Exercise Training in Metabolic and Bariatric Surgery
An Overview of Systematic Reviews
DOI:
https://doi.org/10.51224/SRXIV.393Keywords:
Umbrella review, Physical activity, ObesityAbstract
Understanding how to incorporate exercise into metabolic and bariatric surgery programs to optimize treatment outcomes is of great interest, as evidenced by 11 reviews published on this topic in 2022 alone. Accordingly, the current overview of reviews was conducted to create a single cohesive resource to aid clinicians and researchers by exploring the effects of pre- and postoperative exercise training on health outcomes. A literature search of seven electronic databases was performed (updated 09/2023) and 25 reviews met preset PICOS eligibility criteria and were included: 4 exploring preoperative exercise training, 14 postoperative, and 7 both. Comparing reviews, outcome results were organized as concordant, discordant, or inconclusive, and then categorized into “what we currently know”, “what we think we know” and “what we still don’t know”. According to systematic reviews, “we currently know” that postoperative exercise training has a (1) positive effect on weight, waist circumference, 6-minute walking test distance and muscle strength and (2) non-significant effects on lean body/fat-free mass, diastolic blood pressure, fasting insulin/glucose, total cholesterol, low density lipoprotein and triglycerides. Despite the abundance of research, much still needs to be done in terms of enhancing methodological rigor and reporting to achieve greater confidence in our conclusions; recommendations for next research steps are made.
Metrics
References
Abraham A, Ikramuddin S, Jahansouz C, Arafat F, Hevelone N, Leslie D. Trends in Bariatric Surgery: Procedure Selection, Revisional Surgeries, and Readmissions. Obes Surg. 2016;26(7):1371-1377. doi:10.1007/s11695-015-1974-2
Malik VS, Willet WC, Hu FB. Nearly a decade on — trends, risk factors and policy implications in global obesity. Nat Rev Endocrinol. 2020;16(11):615-616. doi:10.1038/s41574-020-00411-y
Angrisani L, Santonicola A, Iovino P, Ramos A, Shikora S, Kow L. Bariatric Surgery Survey 2018: Similarities and Disparities Among the 5 IFSO Chapters. Obes Surg. 2021;31(5):1937-1948. doi:10.1007/s11695-020-05207-7
Kolotkin RL, Andersen JR. A systematic review of reviews: exploring the relationship between obesity, weight loss and health-related quality of life. Clin Obes. 2017;7(5):273-289. doi:10.1111/cob.12203
Biobaku F, Ghanim H, Monte SV, Caruana JA, Dandona P. Bariatric Surgery: Remission of Inflammation, Cardiometabolic Benefits, and Common Adverse Effects. J Endocr Soc. 2020;4(9):bvaa049. doi:10.1210/jendso/bvaa049
Arterburn DE, Telem DA, Kushner RF, Courcoulas AP. Benefits and Risks of Bariatric Surgery in Adults: A Review. JAMA. 2020;324(9):879-887. doi:10.1001/jama.2020.12567
Karmali S, Brar B, Shi X, Sharma AM, de Gara C, Birch DW. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23(11):1922-1933. doi:10.1007/s11695-013-1070-4
King WC, Hinerman AS, Belle SH, Wahed AS, Courcoulas AP. Comparison of the Performance of Common Measures of Weight Regain After Bariatric Surgery for Association With Clinical Outcomes. JAMA. 2018;320(15):1560-1569. doi:10.1001/jama.2018.14433
Baillot A, St-Pierre M, Bernard P, et al. Exercise and bariatric surgery: A systematic review and meta-analysis of the feasibility and acceptability of exercise and controlled trial methods. Obes Rev. 2022;23(9):e13480. doi:10.1111/obr.13480
Carretero-Ruiz A, Martínez-Rosales E, Cavero-Redondo I, et al. Impact of exercise training after bariatric surgery on cardiometabolic risk factors: a systematic review and meta-analysis of controlled trials. Rev Endocr Metab Disord. 2021;22(4):891-912. doi:10.1007/s11154-021-09651-3
Gasmi A, Boukhmis B, Bjørklund G, et al. Physical activity and obesity spectrum disorders in post-bariatric surgery patients: A systematic review and Meta-analysis. Crit Rev Food Sci Nutr. Published online April 20, 2022:1-12. doi:10.1080/10408398.2022.2056868
