Effects of a bariatric preoperative exercise program: A pilot randomized study

Chao Li, MD, Gerald S Zavorsky, PhD, Do J Kim, MSc, Nicolas V Christou, MD, Liane S Feldman, MD, Francesco Carli, MD, MPhil

McGill University Health Centre, Montreal, Quebec, Canada and Marywood University, Scranton, PA

Introduction: Within a bariatric surgery program, there is evidence that postoperative exercise improves weight loss. The preoperative period may be a salient time to initiate lifestyle modification. We performed a three-arm unblinded pilot randomized trial to investigate the effects of a structured exercise program (home-based or gym-based) on percent excess weight loss (EWL) and maximal aerobic capacity (VO2max) before and after bariatric surgery.

Methods: Patients with BMI > 40 planned for gastric bypass were recruited at the bariatric surgery clinic of a university-affiliated hospital two-months prior to surgery and randomized into one of three groups: a home-based exercise program, a gym-based exercise program, or no intervention. Patients were excluded if BMI > 70. The home-based group was unsupervised whereas the gym-based group was supervised by a trainer. Patients were instructed to perform three 30-minute aerobic training and two resistance exercise sessions a week in both intervention groups. Intensity was incrementally increased over the training period. Nutrition was not controlled. Measures were taken at baseline, before surgery, and 10-weeks after surgery. Data are shown as mean ± sd and compared using analysis of variance.

Results: Twenty-two patients participated in the study; 8 in the home-based group, 7 in the gym-based group, and 7 in the non-intervention group. Patient characteristics were similar with respect to age and gender. Body-mass index (average 47±6 kg/m2) and aerobic capacity at baseline (average 15±3 ml/kg/min) were also similar between groups. There was a trend towards greater preoperative weight loss in the gym-based group (7±7 %EWL) vs the home-based (1±5 %EWL) and non-intervention (1±3 %EWL) groups (p=0.11). Postoperatively, there was no effect of exercise programs on weight loss in the initial 10-weeks after surgery (31±11 vs 33±5 vs 25±8 %EWL respectively, p=0.29). Similarly, the gym-based group trended towards improved aerobic capacity preoperatively (+2.5±3 vs +0.6±1 vs +0.3±1 ml/kg/min, p=0.15) but this trend did not continue postoperatively (+3.3±5 vs +1.2±2 vs +1.6±1 ml/kg/min, p=0.43).

Conclusion: This pilot trial suggests that a supervised preoperative exercise program may be advantageous compared to a non-supervised program when preparing for bariatric surgery.

Session: Poster Presentation

Program Number: P439

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