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Exercise improved bariatric surgery candidates' health-related quality of life
Increased physical activity before bariatric surgery improved both physical and mental health-related quality of life for candidates, according to research published in Obesity.
“Individuals preparing to undergo bariatric surgery are typically inactive and report significant health-related quality of life impairments,” Dale S. Bond, PhD, of the department of psychiatry and human behavior at the Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center in Providence, R.I., told Endocrine Today.
Dale S. Bond
“This study shows that with behavioral intervention, these individuals can make substantial increases in physical activity and experience corresponding improvements in physical and mental health-related quality of life even before the surgery is performed and weight loss and related improvements in comorbidities occur,” he said.
Bond and colleagues examined the effect of a pre-bariatric surgery physical activity intervention in a randomized trial of 75 adults. Patients aged 18 to 70 years (86.7% women; BMI, 45 ± 6.5 kg/m2) from three surgery clinics were assigned to the physical activity intervention (n=40) or standard presurgical care (n=35) for 6 weeks. The intervention was designed to increase bout-related (≥10 minutes) moderate to vigorous physical activity (MVPA).
Patients in the intervention group had 6 individual weekly counseling sessions to increase walking exercise and wore an objective activity monitor for 7 days. They completed the SF-36 Health Survey at baseline and after intervention to assess bout-related MVPA and health-related quality of life (HRQoL) changes, respectively.
From baseline to the end of intervention, the physical activity group increased bout-related MVPA (4.4 ± 5.5 to 21 ± 21.4 min/day-1) compared with no change for the standard care group (7.9 ± 16.6 to 7.6 ± 11.5 min/day-1; P=.001). Compared with standard care, greater improvements were reported with the physical activity intervention on all SF-36 physical and mental scales (P<.05), except for the role-emotional component.
Better baseline scores on the physical function and general health scales were predictive of greater bout-related MVPA increases in patients with the intervention (P<.05). Further, increases in greater bout-related MVPA were associated with greater post-intervention improvements on the physical function, bodily pain and general health scales (P<.05).
“These findings provide additional support for integrating more structured physical activity counseling efforts within a multidisciplinary approach to bariatric surgery,” Bond said.
Previous research suggests that patients do not make substantial changes in their physical activity postoperatively despite large weight losses and improvements in comorbidities, he underscored.
“Interventions that promote adoption of habitual physical activity and reinforcing improvements in health-related quality of life during the preoperative period could help to maintain this behavior change postoperatively and ultimately enhance and/or maintain postoperative weight loss and other outcomes,” Bond said.
Further investigation could help elucidate whether the observed effect improves surgical safety, weight loss outcomes and HRQoL after surgery, according to the researchers.
“Longer-term randomized controlled trials are needed to determine whether intervention-related increases in physical activity contribute to better long-term maintenance of postoperative weight loss, health-related quality of life and comorbidity improvements,” Bond said. – by Allegra Tiver
For more information: Dale S. Bond, PhD, can be reached at the Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, The Miriam Hospital Weight Control and Diabetes Research Center, 196 Richmond Street, Providence, RI 02903; email: dbond@Lifespan.org.
Disclosure: The researchers report no relevant financial disclosures.