Exercise After Bariatric Surgery

Exercise after bariatric surgery is important to overall health and aids in weight loss and weight maintenance.  Guidelines for exercise vary with each patient and their functional health status before and after surgery. While most patients’ health and mobility improves significantly, they can still have joint, cardiovascular, or other limitations to physical activity. In general, the best activity to do for the initial post-operative phase is walking.

When To Start

Starting an exercise program too early after surgery when the minimum caloric intake is not met can lead to fatigue, injury, and weight plateaus. Starting with the patient’s preoperative baseline activity level and increasing each session by 5 minutes each week as tolerated until a 30-minute session is able to be completed. If patients are unable to maintain walking exercises postoperatively, then seated exercises are a great option.

On the other end of the spectrum, patients who are without joint problems and cardiovascular issues, may be able to increase the intensity of their workouts by increasing the speed and incline of a walk. The exercise goal for patients set forth by the American College of Sports Medicine is 30-minutes-a-day, 5-days-a-week of moderate intensity exercise. Once a patient is able to achieve a caloric intake of 1000-1200 kcal, eat 5-6 small protein based meals a day, and achieve a protein intake goal of 60-80 grams of protein a day, they can begin to start more vigorous exercise that focuses on strength and endurance.

What Type of Exercise?

There are many modalities of exercise, but adding in some form of strength training will build muscle and help counteract muscle loss during the rapid weight loss phase, as well as increase muscle mass to continue burning calories in weight maintenance. While patients can’t out exercise a bad diet, consistent exercise is one of the most common things that successful weight loss surgery patients who maintain their weight loss have in common.

Exercise does not have to be overly vigorous or intense to be effective. Patients should aim to be between 50-70 % of their maximum heart rate for fat burning (see calculation below). Exercise after surgery should focus on rounding out endurance, flexibility, & strength. The recent PURE study published in Lancet study showed that 1 in 12 deaths can be prevented with 150 min of exercise a week from a reduction in heart disease related deaths.

Keep It Up

Many patients think exercise is prescribed after weight loss surgery only for weight loss and once that is achieved, they don’t need to continue to exercise. However, there are a myriad of benefits from exercise that are equally as important as weight loss and maintenance. Exercise strengthens the heart and lungs, it builds muscle and strengthens bone to prevent fractures later in life, it allows the metabolic system to function more effectively, it increases the body’s sensitivity to insulin, and can increase hormone levels. It improves cognition and sleep.

The benefits of exercise extend beyond weight loss. Bariatric surgery is a tool to help patients lose weight and utilizing physical activity after surgery is an important component in the success of patient’s bariatric surgical outcomes.

Calculating a Target Heart Rate

220-age= ?

? x .50= bottom number of range

? x .70= top number of range

Example (age 50)

220-50=170

170x.50=85

170x.70=119

Your target heart rate range for moderate intensity exercise is 85-119 bpm

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