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Imhagen A, Karlsson J, Ohlsson-Nevo E, Stenberg E, Jansson S, Hagberg L. Levels of Physical Activity, Enjoyment, Self-Efficacy for Exercise, and Social Support Before and After Metabolic and Bariatric Surgery: a Longitudinal Prospective Observational Study. Obes Surg 2023; 33:3899-3906. [PMID: 37837533 PMCID: PMC10687134 DOI: 10.1007/s11695-023-06887-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/29/2023] [Accepted: 10/04/2023] [Indexed: 10/16/2023]
Abstract
INTRODUCTION Physical activity (PA) after metabolic and bariatric surgery (MBS) can influence weight loss, health status, and quality of life. Known mediators to participate in PA are enjoyment, self-efficacy, and social support. Little is known about PA behavior in MBS individuals. The aim of this study was to explore levels of PA and the PA mediators enjoyment, self-efficacy, and social support before and after MBS and to investigate changes over time. METHODS Adults scheduled to undergo MBS were recruited from a Swedish university hospital. Accelerometer-measured and self-reported PA, body weight, and PA mediators were collected at baseline and at 12 to 18 months post-surgery. RESULTS Among 90 individuals included, 50 completed the follow-up assessment and had valid accelerometer data. Sedentary time (minutes/day) was unchanged, but sedentary time as percentage of wear time decreased significantly from 67.2% to 64.5% (p<0.05). Time spent in light PA and total PA increased significantly from 259.3 to 288.7 min/day (p < 0.05) and from 270.5 to 303.5 min/day (p < 0.01), respectively. Step counts increased significantly from 6013 to 7460 steps/day (p < 0.01). There was a significant increase in self-reported PA, enjoyment, self-efficacy for exercise, and positive social support from family. The increase in PA mediators did not lead to a significant change in time spent in moderate to vigorous PA. CONCLUSION The increase in PA-mediators was not associated with an increase in moderate to vigorous PA, but the strengthened PA mediators suggest potential for an increase in moderate to vigorous PA in patients undergoing MBS.
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Affiliation(s)
- Annika Imhagen
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden.
| | - Jan Karlsson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden
| | - Emma Ohlsson-Nevo
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden
- Department of Surgery, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden
| | - Erik Stenberg
- Department of Surgery, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden
- School of Medical Sciences, Örebro University, SE-701 82, Örebro, Sweden
| | - Stefan Jansson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden
| | - Lars Hagberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden
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Sundgot-Borgen C, Bond DS, Sniehotta FF, Kvalem IL, Hansen BH, Bergh I, Rø Ø, Mala T. Associations of changes in physical activity and sedentary time with weight recurrence after bariatric surgery: a 5-year prospective study. Int J Obes (Lond) 2023; 47:463-470. [PMID: 36828898 PMCID: PMC9951836 DOI: 10.1038/s41366-023-01284-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Increasing physical activity and limiting sedentary time may minimize weight recurrence after bariatric surgery. However, few studies have evaluated potential associations of objectively-measured physical activity and sedentary time with post-surgical weight recurrence over time. AIMS To evaluate associations of change in physical activity and sedentary time with weight recurrence after bariatric surgery. METHODS Participants from the Oslo Bariatric Surgery Study, a prospective cohort study, wore an ActiGraph monitor for seven days at 1- and 5 years after surgery to assess daily physical activity and sedentary time. Participants' weight was measured at in-person clinic visits. Chi-square Test and Paired-samples T-test evaluated group differences and change over time, while Pearson's Correlation, multiple logistic and linear regression investigated associations between variables. RESULTS Five years after surgery 79 participants (70.5% response rate, 81% female) (mean (sd) age: 54.0 (±9.3), BMI: 32.1 (±4.7)) had valid monitor data. Participants increased their sedentary time (71.4 minutes/day (95% CI: 54.2-88.6, p = <0.001)) and reduced daily steps (-1411.1 (95% CI: 737.8-208.4), p = <0.001), light physical activity (-54.1 min/day (95% CI: 40.9-67.2, p = <0.001)), and total physical activity (-48.2 (95% CI: 34.6-63.3), p = <0.001) from 1- to 5 years after surgery. No change was found for moderate-to-vigorous intensity physical activity. No associations were found between changes in steps, physical activity or sedentary time and weight recurrence. CONCLUSION Participants increased sedentary time and decreased light- and total physical activity between 1- and 5 years post-surgery. Overall, changes in physical activity and sedentary time were not associated with weight recurrence. Interventions to help patients increase physical activity and limit sedentary time after bariatric surgery are needed.
