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Obesity Surgery
Published in: Obesity Surgery 7/2014

01-07-2014 | Original Contributions

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

Authors: Katya M. Herman, Tamara E. Carver, Nicolas V. Christou, Ross E. Andersen

Published in: Obesity Surgery | Issue 7/2014

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Abstract

Background

Bariatric surgery patients often exhibit low levels of physical activity (PA), despite the presumed importance of PA as an adjunct to surgery for successful weight loss. Little is known regarding the associations of PA and sedentary behaviors to weight loss outcomes in the long term following surgery. The objective of the study was to assess the associations of PA and sitting time with weight status, weight loss, and weight maintenance outcomes in bariatric patients 2–16 years postsurgery.

Methods

A total of 303 Roux-en-Y Gastric Bypass patients (73 % female; mean age 47 ± 10 years, mean 7 ± 4 years since surgery) completed a telephone questionnaire. Patients reported moderate-to-vigorous PA (MVPA: # sessions/week ≥30 min) and average daily sitting time (h/day). Associations with various weight outcomes were assessed.

Results

Only 48 % of patients reported ≥1 session/week MVPA, and mean reported sitting time was 7 ± 4 h/day. Neither MVPA nor sitting time was associated with weight loss outcomes at patients’ lowest weight postsurgery. However, both MVPA and sitting time were independently positively and inversely, respectively, associated with total (kg) weight loss, % weight loss, and % excess weight loss at current weight, as well as weight loss maintained vs. regained, controlling for age, sex, surgery type, presurgery BMI, total initial weight loss, and time since surgery.

