Supervised Physical Training Improves Weight Loss After Roux‐en‐Y Gastric Bypass Surgery: A Randomized Controlled Trial

Mundbjerg, Lene Hymøller; Stolberg, Charlotte Røn; Cecere, Sabrina Chiara; Bladbjerg, Else‐Marie; Funch‐Jensen, Peter; Gram, Bibi; Juhl, Claus Bogh

doi:10.1002/oby.22143

Cited by 53 publications

(133 citation statements)

References 41 publications

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“…Four interventions (n = 6 publications) delivered lifestyle and nutrition counselling‐focused MDT support, four interventions (n = 7 publications) delivered psychology‐focused MDT support, and 10 interventions (n = 21 publications) delivered exercise‐focused MDT support (Table ). There were five interventions delivered preoperatively, 10 post‐operatively, and three preoperatively and post‐operatively (Table ; detailed characteristics in Table S2). Of the post‐operative interventions, seven were concluded within the first 6‐month post‐operative, and six extended beyond or commenced after 6‐month post‐operative …”

Section: Resultsmentioning

confidence: 99%

Does intensive multidisciplinary intervention for adults who elect bariatric surgery improve post‐operative weight loss, co‐morbidities, and quality of life? A systematic review and meta‐analysis

Marshall

Mackay²,

Matthews

et al. 2020

Obesity Reviews

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This systematic review and meta-analysis of intervention studies aims to evaluate the effect of preoperative and/or post-operative support for adults who elect bariatric surgery delivered by a multidisciplinary team (MDT) on post-operative body composition, mental health, co-morbidities, quality of life, and side effects. Six electronic databases were searched. Revman and GRADE were used to assess confidence in pooled effects. Included interventions (N = 1533 participants in total) focused on lifestyle counselling (n = 4 studies), psychology (n = 4 studies), or exercise (n = 10 studies); comparator groups were less intensive usual care. Intensive MDT interventions increased post-operative weight loss (SMD: −0.94; 95% CI: −1.27 to −0.61) if delivered post-operatively. Preoperative and post-operative intensive interventions improved symptoms of depression and anxiety, quality of life, diastolic blood pressure, and resting heart rate but not lipids or glycaemic measures. Whilst usual MDT care is important preoperatively, this review conditionally recommends intensive MDT interventions for enhanced post-operative weight loss if delivered in the post-operative period, led by any health professional, based on moderate evidence. This review also conditionally recommends preoperative and/or post-operative lifestyle, nutrition, or psychology counselling and/or physical activity for improved mental and physical health. Further randomized controlled trials are required, which aim to specifically evaluate the best use of MDT resources. K E Y W O R D S bariatric surgery, interdisciplinary research, obesity, weight loss

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Section: Resultsmentioning

confidence: 99%

Does intensive multidisciplinary intervention for adults who elect bariatric surgery improve post‐operative weight loss, co‐morbidities, and quality of life? A systematic review and meta‐analysis

Marshall

Mackay²,

Matthews

et al. 2020

Obesity Reviews

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“…The eight included trials 17 28–34 were published from 2011 to 2018 and performed in the USA, 28 30–33 England, 29 Iran 17 and Denmark. 34 All of the studies focused on patients who underwent roux-en-Y gastric bypass, 17 28–34 gastric banding, 29 31 32 sleeve gastric 17 29 31 or lap band 31 bariatric surgery. The included studies reported data on 347 patients.…”

Section: Resultsmentioning

confidence: 99%

Effect of physical exercise on weight loss and physical function following bariatric surgery: a meta-analysis of randomised controlled trials

Ren

Zhang

et al. 2018

BMJ Open

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ObjectivesWe performed a meta-analysis of all of the available randomised controlled trials (RCTs) to investigate whether physical exercise contributes to weight loss or physical function improvement in adults receiving bariatric surgery.MethodsWe searched PubMed, Embase, the Cochrane Library, OVID and the CINAHL up through May 2018. RCTs that assigned adults with obesity to either an exercise training group or a no-exercise group after bariatric surgery were included. The primary outcomes were weight loss and physical function. Study bias was assessed using the Cochrane risk of bias tool, and the quality of evidence was assessed using GRADEpro.ResultsA total of eight studies met the inclusion criteria (n=347 participants). Most of the studies carried a low risk of bias due to randomisation and blinding. Compared with those without exercise intervention after surgery, patients engaging in physical exercise were associated with greater weight loss (weighted mean difference (WMD) −1.94 kg; 95% CI −3.18 to −0.69; n=8) and longer 6 min walk distance (6MWD; WMD29.67 m; 95% CI 25.97 to 33.37; n=2) during follow-up. By subgroup analyses, the additional weight loss in exercise group was related to the starting time and type of exercise: patients engaging in exercise 1 year or more after surgery and patients received aerobic–resistance exercise experienced more weight loss. Besides, patients in exercise training group also had lower systolic blood pressure and resting heart rate after surgery. The quality of evidence for these outcomes was moderate to very low.ConclusionsPhysical exercise after bariatric surgery provides 1.94 kg additional weight loss and 29.67 m longer 6MWD compared with surgery alone. Moreover, engaging in exercise 1 year or more after surgery, and a combined aerobic and resistance training programme may result in greater weight loss.