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Affiliation(s)
- C. Sundgot-Borgen
- grid.55325.340000 0004 0389 8485Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - D. S. Bond
- grid.277313.30000 0001 0626 2712Department of Surgery and Research, Hartford Hospital, Hartford, CT USA
| | - F. F. Sniehotta
- grid.1006.70000 0001 0462 7212Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK ,grid.7700.00000 0001 2190 4373Department of Public Health, Preventive and Social Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - I. L. Kvalem
- grid.5510.10000 0004 1936 8921Department of Psychology, University of Oslo, Oslo, Norway
| | - B. H. Hansen
- grid.23048.3d0000 0004 0417 6230Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | | | - Ø. Rø
- grid.55325.340000 0004 0389 8485Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - T. Mala
- grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, University of Oslo, Oslo, Norway ,grid.55325.340000 0004 0389 8485Center for Morbid Obesity and Bariatric Surgery, Oslo University Hospital, Oslo, Norway
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The Need for Objective Physical Activity Measurements in Routine Bariatric Care. Obes Surg 2022; 32:2975-2986. [PMID: 35739414 PMCID: PMC9392711 DOI: 10.1007/s11695-022-06165-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/12/2022] [Accepted: 06/15/2022] [Indexed: 11/17/2022]
Abstract
Purpose This study aims to (1) quantify physical behavior through self-reports and sensor-based measures, (2) examine the correlation between self-reported and sensor-based physical activity (PA) and (3) assess whether bariatric patients adhere to PA guidelines. Methods A Fitbit accelerometer was used to collect minute-to-minute step count and heart rate data for 14 consecutive days. Total physical activity levels (PAL), moderate-to-vigorous intensity physical activity (MVPA) and sedentary behavior (SB) were used to quantify physical behavior. Self-reported PA was assessed with the International Physical Activity Questionnaire (IPAQ). To analyze the association between sensor-based and self-reported PA, Spearman’s correlation was used. A minimum of 150 MVPA minutes per week was considered as compliance with the PA guidelines. Results Fitbit data of 37 pre- and 18 post-surgery patients was analyzed. Participants averaged 7403 ± 3243 steps/day and spent most of their time sedentary (832 min, IQR: 749 – 879), especially in prolonged periods of ≥ 30 min (525, IQR: 419 – 641). Median MVPA time was 5.6 min/day (IQR: 1.7 – 10.6). Correlations between self-reported and sensor-based MVPA and SB were respectively 0.072 and 0.455. Only 17.1% was objectively adherent to MVPA guidelines ≥ 150 min/week, while 94.3% met the guidelines in case of self-reports. Conclusion PA quantification confirmed that bariatric patients are highly sedentary and rarely engage in MVPA, despite a relatively high daily step count. Moreover, bariatric patients are not able to assess MVPA and moderately their SB by self-reports. Our results indicate the need for sensor-based PA monitoring in routine bariatric care. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s11695-022-06165-y.
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What Is Weight Loss After Bariatric Surgery Expressed in Percentage Total Weight Loss (%TWL)? A Systematic Review. Obes Surg 2021; 31:3833-3847. [PMID: 34002289 DOI: 10.1007/s11695-021-05394-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/21/2021] [Accepted: 03/25/2021] [Indexed: 12/15/2022]
Abstract
Percentage total weight loss (%TWL) might be better than percentage excess weight loss to express weight loss in bariatric surgery. In this systematic review, performed according to the PRISMA statement, results of laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB) are assessed in %TWL. A total of 13,426 studies were screened and 49 included, reporting data of 24,760 patients. The results show that, despite limiting data, LRYGB is favorable over LSG in terms of weight loss in short-term follow-up. Although recent guidelines recommend to use %TWL when reporting outcome in bariatric surgery, this study shows that there is still insufficient quality data in %TWL, especially on LSG. The use of %TWL as the primary outcome measure in bariatric surgery should be encouraged.
