Aspects of Exercise before or after Bariatric Surgery: A Systematic Review

Abstract

Background: Bariatric surgery has a considerable effect on weight loss. A positive relation of exercise and weight loss has been described before. However, the mode of exercise and its timing pre- or postoperatively or a combination remains unclear. Methods: A multi-database search was conducted. Identified articles were reviewed on description of exercise, timing around a bariatric intervention, and outcome. Methodological quality of the included studies was rated using the Physiotherapy Evidence Database scale. A Cohen's kappa score assessed the level of agreement. Outcome measurements were improvement of anthropometric and physical fitness variables, operation related complications, weight regain, and quality of life. Results: A total of 8 prospective studies were included. Four focused on training before and 4 on training after a bariatric procedure. Details of exercises varied from 45 min treadmill up to full descriptive programs. Supervision was frequently included. Significant improvement was encountered for biometric results physical fitness variables. Conclusion: In the majority of reports on exercising in a (future) bariatric population, positive effects on anthropometrics, cardiovascular risk factors and physical fitness were described. However, the results were not unanimous, with a wide range of exercise programs and perioperative timing, therefore hampering adequate practical guidance.

The Relation Among the Physical Activity Level During Leisure Time, Anthropometry, Body Composition, and Physical Fitness of Women Underwent of Bariatric Surgery and an Equivalent Group With No Surgery

“…Regarding the both physically active operated and non-operated groups, was verified difference only on the variable age. Supporting these results, other studies made evident the relation between the regular practice of physical activity and an enhancement of the functional capacity and quality of life of operated patients 12 , 14 , 21 , 25 .…”

“…Nevertheless, there are evidences that regular physical activity practice promotes an enhancement on the physical fitness parameters, and it contributes directly to the functional capacity and quality of life of the operated individuals 14 , 21 , 25 . Healthy lifestyle, including a healthy food intake and regular physical activity practice, contributes not only to the maintenance of the positive results acquired with the surgery, but also to the general health conditions of these patients 1 .…”

Indications for Surgery for Obesity and Weight-Related Diseases: Position Statements from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO)

“…It has been suggested that loss of lean body mass may be substantial after surgery for obesity and weight-related diseases [424, 425]. In a recent systematic review of the literature, the majority of reports found positive effects of exercise before and following surgery for obesity and related diseases on anthropometric parameters, cardiovascular risk factors and physical fitness [426]. In the long-term, higher physical activity and lower sedentary time is associated with greater excess weight loss and maintenance of reduced body weight following surgery for obesity and weight-related diseases [427].…”

Study of body composition, physiological variables in Grade III obese submitted to arm ergometer test

“…World Health Organization (OHS) de ines obesity as excessive accumulation of adipose tissue with health implications, [2] with multifactorial etiology, [2][3][4] and can be classi ied as several grades according to BMI´s values over 40kg/ m² [3,5,6]. The importance of this study about obesity relates to its consequences in other diseases development, such as: diabetes mellitus type II; arterial hypertension; dyslipidemia; chronic obstructive pulmonary disease; heart disease and certain cancers [4,[6][7][8][9]].…”