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“…The present sub‐study is part of a larger study investigating the effects of supervised physical training following RYGB on weight loss, 24 muscle strength and aerobic capacity, 26 physical activity and quality of life 27 and markers of CVD 17,25 . Results reported in this paper are based on secondary outcome variables and only include samples before and 6 months after bariatric surgery, that is, relatively early after bariatric surgery.…”

Section: Methodsmentioning

confidence: 99%

“…The study design has been described in detail elsewhere 24 . In the present study, we included 42 women and 18 men, mean age 42.3 years, who were eligible for RYGB according to the national and international guidelines, as well as Danish criteria regulating free access to bariatric surgery (body mass index [BMI] > 35 kg/m 2 with obesity‐related disease or BMI > 50 kg/m 2 with obesity‐related social or physical complications).…”

Section: Methodsmentioning

confidence: 99%

“…Among these variables only fibrinogen and PAI‐1 have been studied after obesity surgery 17 . Further, triglycerides, cholesterols, glucose, IL‐6 and other metabolic variables are significantly reduced after obesity surgery, 24,25 and it is unknown whether metabolic improvements are associated with changes in the fibrinolytic variables. Our aim was therefore to measure FXIII, TAFI, plasminogen and PI before and 6 months after RYGB and to identify predictors of the RYGB‐induced changes in fibrin clot lysis and structure among changes in fibrinolytic variables.…”

Section: Introductionmentioning

confidence: 99%

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Reductions in plasmin inhibitor and fibrinogen predict the improved fibrin clot lysis 6 months after obesity surgery

et al. 2020

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Summary Prothrombotic and metabolic variables are decreased after obesity surgery, and fibrin clot lysis is increased. It is unknown how fibrinolytic variables are affected, and whether fibrinolytic and metabolic changes predict the enhanced clot lysis. Study aims were to determine fibrinolytic biomarkers before and 6 months after Roux‐en‐Y gastric bypass (RYGB) and to identify predictors of the RYGB‐induced increase in clot lysis. Women (n = 42) and men (n = 18) with obesity underwent RYGB, and factor XIII (FXIII), thrombin activatable fibrinolysis inhibitor (TAFI), plasminogen and plasmin inhibitor (PI) were measured before and 6 months after surgery. Regression analyses identified determinants of the RYGB‐induced increase in clot lysis among changes in fibrinogen and in fibrinolytic and metabolic variables. Results showed that after RYGB, FXIII, TAFI, plasminogen and PI were reduced (P < .0005). Reductions in PI (β = −0.59) and fibrinogen (β = −0.35), together with age (β = −0.22) and male sex (β = 0.22), predicted the enhanced clot lysis with the model explaining 56% (P < .0005). Predictors of the reduction in PI were reductions in cholesterol (β = 0.37) and glucose (β = 0.29), together with male sex (β = −0.28), whereas reductions in fibrinogen were predicted by lowering of interleukin‐6 (IL‐6) (β = 0.32). In conclusion, fibrinolytic variables were reduced 6 months after RYGB. Targeting PI and fibrinogen, by reducing metabolic variables such as glucose, cholesterol and IL‐6, has a profibrinolytic effect in obesity.

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Supervised Physical Training Improves Weight Loss After Roux‐en‐Y Gastric Bypass Surgery: A Randomized Controlled Trial

Abstract: Physical training following RYGB improves weight loss and cardiovascular health.

Cited by 53 publications

References 41 publications

Does intensive multidisciplinary intervention for adults who elect bariatric surgery improve post‐operative weight loss, co‐morbidities, and quality of life? A systematic review and meta‐analysis

Does intensive multidisciplinary intervention for adults who elect bariatric surgery improve post‐operative weight loss, co‐morbidities, and quality of life? A systematic review and meta‐analysis

Effect of physical exercise on weight loss and physical function following bariatric surgery: a meta-analysis of randomised controlled trials

Reductions in plasmin inhibitor and fibrinogen predict the improved fibrin clot lysis 6 months after obesity surgery

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