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de Aguiar JB, Gurgel LA, Santos ALB, Arruda SPM. Barriers to Physical Exercise and Associated Factors in the Pre- and Postoperative Periods of Bariatric Surgery. Obes Surg 2021; 31:1696-1704. [PMID: 33394252 DOI: 10.1007/s11695-020-05183-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/09/2020] [Accepted: 12/21/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND To compare the barriers to exercise and its associated factors among patients in the pre- and postoperative periods of bariatric surgery. METHODS Cross-sectional study with patients who were split into preoperative (n = 81) and postoperative (n = 209) groups. It was collected sociodemographic characteristics, and the Exercise Benefits Barriers Scale was adopted in order to identify the barriers related to exercise practice. Chi-square, Mann-Whitney, and Poisson regression were applied for comparisons and associations. RESULTS The postoperative group had a lower score on the barrier scale, except for the lack of time subdimension. In the preoperative, the subjects were considered physically active (p = 0.03), and those over 42 years old (p < 0.001) had the lowest score in lack of time subdimension. Those with a body mass index (BMI) higher than 36.89 kg/cm2 had a higher overall score on the scale (p < 0.001), also in the lack of time (p = 0.003) and physical effort subdimensions (p < 0.001). Those with higher education scored more in the lack of time (p = 0.014) and family discouragement subdimensions (p = 0.034). In the postoperative, the participants considered active had the lowest score on the general scale, as well as in all subdimensions (p < 0.001), and the ones with higher education presented better scores in physical effort subdimension (p = 0.041). CONCLUSIONS The preoperative group had a higher score of barriers to practice exercises related to physical effort, environment, and family discouragement, when compared to the postoperative. The factors associated were physical inactivity, BMI over 36.89 kg/cm2, age 42 years old or under, and higher education.
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Affiliation(s)
- Jaina Bezerra de Aguiar
- Health Sciences Center, Ceará State University, Avenue Dr Silas Munguba, 1700, Fortaleza, Ceará, 84030-900, Brazil.
| | - Luilma Albuquerque Gurgel
- Health Sciences Center, Ceará State University, Avenue Dr Silas Munguba, 1700, Fortaleza, Ceará, 84030-900, Brazil
| | - Ana Luisa Batista Santos
- Health Sciences Center, Ceará State University, Avenue Dr Silas Munguba, 1700, Fortaleza, Ceará, 84030-900, Brazil
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Kovacs SJ, Courcoulas AP, Rogers RJ, Davis KK, Jakicic JM. Psychosocial factors associated with physical activity in patients who have undergone bariatric surgery. Surg Obes Relat Dis 2020; 16:1994-2005. [PMID: 32919909 DOI: 10.1016/j.soard.2020.07.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/11/2020] [Accepted: 07/26/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Identifying psychosocial variables associated with physical activity may lead to the development of interventions that better address the challenges to participating in physical activity experienced by postbariatric surgery patients. OBJECTIVE To examine associations between select psychosocial variables and physical activity in patients who had undergone bariatric surgery within the past 2 years. SETTINGS Bariatric surgery candidates were recruited from the Greater Pittsburgh region. METHODS Eighty-three patients who had undergone bariatric surgery self-reported current physical activity and select psychosocial constructs. In addition, participants provided retrospective information on physical activity and psychosocial constructs before surgery. RESULTS Patients increased physical activity from baseline (median = 156.00 [25th, 75th percentiles: 53.00, 600.00] kcal/week) to post surgery (median = 976.00 [25th, 75th percentiles: 344.00, 1832.00] kcal/week) (P < .001). A number of pre- to postsurgery changes in psychosocial variables were associated with change in physical activity; however, only change in fitness orientation (P = .001), change in social support from friends (P = .005), and change in self-reported weight (P = .012) emerged as predictors of change in physical activity from pre- to postsurgery. Several postsurgery psychosocial factors were also significantly associated with postsurgery physical activity, but only postsurgery fitness orientation (P < .001), social support from co-workers (P = .002), and physical function (P = .023) emerged as predictive of the amount of postsurgical PA. CONCLUSIONS Pre- and postbariatric surgery interventions aimed at increasing physical activity participation may need to target important constructs that include the encouragement of social support and strategies to enhance the effort individuals put forward to engage in physical activity, as well as a focus on enhancing physical function and awareness of weight status.
