Behavioural interventions appear to improve weight loss at 12 months after bariatric surgery .
Background Significant , sustained weight loss through conventional , non-surgical interventions is often unattainable for people with severe obesity ( e.g. BMI ≥40 or ≥35 kg/m2 with co-morbidities ) .
Bariatric surgery is effective in treating severe obesity , but surgery alone without additional behaviour change management may not result in optimum long-term weight loss and maintenance .
This systematic review and meta- analysis of r and omised controlled trials evaluated the effectiveness of lifestyle interventions before and /or after bariatric surgery .
Clinical trial demonstrates exercise following bariatric surgery improves insulin sensitivity.
BACKGROUND Roux-en-Y gastric bypass ( RYGB ) surgery causes profound weight loss and improves insulin sensitivity ( S(I ) ) in obese patients .  Regular exercise can also improve S(I ) in obese individuals ; however , it is unknown whether exercise and RYGB surgery-induced weight loss would additively improve S(I ) and other cardiometabolic factors . METHODS We conducted a single-blind , prospect i ve , r and omized trial with 128 men and women who recently underwent RYGB surgery ( within 1 - 3 months ) . Participants were r and omized to either a 6-month semi-supervised moderate exercise protocol ( EX , n = 66 ) or a health education control ( CON ; n = 62 ) intervention . Main outcomes measured included S(I ) and glucose effectiveness ( S(G ) ) , which were determined from an intravenous glucose tolerance test and minimal modeling . Secondary outcomes measured were cardiorespiratory fitness ( VO2 peak ) and body composition . Data were analyzed using an intention-to-treat ( ITT ) and per- protocol ( PP ) approach to assess the efficacy of the exercise intervention ( > 120 min of exercise/week ) . RESULTS 119 ( 93 % ) participants completed the interventions , 95 % for CON and 91 % for EX . There was a significant decrease in body weight and fat mass for both groups ( P < 0.001 for time effect ) . S(I ) improved in both groups following the intervention ( ITT : CON vs. EX ; + 1.64 vs. + 2.24 min⁻¹/μU/ml , P = 0.18 for Δ , P < 0.001 for time effect ) . A PP analysis revealed that exercise produced an additive S(I ) improvement ( PP : CON vs. EX ; + 1.57 vs. + 2.69 min⁻¹/μU/ml , P = 0.019 ) above that of surgery . Exercise also improved S(G ) ( ITT : CON vs. EX ; + 0.0023 vs. + 0.0063 min⁻¹ , P = 0.009 ) compared with the CON group . Exercise improved cardiorespiratory fitness ( VO2 peak ) compared with the CON group . CONCLUSION Moderate exercise following RYGB surgery provides additional improvements in S(I ) , S(G ) , and cardiorespiratory fitness compared with a sedentary lifestyle during similar weight loss . TRIAL REGISTRATION clinical trials.gov identifier : NCT00692367 . FUNDING This study was funded by the NIH/National Institute of Diabetes and Digestive and Kidney Diseases ( R01 DK078192 ) and an NIH/National Center for Research Re sources / Clinical and Translational Science Award ( UL1 RR024153 )
Behavioural interventions appear to improve weight loss at 12 months after bariatric surgery .
Background Significant , sustained weight loss through conventional , non-surgical interventions is often unattainable for people with severe obesity ( e.g. BMI ≥40 or ≥35 kg/m2 with co-morbidities ) .
Bariatric surgery is effective in treating severe obesity , but surgery alone without additional behaviour change management may not result in optimum long-term weight loss and maintenance .
This systematic review and meta- analysis of r and omised controlled trials evaluated the effectiveness of lifestyle interventions before and /or after bariatric surgery .