Conclusions

Results demonstrate associations between MVPA and high sitting time and weight loss outcomes among bariatric patients in the long term. The implications for long-term weight management and concomitant health outcomes highlight the need for appropriate follow-up and interventions in this unique high-risk patient population.
Literature
1.
2.
Shields M, Carroll MD, Ogden CL. Adult obesity prevalence in Canada and the United States. NCHS Data Brief. 2011;56:1–8.PubMed
3.
Andreyeva T, Sturm R, Ringel JS. Moderate and severe obesity have large differences in health care costs. Obes Res. 2004;12(12):1936–43.PubMedCrossRef
4.
Lau DC, Douketis JD, Morrison KM, et al. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ. 2007;176(8):S1–S13.PubMedCentralPubMedCrossRef
5.
Mechanick JI, Kushner RF, Sugerman HJ, et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Obesity. 2009;17 Suppl 1:S1–70, v.PubMed
6.
Christou NV, Sampalis JS, Liberman M, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg. 2004;240(3):416–24.PubMedCentralPubMedCrossRef
7.
Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.PubMedCrossRef
8.
Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357(8):753–61.PubMedCrossRef
9.
Sampalis JS, Liberman M, Auger S, et al. The impact of weight reduction surgery on health-care costs in morbidly obese patients. Obes Surg. 2004;14(7):939–47.PubMedCrossRef
10.
Arkinson J, Ji H, Fallah S, et al. CIHI survey: bariatric surgery in Canada. Healthc Q. 2010;13(2):14–7.PubMedCrossRef
11.
Ross R, Lam M, Blair SN, et al. Trial of prevention and reduction of obesity through active living in clinical settings: a randomized controlled trial. Arch Intern Med. 2012;172(5):414–24.PubMedCrossRef
12.
Shaw K, Gennat H, O'Rourke P, et al. Exercise for overweight or obesity. Cochrane Database Syst Rev. 2006;4, CD003817.PubMed
13.
Goodpaster BH, Delany JP, Otto AD, et al. Effects of diet and physical activity interventions on weight loss and cardiometabolic risk factors in severely obese adults: a randomized trial. JAMA. 2010;304(16):1795–802.PubMedCentralPubMedCrossRef
14.
Tremblay MS, Warburton DE, Janssen I, et al. New Canadian physical activity guidelines. Appl Physiol Nutr Metab. 2011;36(1):36-46; 47-58.
15.
Bond DS, Jakicic JM, Vithiananthan S, et al. Objective quantification of physical activity in bariatric surgery candidates and normal-weight controls. Surg Obes Relat Dis. 2010;6(1):72–8.PubMedCentralPubMedCrossRef
16.
Hatoum IJ, Stein HK, Merrifield BF, et al. Capacity for physical activity predicts weight loss after Roux-en-Y gastric bypass. Obesity. 2009;17(1):92–9.PubMedCrossRef
17.
18.
Jacobi D, Ciangura C, Couet C, et al. Physical activity and weight loss following bariatric surgery. Obes Rev. 2011;12(5):366–77.PubMedCrossRef
19.
Egberts K, Brown WA, Brennan L, et al. Does exercise improve weight loss after bariatric surgery? A systematic review. Obes Surg. 2012;22(2):335–41.PubMedCrossRef
20.
Klem ML, Wing RR, McGuire MT, et al. A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am J Clin Nutr. 1997;66(2):239–46.PubMed
21.
McGuire MT, Wing RR, Klem ML, et al. Behavioral strategies of individuals who have maintained long-term weight losses. Obes Res. 1999;7(4):334–41.PubMedCrossRef
22.
Livhits M, Mercado C, Yermilov I, et al. Behavioral factors associated with successful weight loss after gastric bypass. Am Surg. 2010;76(10):1139–42.PubMed
23.
Klem ML, Wing RR, Chang CC, et al. A case-control study of successful maintenance of a substantial weight loss: individuals who lost weight through surgery versus those who lost weight through non-surgical means. Int J Obes Relat Metab Disord. 2000;24(5):573–9.PubMedCrossRef
24.
Tremblay MS, Colley RC, Saunders TJ, et al. Physiological and health implications of a sedentary lifestyle. Appl Physiol Nutr Metab. 2010;35(6):725–40.PubMedCrossRef
25.
Sedentary Behaviour Research Network. Standardized use of the terms “sedentary” and “sedentary behaviours”. Appl Physiol Nutr Metab. 2012;37:540–2.PubMedCrossRef
26.
Healy GN, Wijndaele K, Dunstan DW, et al. Objectively measured sedentary time, physical activity, and metabolic risk: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Diabetes Care. 2008;31(2):369–71.PubMedCrossRef
27.
28.
Bond DS, Unick JL, Jakicic JM, et al. Objective assessment of time spent being sedentary in bariatric surgery candidates. Obes Surg. 2011;21(6):811–4.PubMedCentralPubMedCrossRef
29.
Unick JL, Bond DS, Jakicic JM, et al. Comparison of two objective monitors for assessing physical activity and sedentary behaviors in bariatric surgery patients. Obes Surg. 2012;22(3):347–52.PubMedCentralPubMedCrossRef
30.
Bond DS, Graham Thomas J, Unick JL, et al. Self-reported and objectively measured sedentary behavior in bariatric surgery candidates. Surg Obes Relat Dis. 2013; 9(1):123–8.
31.
Shields M, Tremblay MS. Sedentary behaviour and obesity. Health Rep. 2008;19(2):19–30.PubMed
32.
Vatier C, Henegar C, Ciangura C, et al. Dynamic relations between sedentary behavior, physical activity, and body composition after bariatric surgery. Obes Surg. 2012;22(8):1251–6.PubMedCrossRef
