Exercise for Bariatric Surgery Patients

Exercise for bariatric surgery patients is often the first part of a patient’s long-term plan to get skipped following surgery. In reality, it is almost as important as your diet. This page explores why along with the best weight loss surgery exercise options…

  • Why it’s important
  • When is it safe?
  • General post-weight loss surgery exercise guidelines

Why Exercise for Bariatric Surgery Patients is Important

The successful bariatric surgery patient regularly takes part in three main activities in their life after surgery:

  1. Follows an appropriate bariatric diet plan
  2. Actively participates in weight loss surgery support groups
  3. Follows a consistent and progressive exercise routine

Two of these are easier to adhere to…

If you don’t follow your diet plan, you will most likely get sick… ranging from trouble with digestion to vitamin deficiency. This risk – or actually getting sick as any patient who has had dumping syndrome can tell you – keeps most patients in line regardless of their motivation.

Participating in weight loss surgery support groups is the next easiest thing to keep consistent. They’re interactive and fun, and if time is an issue there are great at-home options available in the form of online weight loss support.

Not surprisingly, exercise for bariatric surgery patients is often the component that slips. It can seem daunting, especially after a long day at work or an especially difficult week.

But you must make it a priority for two big reasons:

  1. You will lose more weight
  2. The benefits to your physical and mental health are astounding

Exercise for Bariatric Surgery Patients Causes More Weight Loss

We’ll let the research do the talking…

  • A recent meta-analysis found that consistent exercise for bariatric surgery patients leads to a 4.2% lower body mass index.1
  • Another study compared the weight loss of gastric bypass surgery patients who completed moderately intense physical activity for a minimum of 2 ½ hours per week against those who did not. The 2 ½ hours+ per week patients showed significantly greater weight loss:2
    • 6 months after surgery – 5.5% greater excess weight loss (56.0% vs. 50.5%)
    • 12 months after surgery – 5.7% greater excess weight loss (67.4% vs. 61.7%)
  • Still not convinced? A third study evaluating 200 bariatric surgery patients found that physical activity adherence was the sole significant behavioral predictor of weight loss outside of dietary habits. In other words, other than sticking to your diet plan it’s the main thing you can do to achieve and sustain your weight loss goals.3

So how does exercise contribute to weight loss?

As you probably know, it burns calories. But this is not the main reason it works. After all, if you weigh 275 pounds, you will burn 200 calories per mile walked at a pace of 5 mph. One cup of dried apples has over 200 calories, let alone your entire daily intake. Exercise will only directly burn a small portion of your daily calories.

The more important reason exercise for bariatric surgery patients works is by boosting your metabolism, which is especially important considering your body’s natural tendency to slow down your metabolism as you lose weight (see Set Point Theory). A higher basal metabolic rate means that your body will automatically burn calories at a faster rate even while you are resting, thus leading to additional weight loss.

Exercise for Bariatric Surgery Patients Leads to Superior Physical and Mental Health

To determine exercise’s impact on weight loss surgery patients, one study divided 60 morbidly obese gastric bypass patients into two groups:

  1. Low-exercise (worked out 1 time for 1 hour per week)
  2. Multiple-exercise (worked out 2 times for 1 hour each per week)

In addition to quicker weight loss, the multiple-exercise group had significantly earlier resolution or improvement of obesity health problems.

In fact, exercise for bariatric surgery patients and obese individuals alike has been shown to improve a vast array of physical and mental issues, including:

Physical Improvements Caused By Exercise for Bariatric Surgery Patients

  • Increased life expectancy5
  • Reduced abdominal fat
  • Stronger heart, muscles, bones and lungs
  • Reduced risk of heart disease
  • Lower blood pressure
  • Reduced triglycerides
  • Increased good cholesterol and reduce bad cholesterol
  • Improved blood sugar control
  • Improved insulin control
  • Reduced risk of cancer
  • More energy
  • Improved balance

Mental Improvements Caused By Exercise for Bariatric Surgery Patients

  • Improved appearance
  • Improved motivation and mental “sharpness”
  • Improved libido

When is Exercise for Bariatric Surgery Patients Safe?

Check with your surgeon to be sure, but exercise for bariatric surgery patients can generally begin within three to six weeks following surgery.

