Highlights
- •Exercise has potential to prevent weight recurrence after bariatric surgery.
- •Exercise interventions had a small effect on weight beyond ≥1-year post surgery.
- •Methodological limitations undermine confidence that the observed effect is accurate.
- •Rigorous testing of exercise effects on postsurgical weight recurrence is needed.
Abstract
Exercise is recommended to prevent post-surgical weight recurrence. Yet, whether exercise
interventions are efficacious in this regard has not been systematically evaluated.
Moreover, clinicians lack evidence-based information to advise patients on appropriate
exercise frequency, intensity, time, and type (FITT) for preventing weight recurrence.
Thus, we conducted a meta-analysis of randomized controlled trials (RCTs) involving
exercise interventions specifying FITT and weight measurement ≥12 months post-surgery.
We reviewed scientific databases up through February 2022 for RCTs comparing exercise
interventions reporting FITT and a nonexercise control group on weight ≥12 months
post-surgery. Procedures following the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses were registered at the international prospective register of systematic
reviews (PROSPERO: CRD42022342337). Of 1368 studies reviewed, 5 met inclusion criteria
(n = 189; 47.8 ± 4.2 yr, 36.1 6 ± 3.8 kg·m2, 83.2 ± 9.5% female; 61.7% underwent Roux-en-Y
gastric bypass). Exercise interventions were largely supervised, lasted 12–26 weeks,
and prescribed 80–210 minutes/week of moderate-to-vigorous intensity combined aerobic
and resistance exercise over ≤5 days. Within-group effects showed non-statistically
significant weight loss for exercise (d = − .15, 95% confidence interval [CI]: −1.96, 1.65; −1.4 kg; P = .87) and weight gain for control (d = .11, 95% CI: −1.70,1.92; +1.0 kg; P = .90), with no difference between these groups (d = −2.26, 95% CI: −2.07, 1.55; −2.4 kg; P = .78). Exercise elicited an additional 2.4 kg weight loss versus control, although
this effect was small and statistically non-significant. Ability to draw definitive
conclusions regarding efficacy of exercise interventions for counteracting post-surgical
weight recurrence was limited by the small number of trials and methodological issues.
Findings highlight the need for more rigorous RCTs of exercise interventions specifically
designed to reduce post-surgical weight recurrence.
Keywords
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Article info
Publication history
Published online: December 19, 2022
Accepted:
December 10,
2022
Received:
August 14,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
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- Comment on: Exercise for Counteracting Weight Recurrence After Bariatric Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsSurgery for Obesity and Related Diseases
- PreviewBariatric surgery is effective for the treatment of obesity and related co-morbidities such as diabetes.1 Despite the overall effectiveness of this medical treatment for obesity, weight recurrence may still occur in response to bariatric surgery and remission from diabetes may not be sustained.2 This suggests the need for ongoing treatment to augment the effectiveness of bariatric surgery to prevent weight recurrence and to sustain other related health benefits.
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