What Is the Best Treatment before Bariatric Surgery? Exercise, Exercise and Group Therapy, or Conventional Waiting: a Randomized Controlled Trial.
This trial's objective was to investigate the effect of an exercise program with and without cognitive-behavioral therapy (CBT), compared by a control group, on weight, functional capacity, and cardiometabolic profile of morbidly obese individuals while waiting for bariatric surgery.



This randomized controlled trial investigated the effect of a 4-month low-intensity exercise program (two weekly sessions of 25 min each) on 66 morbidly obese individuals awaiting bariatric surgery. Participants were randomly divided into three groups: EXER, exercise program; EXER + CBT, exercise program plus support group sessions for lifestyle modification, with a CBT; and CONTROL, routine treatment. They were compared on weight, functional capacity, and cardiometabolic profile.



The weight change (Kg) was -7.4 (-9.6 to 5,1); -4,2 (-6,8 to -1.6) and 2.9 (0.4 to 5.3) and the BMI change (kg/m2) was -2.7 (-3.6 to -1.8); -1.4 (-2.4 to -0.4) and 1.1 (0.1 to 2.1) for groups EXER, EXER + CBT, and CONTROL, respectively. Changes were significant when compared to the control group (p < 0.001), but there were no differences between the two intervention arms (p = 0.2). Functional capacity and cardiometabolic parameters significantly improved in the intervention arms and worsened in the control group. The adherence to the exercise program in both groups was above 78 %.



A 4-month, twice-weekly supervised program of low-intensity physical activity that encourages individuals to adopt a more active lifestyle can positively interfere with weight loss and improvement in functional capacity and cardiometabolic parameters of morbidly obese individuals with and without the aid of support group sessions.
Bariatric Surgery Department, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Zip Code 90035-007, Brazil. erejanemarcon@ig.com.br.|Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. erejanemarcon@ig.com.br.
Emilian Rejane
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Marcon
Studio Rejane Marcon, Porto Alegre, Brazil.
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Baglioni
Studio Rejane Marcon, Porto Alegre, Brazil.
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Bittencourt
Studio Rejane Marcon, Porto Alegre, Brazil.
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Lopes
Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.|Primary Care Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
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Neumann
Bariatric Surgery Department, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Zip Code 90035-007, Brazil.|Department of Surgery, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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Trindade
D000328:Adult; D000886:Anthropometry / Q000379:methods; D050110:Bariatric Surgery; D001794:Blood Pressure / Q000502:physiology; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D005080:Exercise Test / Q000379:methods; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery; D010349:Patient Compliance; D011615:Psychotherapy, Group / Q000379:methods*; D014850:Waiting Lists; D015431:Weight Loss / Q000502:physiology
Bariatric surgery; Cardiovascular risk; Cognitive behavioral therapy; Morbid obesity; Physical exercise