Objective Physical activity and dietary regimens to optimize health outcomes after bariatric surgery are not well known. This study aimed to determine whether resistance training with dietary protein supplementation is effective in maintaining body composition and physical fitness after obesity surgery. Methods Seventy‐six women with obesity undergoing Roux‐en‐Y gastric bypass were randomly assigned at the time of surgery to receive either usual care (controls [CON], n = 22), usual care and additional (whey) protein intake (PRO, n = 31), or usual care, additional protein intake, and supervised strength training for 18 weeks (PRO+EX, n = 23). The primary outcome was pre‐ to 6‐month postsurgery change in lean body mass (by dual‐energy x‐ray absorptiometry). Secondary outcomes included changes in muscle strength (by one‐repetition maximum testing). Results Loss over time in lean body mass did not differ between groups (CON: mean,−8.8 kg; 95% CI: −10.1 to −7.5 kg; PRO: mean, −8.2 kg; 95% CI: −9.3 to −7.1 kg; PRO+EX: mean, −7.7 kg; 95% CI: −9.0 to −6.5 kg; P = 0.899). The increase in relative lower‐limb muscle strength was higher in the PRO+EX group (+0.6 [0.3 to 0.8]) versus +0.1 (−0.1 to 0.4) and +0.2 (0.0 to 0.4) kg/kg body mass in CON and PRO groups, respectively (P = 0.021). Conclusions Loss in muscle strength observed after bariatric surgery can be overcome by resistance training with additional protein intake.

This overview of reviews aimed to summarize the effects of exercise training programs on weight loss, changes in body composition, and weight maintenance in adults with overweight or obesity. A systematic search of systematic reviews and metaanalyses (SR-MAs) published between 2010 and December 2019 was performed. Only SR-MAs of controlled trials were included. The mean difference (MD) or standardized MD (SMD) were extracted from SR-MAs. Twelve SR-MAs (149 studies) were included. Exercise led to a significant weight loss (4 SR-MAs, MDs ranging from −1.5 to −3.5 kg), fat loss (4 SR-MAs, MDs ranging from −1.3 to −2.6 kg) and visceral fat loss (3 SR-MAs, SMDs ranging from −0.33 to −0.56). No difference in weight, fat, and visceral loss was found between aerobic and high-intensity interval training as