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Affiliation(s)
- Sara J Kovacs
- Department of Kinesiology, Temple University, Philadelphia, Pennsylvania.
| | - Anita P Courcoulas
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Renee J Rogers
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania; Healthy Lifestyle Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kelliann K Davis
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - John M Jakicic
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania; Healthy Lifestyle Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
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Baillot A, Black M, Brunet J, Romain AJ. Biopsychosocial correlates of physical activity and sedentary time in adults with severe obesity. Clin Obes 2020; 10:e12355. [PMID: 31965721 DOI: 10.1111/cob.12355] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/10/2019] [Accepted: 01/03/2020] [Indexed: 11/30/2022]
Abstract
Adults with severe obesity have poorer health, are less active and spend more time sedentary compared to people with a lower body mass index (BMI). There is a pressing need to understand the factors associated with low physical activity (PA) and excessive sedentary time to develop more effective behaviour change interventions for this population. The purpose of this study was to identify biopsychosocial correlates of PA and sedentary time in adults living with severe obesity. Forty-four adults living with severe obesity (age = 50.5 ± 13.3 years; BMI = 44.3 ± 7.8 kg/m2 ) completed a survey including questions on sociodemographic characteristics, comorbidities, psychosocial factors (eg, social physique anxiety [SPA], social support for PA, PA level self-perception), quality of life, daily pain and self-reported moderate-to-vigorous intensity PA (MVPA). Participants also completed the 6-minute walk test (6MWT) to assess physical fitness and wore an accelerometer to assess objective PA and sedentary time. In stepwise linear multivariate analyses, higher objective MVPA was associated with higher 6MWT distance, being single and lower SPA (R2 = 0.46, P < .001), whereas higher self-reported MVPA was associated with greater PA level self-perceptions (R2 = 0.47, P < .001). Greater objective light intensity PA was associated with greater quality of life and self-efficacy for PA (R2 = 0.26, P = .001). Greater sedentary time was associated with having more comorbidities (R2 = 0.25, P < .001). This study shows that adults living with severe obesity who have more comorbidities, poorer quality of life and/or lower self-efficacy perception for PA are more likely to be sedentary and to practice less light intensity PA. Additionally, those who were in a relationship, had higher SPA and/or had lower physical fitness practiced less MVPA. Future research is needed to determine causal effects.
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Affiliation(s)
- Aurélie Baillot
- Université du Québec en Outaouais, Gatineau, Québec, Canada
- Centre de recherche du Centre Intégré de Santé et Services Sociaux de l'Outaouais, Gatineau, Québec, Canada
- Institut du savoir Montfort-Recherche, Ottawa, Ontario, Canada
| | - Melissa Black
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Jennifer Brunet
- Institut du savoir Montfort-Recherche, Ottawa, Ontario, Canada
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Ahmed J Romain
- Faculty of Medicine, School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montreal, Québec, Canada
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Does Lifestyle Intervention After Gastric Bypass Surgery Prevent Weight Regain? A Randomized Clinical Trial. Obes Surg 2020; 29:3419-3431. [PMID: 31363961 DOI: 10.1007/s11695-019-04109-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Weight regain after bariatric surgery often starts after 1-2 y, but studies evaluating strategies to prevent weight regain are lacking. The aim of this intervention was to evaluate the efficacy of a 2-y-group-based lifestyle intervention starting approximately 2 y after Roux-en-Y gastric bypass (RYGB) compared with usual care on weight regain and related metabolic risk factors. METHODS A total of 165 patients with a mean of 21 months (range 14-32) after RYGB were randomized to a lifestyle intervention group (LIG) or a usual care group (UCG). Of the 165 participants 86% completed the study. The LIG was offered 16 group meetings over 2 y with focus on healthy diet, physical activity, and behavioural strategies to prevent weight regain, in addition to usual care. RESULTS Mean (SD) total weight loss at study start was 30.1 ± 8.2%, while weight regain during the intervention was 4.9 ± 7.4 and 4.6 ± 9.2% in the LIG and UCG, respectively (P = 0.84). There were no differences in metabolic risk factors between the groups. The LIG participants attended 8 ± 4 group meetings, with no difference in weight regain between participants with high compared to lower participation. In all the participants, a positive association between weight increase from nadir to study start and weight regain during the intervention was found. Participants who reported physical activity ≥ 150 min/wk had smaller % weight regain compared with less active participants (β = - 5.2 [SE 2.0, 95% CI - 9.1 to - 1.4]). CONCLUSION We found no difference in weight regain between LIG and UCG.
