Physical Activity, Fitness, and Body Composition After a 5-yr Exercise Counseling Intervention

Abstract

ABSTRACT Introduction Physical activity (PA) is recommended to optimize health after bariatric surgery. However, there is limited evidence on how to deliver these interventions and whether they are effective long-term. The present study aimed to examine PA levels, body composition, and physical fitness outcomes up to 5 yr after bariatric surgery following engagement in a PA intervention, with a focus on whether dose and/or timing of delivery impacts postoperative outcomes. Methods Individuals (n = 80) who completed a 6-month randomized treatment study to increase PA (phase 1) were invited to receive up to six exercise counseling sessions from 1 to 5 yr after operation (phase 2). Phase 2 participants (n = 64) completed assessments at 1, 1.5, 2, 3, 4, and 5 yr after operation. Results Five years after surgery, participants (84.4% female; mean age, 52.9 (standard deviation, 11.5); mean body mass index, 33.8 (standard error, 1.1)) increased minutes of moderate-to-vigorous physical activity (MVPA; P = 0.001) but not steps per day, exercise bouts per week, or bout minutes per week. Participants experienced significant cardiovascular endurance improvements but decreased strength (P < 0.05). Greater intervention dose (i.e., greater number of counseling visits attended 1–5 yr after surgery) was significantly associated with steps per day (P = 0.003), weight (P = 0.03), and nondominant handgrip strength (P = 0.002). Those who started counseling preoperatively (i.e., randomized to counseling in phase 1) versus 1 yr after surgery (i.e., beginning in phase 2) had greater steps per day (P = 0.04), exercise bouts per week (P = 0.006), and exercise bout minutes per week (P = 0.002). No other associations were significant. Conclusions Participants increased MVPA 5 yr after bariatric surgery and experienced improvements in cardiovascular functioning after engagement in a PA intervention. In general, individuals experienced modestly better outcomes with more treatment. Beginning exercise counseling preoperatively, instead of 1 yr postoperatively, improved PA but not body composition or physical fitness.