Boppre G, Diniz-Sousa F, Veras L, Oliveira J, Fonseca H. Can exercise promote additional benefits on body composition in patients with obesity after bariatric surgery? A systematic review and meta-analysis of randomized controlled trials. Obes Sci Pract. 2021;8(1):112-123. doi:10.1002/osp4.542
Bellicha A, van Baak MA, Battista F, et al. Effect of exercise training before and after bariatric surgery: A systematic review and meta-analysis. Obes Rev. 2021;22(S4):e13296. doi:10.1111/obr.13296
Ren ZQ, Lu GD, Zhang TZ, Xu Q. Effect of physical exercise on weight loss and physical function following bariatric surgery: a meta-analysis of randomised controlled trials. BMJ Open. 2018;8(10):e023208. doi:10.1136/bmjopen-2018-023208
Vieira FT, Oliveira GS de, Gonçalves VSS, Neri SGR, Carvalho KMB de, Dutra ES. Effect of physical exercise on muscle strength in adults following bariatric surgery: A systematic review and meta-analysis of different muscle strength assessment tests. PLOS ONE. 2022;17(6):e0269699. doi:10.1371/journal.pone.0269699
Durey BJ, Fritche D, Martin DS, Best LMJ. The Effect of Pre-operative Exercise Intervention on Patient Outcomes Following Bariatric Surgery: a Systematic Review and Meta-analysis. Obes Surg. 2022;32(1):160-169. doi:10.1007/s11695-021-05743-w
da Silva ALG, Sardeli AV, André LD, et al. Exercise Training Does Improve Cardiorespiratory Fitness in Post-Bariatric Surgery Patients. Obes Surg. 2019;29(4):1416-1419. doi:10.1007/s11695-019-03731-9
Diniz-Sousa F, Boppre G, Veras L, Hernández-Martínez A, Oliveira J, Fonseca H. The Effect of Exercise for the Prevention of Bone Mass After Bariatric Surgery: a Systematic Review and Meta-analysis. Obes Surg. 2022;32(3):912-923. doi:10.1007/s11695-021-05873-1
Herrera-Santelices A, Argüello-Florencio G, Westphal G, Nardo Junior N, Zamunér AR. Effects of Supervised Physical Exercise as Prehabilitation on Body Composition, Functional Capacity and Quality of Life in Bariatric Surgery Candidates: A Systematic Review and Meta-Analysis. J Clin Med. 2022;11(17):5091. doi:10.3390/jcm11175091
Roth A, Sattelmayer M, Schorderet C, Gafner S, Allet L. Effects of exercise training and dietary supplement on fat free mass and bone mass density during weight loss – a systematic review and meta-analysis. F1000Research. 2022;11:8. doi:10.12688/f1000research.75539.3
Boppre G, Diniz-Sousa F, Veras L, Oliveira J, Fonseca H. Does Exercise Improve the Cardiometabolic Risk Profile of Patients with Obesity After Bariatric Surgery? A Systematic Review and Meta-analysis of Randomized Controlled Trials. Obes Surg. 2022;32(6):2056-2068. doi:10.1007/s11695-022-06023-x
Schurmans G, Caty G, Reychler G. Is the Peri-Bariatric Surgery Exercise Program Effective in Adults with Obesity: a Systematic Review. Obes Surg. 2022;32(2):512-535. doi:10.1007/s11695-021-05693-3
Jabbour G, Ibrahim R, Bragazzi N. Preoperative Physical Activity Level and Exercise Prescription in Adults With Obesity: The Effect on Post-Bariatric Surgery Outcomes. Front Physiol. 2022;13. Accessed October 4, 2023. https://www.frontiersin.org/articles/10.3389/fphys.2022.869998
Lodewijks Y, van der Ven R, Nienhuijs S. A broad focus on additional programmes prior to bariatric surgery: A systematic review. Clin Obes. 2022;12(3):e12518. doi:10.1111/cob.12518
Oppert JM, Bellicha A, Ciangura C. Physical activity in management of persons with obesity. Eur J Intern Med. 2021;93:8-12. doi:10.1016/j.ejim.2021.04.028
Gates M, Gates A, Pieper D, et al. Reporting guideline for overviews of reviews of healthcare interventions: development of the PRIOR statement. BMJ. 2022;378:e070849. doi:10.1136/bmj-2022-070849
Methley A, Campbell S, Chew-Graham C, McNally R, Cheraghi-Sohi S. PICO, PICOS and SPIDER: A comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Serv Res. 2014;14:579. doi:10.1186/s12913-014-0579-0
