Physical fitness in morbidly obese patients: effect of gastric bypass surgery and exercise training.
BACKGROUND
There is a growing consensus that bariatric surgery is currently the most efficacious and long-term treatment for clinically severe obesity. However, it remains to be determined whether poor physical fitness, an important characteristic of these patients, improves as well. The purpose of this pilot study is to investigate the effect of gastric bypass surgery on physical fitness and to determine if an exercise program in the first 4 months is beneficial.


METHODS
Fifteen morbidly obese patients (BMI 43.0 kg/m(2)) were tested before and 4 months after gastric bypass surgery. Eight of them followed a combined endurance and strength training program. Before and after 4 months the operation, anthropometrical characteristics were measured, and an extensive assessment of physical fitness (strength, aerobic, and functional capacity) was performed.


RESULTS
Large-scale weight loss through gastric bypass surgery results in a decrease in dynamic and static muscle strength and no improvement of aerobic capacity. In contrast, an intensive exercise program could prevent the decrease and even induced an increase in strength of most muscle groups. Together with an improvement in aerobic capacity, functional capacity increased significantly. Both groups evolved equally with regard to body composition (decrease in fat mass and fat-free mass).


CONCLUSIONS
An exercise training program in the first 4 months after bariatric surgery is effective and should be promoted, considering the fact that physical fitness does not improve by weight loss only.
Stegen
Sanne
S
Department Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium. sanne.stegen@ugent.be
Derave
Wim
W
Calders
Patrick
P
Van Laethem
Christophe
C
Pattyn
Piet
P
D000328:Adult; D015444:Exercise; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D009767:Obesity, Morbid / Q000601:surgery* / Q000628:therapy; D010809:Physical Fitness; D016896:Treatment Outcome