Advertisement

Obesity Surgery

, Volume 22, Issue 2, pp 335–341 | Cite as

Does Exercise Improve Weight Loss after Bariatric Surgery? A Systematic Review

  • Kristine Egberts
  • Wendy A. Brown
  • Leah Brennan
  • Paul E. O’Brien
Review

Abstract

Bariatric surgery leads to significant weight loss in the obese patient. Exercise has been shown to improve weight loss and body composition in non-surgical weight loss programmes. The role of exercise to improve weight loss following bariatric surgery is unclear. The objective of this review is to systematically appraise the evidence regarding exercise for weight loss in the treatment of obesity in bariatric surgery patients. MEDLINE, AMED, CINAHL, EBM Reviews (Cochrane Database, Cochrane Clinical Trials Register) were searched, obesity-related journals were hand-searched and reference lists checked. Studies containing post-surgical patients and exercise were included with the primary outcome of interest being weight loss. A literature search identified 17 publications exploring exercise in bariatric surgery patients. All studies were observational; there were no intervention studies found. The most commonly used instruments to measure activity level were questionnaires followed by telephone interview, surgeon reporting and clinical notes. There was a positive relationship between increased exercise and weight loss after surgery in 15 studies. Meta-analysis demonstrated in patients participating in exercise a standardised mean of 3.62 kg (CI = 1.28, 5.96) greater weight loss compared to the minimal exercise groups. Observational studies suggest that exercise is associated with greater weight loss following bariatric surgery. Randomised controlled trials are required to further examine this relationship.

Keywords

Laparoscopic adjustable gastric banding Surgery Exercise Weight loss 

Notes

Disclosures

The Centre for Obesity Research and Education (CORE) at Monash University which receives a grant from Allergan Inc for research support. The grant is not tied to any specified research projects and Allergan has no control of the protocol, analysis and reporting of any studies. CORE also receives a grant from Applied Medical towards educational programmes.

Dr Wendy Brown received an Honorarium from Allergan to attend a Surgical Advisory Panel in London in 2009.

Dr Paul O'Brien has written a patient information book entitled ‘The Lap-Band Solution: A Partnership for Weight Loss’ which is given to patients without charge but some are sold to surgeons and others for which he receives a royalty. He is employed as the National Medical Director for the American Institute of Gastric Banding, a multicentre facility, based in Dallas, Texas, that treats obesity predominantly by gastric banding.