33.
34.
Bray GA, Bouchard C, Church TS, et al. Is it time to change the way we report and discuss weight loss? Obesity. 2009;17(4):619–21.PubMedCrossRef
35.
Evans RK, Bond DS, Wolfe LG, et al. Participation in 150 min/wk of moderate or higher intensity physical activity yields greater weight loss after gastric bypass surgery. Surg Obes Relat Dis. 2007;3(5):526–30.PubMedCrossRef
36.
Colles SL, Dixon JB, O'Brien PE. Hunger control and regular physical activity facilitate weight loss after laparoscopic adjustable gastric banding. Obes Surg. 2008;18(7):833–40.PubMedCrossRef
37.
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. 2009;17(1):78–83.PubMedCrossRef
38.
King WC, Bond DS. The importance of preoperative and postoperative physical activity counseling in bariatric surgery. Exerc Sport Sci Rev. 2013;41(1):26–35.PubMedCentralPubMedCrossRef
39.
Papalazarou A, Yannakoulia M, Kavouras SA, et al. Lifestyle intervention favorably affects weight loss and maintenance following obesity surgery. Obesity. 2010;18(7):1348–53.PubMedCrossRef
40.
Chaston TB, Dixon JB, O'Brien PE. Changes in fat-free mass during significant weight loss: a systematic review. Int J Obes. 2007;31(5):743–50.
41.
Brzozowska MM, Sainsbury A, Eisman JA, et al. Bariatric surgery, bone loss, obesity and possible mechanisms. Obes Rev. 2013;14(1):52–67.PubMedCrossRef
42.
Franckowiak SC, Andersen RE. Metabolic assessment of overweight patients. In: Berdanier CD, Feldman EB, Dwyer J, editors. Handbook of Nutrition and Food. 2nd ed. Boca Raton (FL): CRC Press; 2008. p. 847–867.
43.
Murphy JC, McDaniel JL, Mora K, et al. Preferential reductions in intermuscular and visceral adipose tissue with exercise-induced weight loss compared with calorie restriction. J Appl Physiol (1985). 2012;112(1):79–85.CrossRef
44.
Hunter GR, Brock DW, Byrne NM, et al. Exercise training prevents regain of visceral fat for 1 year following weight loss. Obesity. 2010;18(4):690–5.PubMedCentralPubMedCrossRef
45.
Pontiroli AE, Frige F, Paganelli M, et al. In morbid obesity, metabolic abnormalities and adhesion molecules correlate with visceral fat, not with subcutaneous fat: effect of weight loss through surgery. Obes Surg. 2009;19(6):745–50.PubMedCrossRef
46.
Johnson MF, Nichols JF, Sallis JF, et al. Interrelationships between physical activity and other health behaviors among university women and men. Prev Med. 1998;27(4):536–44.PubMedCrossRef
47.
Hildebrandt SE. Effects of participation in bariatric support group after Roux-en-Y gastric bypass. Obes Surg. 1998;8(5):535–42.PubMedCrossRef
48.
Andersen RE, Jakicic JM. Interpreting the physical activity guidelines for health and weight management. J Phys Act Health. 2009;6(5):651–6.PubMed
49.
Dunstan DW, Howard B, Healy GN, et al. Too much sitting—a health hazard. Diabetes Res Clin Pract. 2012;97(3):368–76.PubMedCrossRef
50.
Chau JY, van der Ploeg HP, Merom D, et al. Cross-sectional associations between occupational and leisure-time sitting, physical activity and obesity in working adults. Prev Med. 2012;54(3–4):195–200.PubMedCrossRef
51.
van Uffelen JG, Watson MJ, Dobson AJ, et al. Sitting time is associated with weight, but not with weight gain in mid-aged Australian women. Obesity. 2010;18(9):1788–94.PubMedCrossRef
52.
Bond DS, Thomas JG, Unick JL, et al. Self-reported and objectively measured sedentary behavior in bariatric surgery candidates. Surg Obes Relat Dis. 2013;9(1):123–8.PubMedCentralPubMedCrossRef
53.
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(2):177–85.PubMedCrossRef
54.
Klem ML, Wing RR, Lang W, et al. Does weight loss maintenance become easier over time? Obes Res. 2000;8(6):438–44.PubMedCrossRef
55.
Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734–40.PubMedCentralPubMedCrossRef
56.
Grundy SM, Blackburn G, Higgins M, et al. Physical activity in the prevention and treatment of obesity and its comorbidities. Med Sci Sports Exerc. 1999;31(11 Suppl):S502–8.PubMedCrossRef
57.
Ekelund U, Brage S, Besson H, et al. Time spent being sedentary and weight gain in healthy adults: reverse or bidirectional causality? Am J Clin Nutr. 2008;88(3):612–7.PubMed
58.
Shields M, Connor Gorber S, Tremblay MS. Estimates of obesity based on self-report versus direct measures. Health Rep. 2008;19(2):61–76.PubMed
59.
Bond DS, Jakicic JM, Unick JL, et al. Pre- to postoperative physical activity changes in bariatric surgery patients: self report vs. objective measures. Obesity. 2010;18(12):2395–7.PubMedCentralPubMedCrossRef
60.
Clemes SA, David BM, Zhao Y, et al. Validity of two self-report measures of sitting time. J Phys Act Health. 2012;9(4):533–9.PubMed
Metadata
Title
Keeping the Weight Off: Physical Activity, Sitting Time, and Weight Loss Maintenance in Bariatric Surgery Patients 2 to 16 Years Postsurgery
Authors
Katya M. Herman
Tamara E. Carver
Nicolas V. Christou
Ross E. Andersen
Publication date
01-07-2014
Publisher
Springer US
Published in
Obesity Surgery / Issue 7/2014
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-014-1212-3

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