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Missing Something? Comparisons of Effectiveness and Outcomes of Bariatric Surgery Procedures and Their Preferred Reporting: Refining the Evidence Base. Obes Surg 2020; 30:3167-3177. [PMID: 32415632 PMCID: PMC7305092 DOI: 10.1007/s11695-020-04659-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Comparisons of effectiveness of bariatric surgery (BS) procedures encompass weight loss, metabolic/clinical outcomes, and improvements or worsening of comorbidities. Post-operative physical activity (PA) and diet influence such outcomes but are frequently not included in comparisons of effectiveness. We assessed the value and necessity of including post-operative PA/diet data when comparing effectiveness of BS. Including post-operative PA/diet data has significant benefits for BS and patients. The paper proposes an explicit preferred reporting system (Preferred REporting of post-operative PHYsical activity and Diet data in comparisons of BS effectiveness: PRE-PHYD Bariatric). Including post-operative PA/diet data could result in more accurate appraisals of effectiveness of BS procedures. This could translate into better 'individualized' BS by achieving a better 'fit' between patient and procedure.
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Quality of Life, BMI, and Physical Activity in Bariatric Surgery Patients: a Structural Equation Model. Obes Surg 2020; 30:2927-2934. [DOI: 10.1007/s11695-020-04615-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Possmark S, Sellberg F, Willmer M, Tynelius P, Persson M, Berglind D. Accelerometer-measured versus self-reported physical activity levels in women before and up to 48 months after Roux-en-Y Gastric Bypass. BMC Surg 2020; 20:39. [PMID: 32103734 PMCID: PMC7045736 DOI: 10.1186/s12893-020-00699-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 02/14/2020] [Indexed: 01/07/2023] Open
Abstract
Background Roux-en-Y Gastric Bypass (RYGB) patients overestimate their time spent in moderate-to-vigorous physical activity (MVPA) to a greater extent post-surgery than pre-surgery. However, there is no data on discrepancy between self-reported and accelerometer-measured MVPA beyond nine months post-RYGB. The aim was to investigate how the duration of MVPA (main outcome) differs when comparing a self-administered questionnaire to accelerometer-data from pre-surgery and up to 48 months post-RYGB. Methods Twenty-six (38%) RYGB-treated women with complete data from the original cohort (N = 69) were included. Participants were recruited from five Swedish hospitals. Mean pre-surgery BMI was 38.9 (standard deviation (SD) = 3.4) kg/m2 and mean age 39.9 (SD = 6.5) years. MVPA was subjectively measured by a self-administered questionnaire and objectively measured by the ActiGraph GT3X+ accelerometer at 3 months pre-RYGB and 9- and 48 months post-RYGB. Means and SD were calculated at 3 months pre- and 9- and 48 months post-RYGB. We calculated the P-values of the differences with Wilcoxon Signed-Rank test. For correlations between the self-administered questionnaire and the accelerometers, Spearman’s rank correlation was used. Results Participants significantly overestimated (i.e. self-reported more time spent in MVPA compared to accelerometry) their MVPA in a higher degree post- compared to pre-RYGB surgery. Compared to pre-surgery, self-reported MVPA increased with 46.9 and 36.5% from pre- to 9- and 48 months, respectively, whereas changes were a 6.1% increase and 3.5% decrease with accelerometers. Correlations between self-reported and accelerometer-measured MVPA-assessments were poor at all measurement points (r = 0.21–0.42) and only significant at 48 months post-RYGB (P = 0.032). Conclusions The discrepancy between self-reported and objectively assessed MVPA within the same individual is greater up to 48 months post-RYGB compared to before surgery. To help bariatric patients understand and hopefully increase their physical activity behaviors post-surgery, objective measures of physical activity should be used.
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Affiliation(s)
- Sofie Possmark
- Department of Global Public Health, Karolinska Institutet, K9, Social Medicine, 171 77, Stockholm, Sweden.
