Meta-analysis of the effect of bariatric surgery on physical activity

Abstract

BackgroundObesity leads to impairment of physical activity as measured by an inability to perform activities of daily living. Literature on the effect of bariatric surgery on physical activity is conflicting. ObjectiveThe aim of this study was to perform a meta-analysis of the effect of bariatric surgery on physical activity from studies employing objective measurement and self-reporting of physical activity before and after bariatric surgery. MethodsBibliographic databases were searched systematically for relevant literature until December 31, 2018. Studies employing objective and self-reported measurement of physical activity were included. Study quality was assessed using Risk of Bias in Nonrandomized Studies - of Interventions tool. Meta-analysis was performed using random effects model and presented as standardized mean difference (SMD) with 95% confidence intervals (CI). ResultsTwenty studies identified 5886 patients suitable for the analysis. Physical activity showed significant improvement at 0–6 months (SMD: .50; 95% CI: .25–.76; P = .0001), >6–12 months (SMD: .58; 95% CI: .26–.91; P = .0004), and >12–36 months (SMD: .82; 95% CI: .27–1.36; P = .004) after bariatric surgery. Self-reported assessment after bariatric surgery showed significant improvement at 0–6 months (SMD: .65; 95% CI: .29–1.01; P = .0004), >6 to 12 months (SMD: .53; 95% CI: .18–.88; P = .003), and >12–36 months (SMD: .51; 95% CI: .46–.55; P < .00001). Objective assessment after bariatric surgery did not show improvement at 0–6 months (SMD: .31; 95%CI:−.05–.66; P = .09), but showed significant improvement at >6–12 months (SMD: .85; 95% CI:−.07–1.62; P = .03), and >12–36 months (SMD: 1.99; 95% CI: 1.13–2.86; P < .00001) after bariatric surgery. ConclusionsBariatric surgery improves physical activity significantly in a population with obesity up to 3 years after surgery. Objective measurement of physical activity does not show significant improvement within 6 months of bariatric surgery but begins to improve at >6 months. Self-reported measurement of physical activity begins to show improvement within 6 months of a bariatric procedure.