References

  1. 1.
    Jakicic JM. The effect of physical activity on body weight. Obesity (Silver Spring). 2009;17 Suppl 3:S34–8.CrossRefGoogle Scholar
  2. 2.
    Garrow JS, Summerbell CD. Meta-analysis: effect of exercise, with or without dieting, on the body composition of overweight subjects. Eur J Clin Nutr. 1995;49(1):1–10.PubMedGoogle Scholar
  3. 3.
    Miller WC, Koceja DM, Hamilton EJ. A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int J Obes Relat Metab Disord. 1997;21(10):941–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Meckling KA, Sherfey R. A randomized trial of a hypocaloric high-protein diet, with and without exercise, on weight loss, fitness, and markers of the Metabolic Syndrome in overweight and obese women. Appl Physiol Nutr Metab. 2007;32(4):743–52.PubMedCrossRefGoogle Scholar
  5. 5.
    Shaw KA, Gennat HC, O'Rourke P et al. Exercise for overweight or obesity. Cochrane Database Syst Rev 2006, Issue 4. Art. No.: CD003817. doi: 10.1002/14651858.CD003817.pub3
  6. 6.
    Van Zant RS. Influence of diet and exercise on energy expenditure—a review. Int J Sport Nutr. 1992;2(1):1–19.PubMedGoogle Scholar
  7. 7.
    Jakicic JM, Clark K, Coleman E, et al. American College of Sports Medicine position stand. Appropriate intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2001;33(12):2145–56.PubMedCrossRefGoogle Scholar
  8. 8.
    Colles SL, Dixon JB, O'Brien PE. Hunger control and regular physical activity facilitate weight loss after laparoscopic adjustable gastric banding. Obes Surg. 2008;18(7):833–40.PubMedCrossRefGoogle Scholar
  9. 9.
    Chaston TB, Dixon JB, O'Brien PE. Changes in fat-free mass during significant weight loss: a systematic review. Int J Obes (Lond). 2007;31(5):743–50.Google Scholar
  10. 10.
    Ciolac EG, Bocchi EA, Bortolotto LA, et al. Effects of high-intensity aerobic interval training vs. moderate exercise on hemodynamic, metabolic and neuro-humoral abnormalities of young normotensive women at high familial risk for hypertension. Hypertens Res. 2010;33(8):836–43.PubMedCrossRefGoogle Scholar
  11. 11.
    Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions 5.0.0. The Cochrane Collaboration, 2008. Available from www.cochrane-handbook.org.
  12. 12.
    Verhagen AP, de Vet HC, de Bie RA, et al. The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. J Clin Epidemiol. 1998;51(12):1235–41.PubMedCrossRefGoogle Scholar
  13. 13.
    Baecke JA, Burema J, Frijters JE. A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr. 1982;36:936–42.PubMedGoogle Scholar
  14. 14.
    Bull FC, Maslin TS, Armstrong T. Global physical activity questionnaire (GPAQ): nine country reliability and validity study. J Phys Act Health. 2009;6(6):790–804.PubMedGoogle Scholar
  15. 15.
    Suzukamo Y, Fukuhara S, Green J, et al. Validation testing of a three-component model of Short Form-36 scores. J Clin Epidemiol. 2011;64(3):301–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Goubert L, Crombez G, Vlaeyen JWS, et al. De Tampa Schaal voor Kinesiofobie. Psychometrische karakteristieken en normering [The Tampa Scale for kinesiophobia: psychometric characteristics and norms]. Gedrag Gezond. 2000;28:54. adapted from the Dutch questionnaire.Google Scholar
  17. 17.
    Josbeno DA, Kalarchian M, Sparto PJ et al. Physical activity and physical function in individuals post-bariatric surgery. Obes Surg. 2010 Dec 11. [Epub ahead of print]Google Scholar
  18. 18.
    Livhits M, Mercado C, Yermilov I, et al. Behavioral factors associated with successful weight loss after gastric bypass. Am Surg. 2010;76(10):1139–42.PubMedGoogle Scholar
  19. 19.
    Chevallier JM, Paita M, Rodde-Dunet MH, et al. Predictive factors of outcome after gastric banding: a nationwide survey on the role of center activity and patients' behavior. Ann Surg. 2007;246(6):1034–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Latner JD, Wetzler S, Goodman ER, et al. Gastric bypass in a low income, inner-city population: eating disturbances and weight loss. Obes Res. 2004;12:956–61.PubMedCrossRefGoogle Scholar
  21. 21.
    Bond DS, Phelan S, Wolfe LG, et al. Becoming physically active after bariatric surgery is associated with improved weight loss and health-related quality of life. Obesity (Silver Spring). 2009;17(1):78–83.CrossRefGoogle Scholar
  22. 22.
    Silver HJ, Torquati A, Jensen GL, et al. Weight, dietary and physical activity behaviors two years after gastric bypass. Obes Surg. 2006;16:859–64.PubMedCrossRefGoogle Scholar
  23. 23.
    Cook CM, Edwards C. Success habits of long-term gastric bypass patients. Obes Surg. 1999;9(1):80–2.PubMedCrossRefGoogle Scholar
  24. 24.
    Metcalf B, Rabkin RA, Rabkin JM, et al. Weight loss composition: the effects of exercise following obesity surgery as measured by bioelectrical impedance analysis. Obes Surg. 2005;15(2):183–6.PubMedCrossRefGoogle Scholar
  25. 25.
    Buddeberg-Fischer B, Klaghofer R, Krug L, et al. Physical and psychosocial outcome in morbidly obese patients with and without bariatric surgery: a 4 1/2-year follow-up. Obes Surg. 2006;16(3):321–30.PubMedCrossRefGoogle Scholar
  26. 26.
    Carrasco F, Papapietro K, Csendes A, et al. Changes in resting energy expenditure and body composition after weight loss following Roux-en-Y gastric bypass. Obes Surg. 2007;17(5):608–16. Erratum in: Obes Surg. 2007 Jul;17 (7):996.PubMedCrossRefGoogle Scholar
  27. 27.
    Chuang CZ, Martin LF, LeGardeur BY, et al. Physical activity, biliary lipids, and gallstones in obese subjects. Am J Gastroenterol. 2001;96(6):1860–5.PubMedCrossRefGoogle Scholar
  28. 28.
    Das SK, Roberts SB, McCrory MA, et al. Long-term changes in energy expenditure and body composition after massive weight loss induced by gastric bypass surgery. Am J Clin Nutr. 2003;78(1):22–30.PubMedGoogle Scholar
  29. 29.
    Pontiroli AE, Fossati A, Vedani P, et al. Post-surgery adherence to scheduled visits and compliance, more than personality disorders, predict outcome of bariatric restrictive surgery in morbidly obese patients. Obes Surg. 2007;17(11):1492–7.PubMedCrossRefGoogle Scholar
  30. 30.
    Larsen JK, Geenen R, van Ramshorst B, et al. Binge eating and exercise behavior after surgery for severe obesity: a structural equation model. Int J Eat Disord. 2006;39:369–75.PubMedCrossRefGoogle Scholar
  31. 31.
    Wolfe BL, Terry ML. Expectations and outcomes with gastric bypass surgery. Obes Surg. 2006;16:1622–9.PubMedCrossRefGoogle Scholar
  32. 32.
    Aills L, Blankenship J, Buffington C, et al. ASMBS Allied Health Nutritional Guidelines for the Surgical Weight Loss Patient, Allied Health Sciences Section Ad Hoc Nutrition Committee. Surg Obes Relat Dis. 2008;4:S73–S108.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2011

Authors and Affiliations

  • Kristine Egberts
    • 1
  • Wendy A. Brown
    • 1
  • Leah Brennan
    • 1
  • Paul E. O’Brien
    • 1
  1. 1.Centre for Obesity Research and Education (CORE), School of Public Health & Preventive MedicineMonash UniversityMelbourneAustralia

Personalised recommendations