Schardt C, Adams MB, Owens T, Keitz S, Fontelo P. Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Decis Mak. 2007;7(1):16. doi:10.1186/1472-6947-7-16
Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008. doi:10.1136/bmj.j4008
Ferguson T, Olds T, Curtis R, et al. Effectiveness of wearable activity trackers to increase physical activity and improve health: a systematic review of systematic reviews and meta-analyses. Lancet Digit Health. 2022;4(8):e615-e626. doi:10.1016/S2589-7500(22)00111-X
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. Ann Intern Med. 2009;151(4):264-269. doi:10.7326/0003-4819-151-4-200908180-00135
Chaput JP, Dutil C, Featherstone R, et al. Sleep duration and health in adults: an overview of systematic reviews. Appl Physiol Nutr Metab. 2020;45(10 (Suppl. 2)):S218-S231. doi:10.1139/apnm-2020-0034
Pieper D, Antoine SL, Mathes T, Neugebauer EAM, Eikermann M. Systematic review finds overlapping reviews were not mentioned in every other overview. J Clin Epidemiol. 2014;67(4):368-375. doi:10.1016/j.jclinepi.2013.11.007
Hennessy EA, Johnson BT. Examining overlap of included studies in meta-reviews: Guidance for using the corrected covered area index. Res Synth Methods. 2020;11(1):134-145. doi:10.1002/jrsm.1390
Baillot A, Vallée CA, Mampuya WM, et al. Effects of a Pre-surgery Supervised Exercise Training 1 Year After Bariatric Surgery: a Randomized Controlled Study. Obes Surg. 2018;28(4):955-962. doi:10.1007/s11695-017-2943-8
Bond DS, Manuel KM, Wu Y, et al. Exercise for counteracting weight recurrence after bariatric surgery: a systematic review and meta-analysis of randomized controlled trials. Surg Obes Relat Dis. 2023;19(6):641-650. doi:10.1016/j.soard.2022.12.029
Carretero-Ruiz A, Olvera-Porcel M del C, Cavero-Redondo I, et al. Effects of Exercise Training on Weight Loss in Patients Who Have Undergone Bariatric Surgery: a Systematic Review and Meta-Analysis of Controlled Trials. Obes Surg. 2019;29(10):3371-3384. doi:10.1007/s11695-019-04096-9
Morales-Marroquin E, Kohl HW, Knell G, de la Cruz-Muñoz N, Messiah SE. Resistance Training in Post-Metabolic and Bariatric Surgery Patients: a Systematic Review. Obes Surg. 2020;30(10):4071-4080. doi:10.1007/s11695-020-04837-1
Civi Karaaslan T, Leblebici G, Ucgul MS, Yilmaz M, Kalayci MG, Kuran Aslan G. Exercise Program in Patients After Bariatric Surgery: A Systematic Review. Bariatr Surg Pract Patient Care. 2020;15(1):3-10. doi:10.1089/bari.2019.0048
Bellicha A, Ciangura C, Poitou C, Portero P, Oppert JM. Effectiveness of exercise training after bariatric surgery—a systematic literature review and meta-analysis. Obes Rev. 2018;19(11):1544-1556. doi:10.1111/obr.12740
Baillot A, Audet M, Baillargeon JP, et al. Impact of physical activity and fitness in class II and III obese individuals: a systematic review. Obes Rev. 2014;15(9):721-739. doi:10.1111/obr.12171
Marshall S, Mackay H, Matthews C, Maimone IR, Isenring E. Does intensive multidisciplinary intervention for adults who elect bariatric surgery improve post-operative weight loss, co-morbidities, and quality of life? A systematic review and meta-analysis. Obes Rev. 2020;21(7):e13012. doi:10.1111/obr.13012
Pouwels S, Wit M, Teijink JAW, Nienhuijs SW. Aspects of Exercise before or after Bariatric Surgery: A Systematic Review. Obes Facts. 2015;8(2):132-146. doi:10.1159/000381201
Fonseca-Junior SJ, Sá CGA de B, Rodrigues PAF, Oliveira AJ, Fernandes-Filho J. Physical exercise and morbid obesity: a systematic review. ABCD Arq Bras Cir Dig São Paulo. 2013;26:67-73. doi:10.1590/S0102-67202013000600015
Baillot A, Mampuya WM, Dionne IJ, Comeau E, Méziat-Burdin A, Langlois MF. Impacts of Supervised Exercise Training in Addition to Interdisciplinary Lifestyle Management in Subjects Awaiting Bariatric Surgery: a Randomized Controlled Study. Obes Surg. 2016;26(11):2602-2610. doi:10.1007/s11695-016-2153-9
Funderburk JA, Callis S. Aquatic intervention effect on quality of life prior to obesity surgery: a pilot study. [Conference Abstract]. Annu Ther Recreat. 2010;18:66-78.
