Study Finds Better Way to Exercise After Weight Loss Surgery

By Kaye Bailey

Physical activity is one important component in optimizing the long-term effectiveness of weight loss surgery. Yet studies indicate that nearly 80 percent of bariatric gastric bypass, gastric lap-band, and gastric sleeve patients fail to meet the prescribed 150 minutes per week of physical activity. People with extreme obesity are markedly sedentary compared to individuals of normal weight simply because they do not have the mobility or respiratory capacity for exercise.

Morbidly obese people often have locomotive handicaps and muscle quality deterioration that truly makes aerobic exercise impossible. When instructed by surgeons to exercise 150 minutes a week many patients are frustrated not knowing how to begin an exercise program to accomplish the instructions. Few fitness centers are prepared to help the morbidly obese on their path to fitness as a "make it burn" and "work it off" boot camp fitness philosophy prevails. Extremely overweight patients are embarrassed and uncomfortable in a gym setting where they feel judged or scorned by those who are more fit and at a healthy weight.

A study published in Bariatric Times May 2010 by Wollner, Adair, Jones and Blackburn indicates that initiating a PRT (Progressive Resistance Training) exercise program prior to weight loss surgery may provide a feasible exercise option for obese patients seeking weight loss and improved health with weight loss surgery. The study finds, "Patients with obesity respond adversely to aerobic exercise compared to patients with normal weight and patients who are overweight. The repetitive movements and prolonged bouts of aerobic exercise training may not be feasible for this patient. We have found that approximately 80 percent of weight loss surgery patients fail to respond to doctors' recommendations to perform 150 minutes or more of moderate-intensity physical activity per week."

The study finds, however, that short intense bursts of PRT exercise combined with the direct supervision of an exercise physiotherapist may help address the unique biomechanical and psychological issues presented by these patients. In this study subjects completed rounds of nine exercises that addressed major muscle groups using strength fitness machines or free weights. A baseline test of leg and chest presses and a walking test was done with subjects to establish beginning fitness levels. The same tests were repeated after four weeks when the patients had completed eight PRT training sessions.

Most weight loss surgery patients report struggling with exercise because it is physically awkward or psychologically challenging. The authors of this study hope these findings will open a door for better pre-operative instruction for morbidly obese patients as they make physical activity part of their recovery from obesity. "Because of its powerful weight loss effects and health benefits, weight loss surgery can often be perceived as a "quick fix." Patients must be aware that exercise is a lifestyle change necessary for the long-term success of surgery. If ambulatory ability improves after PRT, patients may be better capable of performing aerobic activity." They concluded that ultimately the combined benefits of resistance training and aerobic training are necessary to promote optimal health.




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