| | - Fanny Sellberg
- Department of Global Public Health, Karolinska Institutet, K9, Social Medicine, 171 77, Stockholm, Sweden
| | - Mikaela Willmer
- Department of Health and Caring Sciences, University of Gävle, 801 76, Gävle, Sweden
| | - Per Tynelius
- Department of Global Public Health, Karolinska Institutet, K9, Social Medicine, 171 77, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Stockholm County Council, Box 45436, 104 31, Stockholm, Sweden
| | | | - Daniel Berglind
- Department of Global Public Health, Karolinska Institutet, K9, Social Medicine, 171 77, Stockholm, Sweden
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Beltrán-Carrillo VJ, Jiménez-Loaisa A, Jennings G, González-Cutre D, Navarro-Espejo N, Cervelló E. Exploring the socio-ecological factors behind the (in)active lifestyles of Spanish post-bariatric surgery patients. Int J Qual Stud Health Well-being 2020; 14:1626180. [PMID: 31187702 PMCID: PMC6566659 DOI: 10.1080/17482631.2019.1626180] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Purpose: Physical activity (PA) is considered essential for the treatment of morbid obesity and the optimization of bariatric surgery outcomes. The objective of this article was to identify the facilitators and barriers that bariatric patients perceived to do PA one year after finishing a PA programme for the promotion of a long-term active lifestyle. This objective was addressed from a socio-ecological and qualitative perspective. Methods: Nine patients (eight women and one man), aged between 31 and 59 years, participated in semi-structured interviews directly following the PA programme and one year after it. A content analysis was carried out to analyze the qualitative data. Results: Weight loss, improvement of physical fitness, perceived competence, and enjoyment were the main facilitators of PA. Complexes related to skin folds, osteoarthritis, perceived unfavourable weather conditions, lack of social support and economic resources, long workdays, lack of specific PA programmes, and other passive leisure preferences were the main barriers to participate in PA. Conclusions: Results highlight the important interplay between personal, social environmental, and physical environmental factors to explain (in)active behaviours of bariatric patients. The findings of this article could be useful for future research and interventions aimed at promoting PA in bariatric patients.
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Affiliation(s)
| | - Alejandro Jiménez-Loaisa
- a Department of Sport Sciences, Sport Research Centre , Miguel Hernández University , Elche , Spain
| | - George Jennings
- b Cardiff School of Sport and Health Sciences , Cardiff Metropolitan University , Cardiff , UK
| | - David González-Cutre
- a Department of Sport Sciences, Sport Research Centre , Miguel Hernández University , Elche , Spain
| | | | - Eduardo Cervelló
- a Department of Sport Sciences, Sport Research Centre , Miguel Hernández University , Elche , Spain
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Possmark S, Berglind D, Sellberg F, Ghaderi A, Persson M. To be or not to be active - a matter of attitudes and social support? Women's perceptions of physical activity five years after Roux-en-Y Gastric Bypass surgery. Int J Qual Stud Health Well-being 2019; 14:1612704. [PMID: 31072238 PMCID: PMC6522969 DOI: 10.1080/17482631.2019.1612704] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose: Despite positive health advantages of post-surgery physical activity (PA) for bariatric surgery patients, the majority is not sufficiently physically active. The aim was to explore women’s perceptions and experiences concerning PA five years after Roux-en-Y Gastric Bypass (RYGB) surgery. Methods: Eleven women were interviewed five years post-surgery. Grounded Theory approach was applied. Results: The core-category “Attitudes and surrounding environment influence activity levels” includes three attitudes towards PA: “Positive attitudes”, “Shifting attitudes” and “Negative attitudes”. Participants with a positive attitude were regularly physically active, felt supported and proud of their achievements. Contrary, participants with a negative attitude didn’t prioritize PA, didn’t feel supported and saw no need or benefit of PA. Some participants revealed an on-off behaviour, hovering between the attitudes of vigorous PA and sedentary lifestyle, without sustainable balance. The majority mostly viewed PA as a mean to lose weight. Conclusion: The level of perceived post-surgery PA was related to the participants’ attitudes towards PA and whether or not they had a supportive environment. These findings might explain why bariatric surgery patients often fail to be sufficiently active post-surgery, and highlight the need for prolonged support and motivational interventions to promote sustainable PA post-bariatric surgery.
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Affiliation(s)
- Sofie Possmark
- a Department of Public Health Sciences , Karolinska Institutet, K9, Social Medicin , Stockholm , Sweden
| | - Daniel Berglind
- a Department of Public Health Sciences , Karolinska Institutet, K9, Social Medicin , Stockholm , Sweden
| | - Fanny Sellberg
- a Department of Public Health Sciences , Karolinska Institutet, K9, Social Medicin , Stockholm , Sweden
| | - Ata Ghaderi
- b Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden
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Monpellier VM, Janssen IMC, Antoniou EE, Jansen ATM. Weight Change After Roux-en Y Gastric Bypass, Physical Activity and Eating Style: Is There a Relationship? Obes Surg 2018; 29:526-533. [DOI: 10.1007/s11695-018-3560-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Ravelli MN, Schoeller DA, Crisp AH, Racine NM, Pfrimer K, Rasera Junior I, Oliveira MRMD. Accuracy of total energy expenditure predictive equations after a massive weight loss induced by bariatric surgery. Clin Nutr ESPEN 2018; 26:57-65. [DOI: 10.1016/j.clnesp.2018.04.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 04/18/2018] [Indexed: 12/31/2022]
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