title: High-volume exercise program in obese bariatric surgery patients: a randomized, controlled trial.
abstract: Weight regain is a problem among many bariatric surgery patients. Whether a high-volume exercise program (HVEP), a strategy to limit weight regain, is feasible in these patients is unknown. The feasibility of an HVEP in obese post-bariatric-surgery patients was determined by randomizing 33 Roux-en-Y gastric bypass (RYGB) and gastric banding (GB) surgery patients with a mean BMI of 41 ± 6 kg/m2 to an HVEP or control group for 12 weeks. The HVEP group was instructed to expend ≥ 2,000 kcal/week in moderate-intensity exercise. All patients were counseled to limit energy intake. Treatment effect was assessed by repeated measures analysis. During the last 4 weeks of the study, 53% of the HVEP group expended ≥ 2,000 kcal/week and 82% expended ≥ 1,500 kcal/week. Step count, reported time spent and energy expended during moderate physical activity, maximal oxygen consumption relative to weight, and incremental area under the postprandial blood glucose curve were significantly improved over 12 weeks in the HVEP group compared to controls (group-by-week effect: P = 0.009-0.03). Both groups reported significant improvement in some quality-of-life scales. Changes in weight, energy and macronutrient intake, resting energy expenditure (REE), fasting lipids and glucose, and fasting and postprandial insulin concentrations were not different between the two groups. HVEP is feasible in about 50% of the patients and enhances physical fitness and reduces postprandial blood glucose in bariatric surgery patients.
authors.affiliation: Division of Nutrition and Metabolic Diseases, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA. meena.shah@utsouthwestern.edu
authors.forename: Meena
authors.initials: M
authors.lastname: Shah
authors.forename: Peter G
authors.initials: PG
authors.lastname: Snell
authors.forename: Sneha
authors.initials: S
authors.lastname: Rao
authors.forename: Beverley
authors.initials: B
authors.lastname: Adams-Huet
authors.forename: Claudia
authors.initials: C
authors.lastname: Quittner
authors.forename: Edward H
authors.initials: EH
authors.lastname: Livingston
authors.forename: Abhimanyu
authors.initials: A
authors.lastname: Garg
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D015992:Body Mass Index; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D004038:Diet, Reducing; D004734:Energy Metabolism; D015444:Exercise; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy / Q000378:metabolism / Q000628:therapy; D009767:Obesity, Morbid / Q000378:metabolism* / Q000523:psychology / Q000601:surgery / Q000628:therapy*; D010101:Oxygen Consumption; D010809:Physical Fitness; D011788:Quality of Life; D013997:Time Factors; D015431:Weight Loss