Aspects of Exercise before or after Bariatric Surgery

Pouwels, S; Wit, M; Teijink, JA; Nienhuijs, SW

Monday 13th of July 15:10-15:40

CONFLICT OF INTEREST

Sjaak Pouwels

I declare that I have no potential conflict of interest

Welcome

Sjaak Pouwels, MD

Resident and PhD student

Catharina Hospital Obesity Centre Eindhoven, Netherlands

YOU DESERVE A RIBBONThe surprised lady in front of me looked at me in total disbelief: “I’m sorry??” “Yes, I believe you deserve a ribbon; It’s quite something what you’ve pulled off: you lost almost 100 pounds.!” (Van Hout et al. 2015)

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(Un)realistic expectations?

We have some work to do!- Obesity = big problem

- Associated with various diseases; Diabetes, Hypertension, dyslipidemia, OSAS

- Bariatric surgery only treatment with longstanding effect

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Perioperative Exercise- A reduction of 1.5 kg was contributed to exercise

(Cochrane review Shaw et al. 2006)

- Physical training in obese patients 4% Excess Weight Loss (%EWL) (Livhits et al. 2010)

- Reduction of 3.6 kg related to exercise (Egberts et al. 2012)

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What do we have to do?- The positive relationship between exercise seems evident

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But what do we have to do? And when?

Materials and Methods (1)

P: Obese patients with a BMI ