Top

Obesity Surgery

Published in:

Open Access 01-12-2011 | Clinical Research

Physical Activity After Surgery for Severe Obesity: The Role of Exercise Cognitions

Authors: Eveline J. Wouters, Junilla K. Larsen, Hanna Zijlstra, Bert van Ramshorst, Rinie Geenen

Published in: Obesity Surgery | Issue 12/2011

Abstract

Background

Physical activity after bariatric surgery is associated with sustained weight loss and improved quality of life. Some bariatric patients engage insufficiently in physical activity. This may be due to exercise cognitions, i.e., specific beliefs about benefits of and barriers to physical exercise. The aim of this study was to examine whether and to what extent both physical activity and exercise cognitions changed at 1 and 2 years post-surgery and whether exercise cognitions predict physical activity.

Methods

Forty-two bariatric patients (38 women, 4 men; mean age 38 ± 8 years, mean body mass index prior to surgery 47 ± 6 kg/m²) filled out self-report instruments to examine physical activity and exercise cognitions pre- and post-surgery.

Results

A large increase in physical activity and favorable changes in exercise cognitions were observed after surgery, viz. a decrease of fear of injury and embarrassment and an increase of the perception of exercise benefits and confidence in exercising. Perceiving less exercise benefits and having less confidence in exercising before surgery predicted less physical activity 2 years after surgery. High fear of injury 1 year after surgery predicted less physical activity 2 years after surgery.

Conclusions

After bariatric surgery, favorable changes in physical activity and beliefs about the benefits and barriers of exercising are observed. Our results suggest that targeting exercise cognitions before and after surgery might be relevant to improve physical activity.

Annesi JJ. Relations of mood with body mass index changes in severely obese women enrolled in a supported physical activity treatment. Obes Facts. 2008;1:88–92.PubMedCrossRef

Annesi JJ, Unruh JL. Relations of exercise, self-appraisal, mood changes and weight loss in obese women: testing propositions based on Baker and Brownell's (2000) model. Am J Med Sci. 2008;335:198–204.PubMedCrossRef

Abu-Omar K, Rutten A, Lehtinen V. Mental health and physical activity in the European Union. Soz Praventivmed. 2004;49:301–9.PubMed

Hamer M, Stamatakis E, Steptoe A. Dose response relationship between physical activity and mental health: The Scottish Health Survey. Br J Sports Med. 2008;43:1111–4.PubMedCrossRef

Adams TB, Moore MT, Dye J. The relationship between physical activity and mental health in a national sample of college females. Women Health. 2007;45:69–85.PubMedCrossRef

Penedo FJ, Dahn JR. Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Curr Opin Psychiatry. 2005;18:189–93.PubMedCrossRef

Aittasalo M, Miilunpalo S, Stahl T, et al. From innovation to practice: initiation, implementation and evaluation of a physician-based physical activity promotion programme in Finland. Health Promot Int. 2007;22:19–27.PubMedCrossRef

Grandes G, Sanchez A, Torcal J, et al. Targeting physical activity promotion in general practice: characteristics of inactive patients and willingness to change. BMC Public Health. 2008;8:172.PubMedCrossRef

Haverly K, Davison KK. Personal fulfillment motivates adolescentsto be physically active. Arch Pediatr Adolesc Med. 2005;159:1115–20.PubMedCrossRef

10.

Villanova N, Pasqui F, Burzacchini S, et al. A physical activity program to reinforce weight maintenance following a behavior program in overweight/obese subjects. Int J Obes (Lond). 2006;30:697–703.CrossRef

11.

Catenacci VA, Wyatt HR. The role of physical activity in producing and maintaining weight loss. Nat Clin Pract Endocrinol Metab. 2007;3:518–29.PubMedCrossRef

12.

Jones F, Harris P, Waller H, et al. Adherence to an exercise prescription scheme: the role of expectations, self-efficacy, stage of change and psychological well-being. Br J Health Psychol. 2005;10:359–78.PubMedCrossRef

13.

McGuire MT, Wing RR, Klem ML, et al. What predicts weight regain in a group of successful weight losers? J Consult Clin Psychol. 1999;67:177–85.PubMedCrossRef

14.

Bond DS, Phelan S, Wolfe LG, et al. Becoming physically active after bariatric surgery is associated with improved weight loss and health-related quality of life. Obesity (Silver Spring). 2009;17:78–83.CrossRef

15.

Bond D, Leahey TM, Vithiananthan S, et al. Bariatric surgery for severe obesity: the role of patient behavior. Med Health R I. 2009;92:58–60.PubMed

16.

Leventhal H, Leventhal EA, Contrada RJ. Self-regulation, health and behavior: a perceptual-cognitive approach. Psychol Health. 1998;13:717–33.CrossRef

17.

Ogden J. Health psychology: a textbook. 3rd ed. Maidenhead, Berkshire, UK: Open University Press; 2004.

18.

Steptoe A, Rink E, Kerry S. Psychosocial predictors of changes in physical activity in overweight sedentary adults following counseling in primary care. Prev Med. 2000;31:183–94.PubMedCrossRef

19.

Courneya KS, Plotnikoff RC, Hotz SB, et al. Predicting exercise stage transitions over two consecutive 6-month periods: a test of the theory of planned behaviour in a population-based sample. Br J Health Psychol. 2001;6:135–50.PubMedCrossRef

20.

Bond DS, Evans RK, DeMaria EJ, et al. Physical activity stage of readiness predicts moderate-vigorous physical activity participation among morbidly obese gastric bypass surgery candidates. Surg Obes Relat Dis. 2006;2:128–32.PubMedCrossRef

21.