But you should begin walking for 20 to 30 minutes per day as soon as you get home. Start with a slow pace and gradually increase the speed at which you walk as your endurance improves.

At first, it’s probably best to spread this out over the day instead of doing it all at once. For example, try going for a 10 minute stroll in the morning, midday and in the evening.

By the time you reach six weeks post-op, you should be able to complete three 10 minute walks per day while walking at a relatively quick pace. After week six, it may be time to begin a more intensive exercise routine including strengthening, flexibility and more aggressive endurance exercises.

Exercise for Bariatric Surgery Patients:
General Guidelines

First, recognize that your ultimate goal is NOT to exercise like a young, lean person. Not only will this make your goals feel more achievable, but it’s simply not necessary.

This stance was confirmed by researchers studying the exercise habits of 100 people: 50 of normal weight who exercised regularly vs. 50 post-gastric bypass patients who achieved 80% or greater excess weight loss. They found that compared to the normal-weight group, the weight loss surgery group maintained a similar body mass index with less rigorous but equally consistent exercise.6

In short, you need to stick to a routine, but you don’t need to win Cross-Fit Trainee of the Year to achieve and maintain a normal BMI.

Now that that’s out of the way, let’s set the foundation for safe and effective exercise for bariatric surgery patients:

  • Start slowly and work your way up. At best, the soreness and fatigue caused by getting too aggressive out of the gate will discourage you. At worst, you could get injured, leaving you unable to exercise for months. Be patient!
  • Prevent skin problems. As you lose more and more weight, loose and sagging skin may present a problem. Short of plastic surgery after weight loss, there are a few things you can do to keep the chafing under control…
    • Apply gels such as Bodyglide to sensitive areas or skin folds to reduce friction.
    • Wear supportive clothing or undergarments that keep the skin tight (but not too tight) against your body.
    • Drink plenty of water – your smaller stomach following surgery can make it tough for your body to absorb the water it needs… especially during and after exercise. Always have water by your side and drink regularly. (See Water After Weight Loss Surgery)
  • Wear good shoes – no one shoe is right for everyone, despite a high price tag. Only buy a pair of shoes if they feel great INSTANTLY after trying them on. In other words, don’t buy a pair hoping to “break them in”.
  • Warm up before exercising and cool down afterwards. The goal of your warm-up is to slowly get your heart rate and breathing up and your muscles loosened in order to prevent muscle injury and maximize the effectiveness of your workouts.
    Your cool down will bring your heart rate and breathing down slowly to prevent dizziness or fainting and to remove waste products from your muscles such as lactic acid. Cooling down may also help to prevent or reduce the severity of sore muscles.
  • Keep your heart rate within the proper range – Your maximum heart rate is a function of your age – the younger you are, the higher it is. According to the American Heart Association (AHA), you should measure your pulse periodically as you exercise and keep your heart rate within 50% to 85% of your maximum heart rate (see chart below).
    Immediately following weight loss surgery (and until you are less than 50 pounds overweight), stay towards the lower end of your range and slowly work your way up as your fitness level progresses. There are two ways to track your heart rate while you exercise:

    • Use a heart rate monitor – this is the easier option, as all you have to do is read the screen. The Omron Heart Rate Monitor/Wristband (aff) is a good option. It’s reasonably priced and has all the bells and whistles, including an alarm option for low and high heart rates and a mounting bracket for treadmills and bikes.
    • Manually take your pulse – place the ends of your index and middle finger on the inside of your other wrist just below your thumb pad muscle. Pressing softly, move your fingers around until you feel your blood pulsing below the skin. Count the beats you feel for 10 seconds using a clock or watch with a second hand as a guide, then multiply your count by six to determine your heart rate per minute.
    The AHA also suggests using a “conversational pace” to keep your heart rate within range in the absence of a monitor or knowledge of how to take your pulse. They advise that “if you can talk and walk at the same time, you aren’t working too hard”, but “if you can sing and maintain your level of effort, you’re probably not working hard enough”.

If you feel pain, STOP IMMEDIATELY. Do not try to work through it. Instead, choose exercises that do not irritate the affected area. For example, if walking hurts your knees, try using a stationary bicycle or elliptical machine.

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