Don't 'Bypass' Exercise After Weight Loss Surgery

Gastric bypass surgery patients may reduce diabetes risk and improve overall health with exercise

(RxWiki News) Having weight loss surgery can improve obese patients' health, but it isn't a fix-all for health problems tied to being obese. Exercise may improve these patients' overall health even more and lower their risk for diabetes.

Patients who exercised moderately after weight loss surgery decreased their risk of developing type 2 diabetes, a new study found. Exercise also improved these patients' ability to move oxygen to their lungs. Regular exercise can also decrease the risk of heart disease and stroke.

"A multidisciplinary approach both before and after surgery, incorporating core strengthening exercises, has been shown to be an excellent tool for achieving substantial and sustained weight loss," said Allan David MacIntyre, DO, a bariatric surgeon at Surgical Weight Loss Solutions Las Vegas.

Dr. MacIntyre said that his practice offers an integrated program that includes nutritional counseling, exercise and support groups.

The authors of this new study said weight loss (bariatric) surgery programs should include a doctor-approved exercise plan after surgery.

"The data support the inclusion of an exercise program following bariatric surgery to further enhance the health of individuals who opt for surgery to lose weight," said study author Bret H. Goodpaster, PhD, of the Translational Research Institute for Metabolism and Diabetes (TRI-MD) in Orlando, FL, in a press release.

Bariatric surgery is used for people who are severely obese. Patients must have tried to lose weight without success to qualify for this type of surgery.

Dr. Goodpaster and colleagues studied people who had had a type of weight loss surgery called Roux-en-Y bypass. This surgery creates a new and much smaller stomach pouch. This keeps patients from being able to digest large amounts of food. They eat less and lose weight.

The patients were 41 years old on average. Dr. Goodpaster and team divided the 128 patients into two groups. After the surgery, one group began a supervised exercise program. Each patient exercised moderately for 120 minutes a week for six months. This group also received education about medication use, nutrition and upper-body stretching.

The second group did not exercise but received the same education.

Both groups of patients lost around 50 pounds after six months. But the exercise group showed other improvements.

After 24 weeks, the exercise group was 30 percent more fit than the education-only group. Being physically fit decreases the risk of heart disease, type 2 diabetes and stroke, among other conditions. People who are physically fit also tend to live longer, Dr. Goodpaster and team noted.

Insulin sensitivity also improved in the exercise group. Insulin is a hormone that affects blood sugar. Obese people tend to be less sensitive to insulin. They also have trouble processing sugar. When people are insulin-resistant, they are more likely to develop type 2 diabetes.

This study was published Dec. 1 in the Journal of Clinical Investigation.

The National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases funded the study. Study author John M. Jakicic received personal fees from Kaiser Permanente. Kaiser Permanente provides insurance coverage for bariatric surgery. George M. Eid received personal fees from Covidien and from Apollo Endosurgery. Both companies make surgical products used in bariatric surgery.

Review Date: 
December 2, 2014