Larsen JK, Geenen R, van Ramshorst B, et al. Binge eating and exercise behavior after surgery for severe obesity: a structural equation model. Int J Eat Disord. 2006;39:369–75.PubMedCrossRef

22.

Barton SB, Walker LL, Lambert G, et al. Cognitive change in obese adolescents losing weight. Obes Res. 2004;12:313–9.PubMedCrossRef

23.

Belachew M, Legrand MJ, Defechereux TH, et al. Laparoscopic adjustable silicone gastric banding in the treatment of morbid obesity. A preliminary report. Surg Endosc. 1994;8:1354–6.PubMedCrossRef

24.

Baecke JA, Burema J, Frijters JE. A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr. 1982;36:936–42.PubMed

25.

Philippaerts RM, Matton L, Wijndaele K, et al. Validity of a physical activity computer questionnaire in 12- to 18-year-old boys and girls. Int J Sports Med. 2006;27:131–6.PubMedCrossRef

26.

Philippaerts RM, Westerterp KR, Lefevre J. Doubly labelled water validation of three physical activity questionnaires. Int J Sports Med. 1999;20:284–9.PubMedCrossRef

27.

Cohen J. Statistical power analysis for the behavioural sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.

28.

Deitel M, Gawdat K, Melissas J. Reporting weight loss 2007. Obes Surg. 2007;17:565–8.PubMedCrossRef

29.

Larsen JK, Geenen R, van Ramshorst B, et al. Psychosocial functioning before and after laparoscopic adjustable gastric banding: a cross-sectional study. Obes Surg. 2003;13:629–36.PubMedCrossRef

30.

van Hout GC, Hagendoren CA, Verschure SK, et al. Psychosocial predictors of success after vertical banded gastroplasty. Obes Surg. 2009;19:701–7.PubMedCrossRef

31.

Wolfe BL, Terry ML. Expectations and outcomes with gastric bypass surgery. Obes Surg. 2006;16:1622–9.PubMedCrossRef

32.

Zijlstra H, Boeije HR, Larsen JK, et al. Patients' explanations for unsuccessful weight loss after laparoscopic adjustable gastric banding (LAGB). Patient Educ Couns. 2009;75:108–13.PubMedCrossRef

33.

Zijlstra H, Larsen JK, de Ridder DT, et al. Initiation and maintenance of weight loss after laparoscopic adjustable gastric banding. The role of outcome expectation and satisfaction with the psychosocial outcome. Obes Surg. 2009;19:725–31.PubMedCrossRef

34.

Zijlstra H, Larsen JK, van Ramshorst B, et al. The association between weight loss and self-regulation cognitions before and after laparoscopic adjustable gastric banding for obesity: a longitudinal study. Surgery. 2006;139:334–9.PubMedCrossRef

35.

Kinzl JF, Schrattenecker M, Traweger C, et al. Psychosocial predictors of weight loss after bariatric surgery. Obes Surg. 2006;16:1609–14.PubMedCrossRef

36.

Curtis P. The experiences of young people with obesity in secondary school: some implications for the healthy school agenda. Health Soc Care Community. 2008;16:410–8.PubMedCrossRef

37.

Ekkekakis P, Lind E. Exercise does not feel the same when you are overweight: the impact of self-selected and imposed intensity on affect and exertion. Int J Obes (Lond). 2006;30:652–60.CrossRef

38.

Leeuw M, Goossens ME, Linton SJ, et al. The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. J Behav Med. 2007;30:77–94.PubMedCrossRef

39.

Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000;85:317–32.PubMedCrossRef

40.

Wouters EJ, van Nunen AM, Vingerhoets AJ, et al. Setting overweight adults in motion: the role of health beliefs. Obes Facts. 2009;2:362–9.PubMedCrossRef

41.

Elfving B, Andersson T, Grooten WJ. Low levels of physical activity in back pain patients are associated with high levels of fear-avoidance beliefs and pain catastrophizing. Physiother Res Int. 2007;12:14–24.PubMedCrossRef

42.

Wouters EJ, Van Nunen AM, Geenen R, et al. Effects of aquajogging in obese adults: a pilot study. J Obes. 2010; Article ID 231074.

Title: Physical Activity After Surgery for Severe Obesity: The Role of Exercise Cognitions
Authors: Eveline J. Wouters
Junilla K. Larsen
Hanna Zijlstra
Bert van Ramshorst
Rinie Geenen
Publication date: 01-12-2011
Publisher: Springer-Verlag
Published in: Obesity Surgery / Issue 12/2011
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-010-0276-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Physical Activity After Surgery for Severe Obesity: The Role of Exercise Cognitions

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 12/2011

Potential Nutritional Conflicts in Bariatric and Renal Transplant Patients

Getting the Most from the Sleeve: The Importance of Post-Operative Follow-up

Our 1-Year Experience in Laparoscopic Sleeve Gastrectomy

Linear Stapler Technique May Be Safer than Circular in Gastrojejunal Anastomosis for Laparoscopic Roux-en-Y Gastric Bypass: A Meta-analysis of Comparative Studies

The Biliopancreatic Diversion with a Duodenal Switch (BPDDS): How Is It Optimally Performed?

Small Bowel Obstruction After Antecolic Antegastric Laparoscopic Roux-en-Y Gastric Bypass Without Division of Small Bowel Mesentery: A Single-Centre, 7-Year Review