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.
Laparoscopic adjustable gastric banding Surgery Exercise Weight loss
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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.
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