Predictors of Physical Activity After Gastric Bypass—a Prospective Study
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Most patients do not meet the recommended level of physical activity after bariatric surgery, and psychological factors underlying postoperative physical activity remain poorly understood. This study aimed at identifying self-regulatory predictors of physical activity after bariatric surgery.
Questionnaire data including self-regulation variables and the short-version of the International Physical Activity Questionnaire were obtained in a prospective cohort of 230 patients 1 year after Roux-en-Y gastric bypass. The study sample consisted of participants consenting to wear an ActiGraph GT3X+ accelerometer for seven consecutive days, 18–24 months after surgery (n = 120).
A total of 112 participants with complete self-report data provided valid accelerometer data. Mean age was 46.8 years (SD = 9.3), and 81.3% was women. Preoperative and postoperative BMI was 44.8 ± 5.5 and 30.6 ± 5.0 kg/m2, respectively. Total weight loss was 28.9% (SD = 7.5). By objective measures, 17.9% of the participants met the recommended level of moderate-to-vigorous-intensity of physical activity of ≥150 min/week, whereas 80.2% met the recommended level according to self-reported measures. Being single, higher education level, and greater self-regulation predicted objective physical activity in multivariate regression analysis. Greater self-regulation also predicted self-reported physical activity. Weight loss 1 year after surgery was not associated with self-reported or objectively measured physical activity.
Despite large differences between accelerometer-based and subjective estimates of physical activity, the associations of self-regulatory factors and weight loss with postoperative physical activity did not vary depending on mode of measurement. Self-regulation predicted both objective and self-reported physical activity. Targeting patients’ self-regulatory ability may enhance physical activity after gastric bypass.
KeywordsPhysical activity Bariatric surgery Gastric bypass Self-regulation Accelerometer Behavior change
We are grateful for the assistance with the recruitment process from the personnel at the Department of Morbid Obesity and Bariatric Surgery, Oslo University Hospital. We also thank Jon A. Kristinsson for contributions to the development of the study and Marianne Sæter and Thomas Nordvik for assistance with data retrieval.
ILK, FFS, and IB designed the study. TM, ILK, and IB were involved in the data collection. IB, ILK, and BHH performed the statistical analyses, and IB drafted the manuscript. All authors contributed to the interpretation of the analyses and revisions of the manuscript. All authors have read and approved the final manuscript.
Compliance with Ethical Standards
The study protocol was approved by the Regional Ethics Committee for Medical Research (2012/17028) South-Eastern Norway and the Data Protection Officer at Oslo University Hospital. Informed consent was obtained from all participants included in the study.
Falko F. Sniehotta is funded by Fuse, the Centre for Translational Research in Public Health, a United Kingdom Clinical Research Collaboration Public Health Research Centre of Excellence based on funding from the British Heart Foundation, Cancer Research United Kingdom, Economic and Social Research Council, Medical Research.
Conflict of Interest
The authors declare that they have no conflict of interest.
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