, recent studies incorporating mobile health (mHealth) technologies (e.g., objective monitors), which assess PA and SB in real-time and in the natural environment, show that most patients are inactive and highly sedentary preoperatively, and only make modest changes in these behaviors postoperatively. In addition to using mHealth technologies for obtaining accurate and detailed information on PA and SB, they are increasingly being employed to intervene on patients’ PA and SB and/or evaluate intervention outcomes. Researchers and clinicians are encouraged to consider the benefits of using mHealth technology when studying and treating PA and SB in bariatric surgery patients.

Physical Activity, Decision-Making Abilities, and Eating Disturbances in Pre- and Postbariatric Surgery Patients

“…Given that postoperative patients did not show higher PA compared to preoperative patients and that both groups showed a rather low PA level, special emphasis should be placed on increasing PA in pre-and postoperative care programs. In addition to traditional face-to-face interventions, personalized adaptive interventions via mobile health (mHealth) technologies could be used to enhance PA in pre-as well postoperative bariatric surgery patients [69,70]. Future studies are needed to investigate whether interactive monitoring and adaptive shaping are effective in the improvement of PA in this patient group.…”

Greater Adherence to Recommended Morning Physical Activity is Associated With Greater Total Intervention-Related Physical Activity Changes in Bariatric Surgery Patients

“…Identifying effective strategies for increasing MVPA in BS patients is important given that the vast majority are inactive preoperatively and bariatric surgery has shown to have limited if any impact on MVPA levels postoperatively. 2–5 Further, morning exercise may help to counter perceived lack of time, a frequently reported barrier to PA participation in BS patients and one which is unlikely to be affected by weight loss and other surgical outcomes. 7,8 …”

“…1,2 Further, approximately two-thirds of BS patients do not perform any bout-related MVPA. 3–5 Efforts to increase bout-related MVPA in BS patients preoperatively are needed given that most patients fail to make substantial MVPA changes postoperatively, 4,5 and higher preoperative MVPA strongly predicts higher postoperative PA. 1,6 One common obstacle to habitual MVPA adoption in obese populations, including BS patients, is perceived lack of time.…”

Ascertaining the Place of Social Media and Technology for Bariatric Patient Support: What Do Allied Health Practitioners Think?

“…Patients attending routine clinical appointments and patient support groups often mention using social media and technology to health care practitioners, but no studies were found which examined how practitioners engage with patient-led social media and mobile apps. There is also a dearth of information and the use of technology such as telehealth and videoconferencing in routine bariatric surgical patient care pre and post-operatively (6,7). No studies were found which explored the use of social media with bariatric surgical patients.…”