Abstract

The majority of Roux-en-Y gastric bypass (RYGB) patients are not sufficiently physically active post-surgery, yet little support from the Swedish healthcare system is offered. We investigated if a dissonance-based group intervention, aiming to increase health-related quality of life after surgery, had any effect on patients' physical activity two years post-RYGB. Women undergoing RYGB surgery were recruited from five Swedish hospitals and randomized to intervention or control group (standard post-surgery care). The dissonance-based intervention was conducted three months post-RYGB and consisted of four group sessions, each with a specific topic, of which one addressed physical activity. ActiGraph GT3X+ accelerometers were used to measure physical activity at pre-RYGB, one- and two-years post-surgery. At pre-RYGB, 259 women were recruited and randomized (intervention n = 156 and control n = 103). Participants had a mean age of 44.7 years (SD 10.3) and pre-RYGB body mass index of 40.8 (SD 4.5) kg/m2. At two-years follow-up, 99 participants (63.5%) in intervention group and 68 (66.0%) in control group had valid accelerometer-measurements. Pre- to post-surgery increases were seen in all physical activity outcomes, but no statistically significant differences between the groups were observed at the two-years follow-up, and intervention effects were poor (d = 0.02-0.35). To our knowledge, this is the first dissonance-based intervention targeting women undergoing RYGB surgery. At two-years follow-up, we did not observe any differences in physical activity levels between the intervention group and control group. Trial registration number: ISRCTN16417174.

Highlights

  • Bariatric surgery has shown significant weight loss with successful long-term weight maintenance [1, 2]

  • We investigated if a dissonance-based group intervention, aiming to increase health-related quality of life after surgery, had any effect on patients’ physical activity two years postRYGB

  • Pre- to post-surgery increases were seen in all physical activity outcomes, but no statistically significant differences between the groups were observed at the two-years follow-up, and intervention effects were poor (d = 0.02–0.35)

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Summary

Introduction

Bariatric surgery has shown significant weight loss with successful long-term weight maintenance [1, 2]. According to a systematic review and meta-analysis, where physical activity was measured objectively post-surgery, patients do not increase their physical activity [12] Another meta-analysis has shown significant increases in objectively measured physical activity after six months and up to three years post-bariatric surgery [13]. Exercise interventions could have beneficial effect on physical activity post-surgery [14, 15]; A randomized controlled trial (RCT), investigating if exercise after surgery could increase health-related quality of life (HRQoL), has reported a small increase in step counts, light physical activity (LPA), MVPA and general health in the intervention group, but improvements were not maintained long-term [14].

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