Aerobic endurance training improves weight loss, body composition, and co-morbidities in patients after laparoscopic Roux-en-Y gastric bypass.
BACKGROUND
One of the most effective treatments of patients with morbid obesity is laparoscopic Roux-en-Y gastric bypass (RYGB). Sudden weight loss after RYGB for morbid obesity can result in a concurrent decrease in the lean body mass. However, the long-term results (weight reduction and reduced co-morbidities) depend on the postoperative long-term therapy. Aerobic physical exercise (APE) has been considered conservative treatment of obesity and type 2 diabetes mellitus. The aim of the present study was to assess the efficacy of APE on weight loss, body composition, and co-morbidities in patients after laparoscopic RYGB. The study was performed at a university hospital in Germany.


METHODS
A total of 60 consecutive morbidly obese patients underwent laparoscopic RYGB. The patients were prospectively randomized into a low-exercise group (APE 1 time for 1 hr/wk) or a multiple-exercise group (APE 2 times for 1 hr/wk). The following prospective data were collected: age, gender, length of hospital stay, operative details, co-morbidities, postoperative complications, initial body weight and height, postoperative weight, and body composition. The patients' body composition was assessed every 8 weeks during the 24-month follow-up period.


RESULTS
The average body mass index (52 kg/m(2)) and other baseline characteristics were distributed equally in the 2 groups. No major complications and no significant differences in the minor complications were found postoperatively between the 2 groups. The multiple exercise group had a significantly more rapid reduction of body mass index, excess weight loss, and fat mass compared with the low-exercise group. The initial loss of body cell mass and lean body mass was significantly lower in the multiple exercise group and was regained more rapidly in the low-exercise group. In addition, the multiple exercise group showed significantly earlier resolution or improvement of co-morbidities.


CONCLUSIONS
APE positively influenced weight loss, body composition, and co-morbidity resolution after RYGB for obesity. Additional controlled studies and longer follow-up are needed to confirm these positive findings.
Shang
Edward
E
Department of Surgery, University Hospital Mannheim, Mannheim, Germany. edward.shang@umm.de
Hasenberg
Till
T
D000328:Adult; D000704:Analysis of Variance; D001823:Body Composition; D015992:Body Mass Index; D016009:Chi-Square Distribution; D015897:Comorbidity; D017097:Electric Impedance; D015444:Exercise / Q000502:physiology*; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D010349:Patient Compliance; D010807:Physical Endurance / Q000502:physiology; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss