Keeping the Weight Off: Physical Activity, Sitting Time, and Weight Loss Maintenance in Bariatric Surgery Patients 2 to 16 Years Postsurgery

Despite bariatric surgery being the most effective treatment for obesity, some individuals do not respond adequately, especially in the long term. Identifying the predictors of correct weight maintenance in the medium (from 1 to 3 years after surgery) and long term (from 3 years and above) is of vital importance to reduce failure after bariatric surgery; therefore, we summarize the evidence about certain factors, among which we highlight surgical technique, psychological factors, physical activity, adherence to diet, gastrointestinal hormones or neurological factors related to appetite control. We conducted a search in PubMed focused on the last five years (2015–2021). Main findings are as follows: despite Roux-en-Y gastric bypass being more effective in the long term, sleeve gastrectomy shows a more beneficial effectiveness–complications balance; pre-surgical psychological and behavioral evaluation along with post-surgical treatment improve long-term surgical outcomes; physical activity programs after bariatric surgery, in addition to continuous and comprehensive care interventions regarding diet habits, improve weight loss maintenance, but it is necessary to improve adherence; the impact of bariatric surgery on the gut–brain axis seems to influence weight maintenance. In conclusion, although interesting findings exist, the evidence is contradictory in some places, and long-term clinical trials are necessary to draw more robust conclusions.

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Optimizing weight loss outcomes for bariatric surgery patients: the role of physical activity

BMC Proceedings ◽

10.1186/1753-6561-6-s4-o1 ◽

2012 ◽

Vol 6 (S4) ◽

Author(s):

R Boddu ◽

E Wilson ◽

B Snyder ◽

TD Wilson

Keyword(s):

Physical Activity ◽

Bariatric Surgery ◽

Weight Loss ◽

Weight Loss Outcomes

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Physical Activity, Weight Loss, and Weight Maintenance in the DiOGenes Multicenter Trial

Frontiers in Nutrition ◽

10.3389/fnut.2021.683369 ◽

2021 ◽

Vol 8 ◽

Author(s):

Marleen A. van Baak ◽

Gabby Hul ◽

Arne Astrup ◽

Wim H. Saris

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Weight Maintenance ◽

Secondary Analysis ◽

Maintenance Phase ◽

Weight Loss Maintenance ◽

Multicenter Trial ◽

Matsuda Index ◽

Training Programmes ◽

Positive Effect

In this secondary analysis of the DiOGenes study, we investigated whether physical activity (PA) contributes to diet-induced weight loss and helps to reduce subsequent regain. We also studied the associations of PA with changes in cardiometabolic variables. Adults with overweight were included and followed an 8-week low-calorie diet (LCD). When successful (>8% weight loss), participants were randomized to different ad libitum diet groups and were advised to maintain their weight loss over the 6-month intervention period. Body weight (BW), body composition, cardiometabolic variables and subjectively-assessed PA were measured at baseline, at the end of weight loss and at the end of the intervention. BW was reduced by the LCD (from 99.8 ± 16.7 to 88.4 ± 14.9 kg; P < 0.001). This reduction was maintained during the weight maintenance period (89.2 ± 16.0 kg). Total PA (sum score of the three subscales of the Baecke questionnaire) increased during the weight loss period (from 8.16 ± 0.83 to 8.39 ± 0.78; P < 0.001) and this increase was subsequently maintained (8.42 ± 0.90). We found no evidence that baseline PA predicted weight loss. However, a higher level of baseline PA predicted a larger weight-loss-induced improvement in total cholesterol, triglycerides, glucose and CRP, and in post-prandial insulin sensitivity (Matsuda index). Subsequent weight and fat mass maintenance were predicted by the post-weight loss level of PA and associated with changes in PA during the weight maintenance phase. In conclusion, despite the fact that higher baseline levels of PA did not predict more weight loss during the LCD, nor that an increase in PA during the LCD was associated with more weight loss, higher PA levels were associated with more improvements in several cardiometabolic variables. The positive effect of higher PA on weight loss maintenance seems in contrast to randomized controlled trials that have not been able to confirm a positive effect of exercise training programmes on weight loss maintenance. This analysis supports the notion that higher self-imposed levels of PA may improve the cardiometabolic risk profile during weight loss and help to maintain weight loss afterwards.

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Physical Activity, Sedentary Behavior, and Sleep Before and After Bariatric Surgery and Associations with Weight Loss Outcome

Obesity Surgery ◽

10.1007/s11695-020-04908-3 ◽

2020 ◽

Author(s):

Mette S. Nielsen ◽

Hagir Alsaoodi ◽

Mads F. Hjorth ◽

Anders Sjödin

Keyword(s):

Physical Activity ◽

Bariatric Surgery ◽

Weight Loss ◽

Sedentary Behavior ◽

Weight Loss Outcome ◽

Before And After

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Higher adherence to the Mediterranean Diet is associated with weight loss maintenance: the MedWeight study

Proceedings of The Nutrition Society ◽

10.1017/s0029665120002888 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Dimitrios Poulimeneas ◽

Katerina Zoupi ◽

Eirini Mamalaki ◽

Eirini Bathrellou ◽

Costas Anastasiou ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Mediterranean Diet ◽

Dietary Pattern ◽

Weight Loss Maintenance ◽

Activity Level ◽

Obesity Management ◽

Maximum Weight ◽

The Mediterranean ◽

Current Weight

AbstractIntroductionAdherence to the Mediterranean dietary pattern has been associated with numerous health benefits in non-communicable diseases, including obesity management. However, the associations of the Mediterranean Diet with weight loss maintenance remain to be evaluated.MethodsWe analyzed data from 500 participants (61% women) of the MedWeight study. Eligible volunteers were men and women 18–65 years old, reporting an intentional weight loss of at least 10%, starting from a BMI ≥ 25 kg/m2. Based on their current weight, participants were characterized as maintainers (current weight ≤ 90% of maximum weight), or regainers (current weight > 95% of maximum weight). Socio-demographics, lifestyle measurements and weight history were recorded. Dietary intake was assessed by 2 telephone 24-hour recalls. Adherence to the Mediterranean Diet was assessed with the MedDietScore (range 0–55, greater scores showing higher adherence). Physical activity levels were assessed with the International Physical Activity Questionnaire-short form. Results are expressed as means ± SD, frequencies (%) or Odds Ratio [OR; 95%Confidence Interval].ResultsCompared to regainers (31%), maintainers were younger (31.4 ± 10.0 vs. 36.6 ± 10.8 years, p < 0.001), had lower BMI (25.7 ± 4.3 vs. 31.4 ± 5.1 kg/m2, p < 0.001), and had greater initial body weight loss (25.5 ± 8.6% vs. 18.4 ± 6.9%, p < 0.001). Sex and years of formal education were not significantly different between maintainers and regainers (p > 0.05). Being in the highest MedDietScore quintile (vs. the lowest) was associated with 91% higher odds of being a maintainer [crude OR = 1.91; 1.05–3.45]. This association remained significant after adjusting for sex, age, physical activity level (METŸminutes/week) and energy intake (kcal/day) [adjusted OR = 2.01; 1.05–3.83].DiscussionHigher adherence to the Mediterranean Diet was independently associated with 2-fold increased likelihood of weight loss maintenance. Our results highlight the favorable effects of a prudent dietary pattern in long-term obesity management, as well as novel targets for diet planning during weight loss maintenance.

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