Castello V, Simões RP, Bassi D, Catai AM, Arena R, Borghi-Silva A. Impact of Aerobic Exercise Training on Heart Rate Variability and Functional Capacity in Obese Women After Gastric Bypass Surgery. Obes Surg. 2011;21(11):1739-1749. doi:10.1007/s11695-010-0319-4
Daniels P, Burns RD, Brusseau TA, et al. Effect of a randomised 12-week resistance training programme on muscular strength, cross-sectional area and muscle quality in women having undergone Roux-en-Y gastric bypass. J Sports Sci. 2018;36(5):529-535. doi:10.1080/02640414.2017.1322217
Hassannejad A, Khalaj A, Mansournia MA, Rajabian Tabesh M, Alizadeh Z. The Effect of Aerobic or Aerobic-Strength Exercise on Body Composition and Functional Capacity in Patients with BMI ≥35 after Bariatric Surgery: a Randomized Control Trial. Obes Surg. 2017;27(11):2792-2801. doi:10.1007/s11695-017-2717-3
Herring LY, Stevinson C, Carter P, et al. The effects of supervised exercise training 12–24 months after bariatric surgery on physical function and body composition: a randomised controlled trial. Int J Obes. 2017;41(6):909-916. doi:10.1038/ijo.2017.60
Mundbjerg LH, Stolberg CR, Cecere S, et al. Supervised Physical Training Improves Weight Loss After Roux-en-Y Gastric Bypass Surgery: A Randomized Controlled Trial. Obesity. 2018;26(5):828-837. doi:10.1002/oby.22143
Shah M, Snell PG, Rao S, et al. High-Volume Exercise Program in Obese Bariatric Surgery Patients: A Randomized, Controlled Trial. Obesity. 2011;19(9):1826-1834. doi:10.1038/oby.2011.172
Stegen S, Derave W, Calders P, Van Laethem C, Pattyn P. Physical Fitness in Morbidly Obese Patients: Effect of Gastric Bypass Surgery and Exercise Training. Obes Surg. 2011;21(1):61-70. doi:10.1007/s11695-009-0045-y
Bellicha A, van Baak MA, Battista F, et al. Effect of exercise training on weight loss, body composition changes, and weight maintenance in adults with overweight or obesity: An overview of 12 systematic reviews and 149 studies. Obes Rev. 2021;22(S4):e13256. doi:10.1111/obr.13256
van Baak MA, Pramono A, Battista F, et al. Effect of different types of regular exercise on physical fitness in adults with overweight or obesity: Systematic review and meta-analyses. Obes Rev. 2021;22(S4):e13239. doi:10.1111/obr.13239
Romeijn MM, Holthuijsen DDB, Kolen AM, et al. The effect of additional protein on lean body mass preservation in post-bariatric surgery patients: a systematic review. Nutr J. 2021;20(1):27. doi:10.1186/s12937-021-00688-3
Sarri G, Patorno E, Yuan H, et al. Framework for the synthesis of non-randomised studies and randomised controlled trials: a guidance on conducting a systematic review and meta-analysis for healthcare decision making. BMJ Evid-Based Med. Published online December 9, 2020. doi:10.1136/bmjebm-2020-111493
Ballesteros-Pomar MD, González-Arnáiz E, Pintor-de-la Maza B, et al. Bioelectrical impedance analysis as an alternative to dual-energy x-ray absorptiometry in the assessment of fat mass and appendicular lean mass in patients with obesity. Nutrition. 2022;93:111442. doi:10.1016/j.nut.2021.111442
Sizoo D, de Heide LJM, Emous M, van Zutphen T, Navis G, van Beek AP. Measuring Muscle Mass and Strength in Obesity: a Review of Various Methods. Obes Surg. 2021;31(1):384-393. doi:10.1007/s11695-020-05082-2
Coyne JC, Thombs BD, Hagedoorn M. Ain’t necessarily so: Review and critique of recent meta-analyses of behavioral medicine interventions in health psychology. Health Psychol. 2010;29(2):107-116. doi:10.1037/a0017633
Downloads
Additional Files
Posted
Categories
License
Copyright (c) 2024 Julia Hussien, Marine Asselin, Dale Bond, Yin Wu, Valentina Ly, David Creel, Pavlos Papasavas, Bret Goodpaster, Aurélie Baillot (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.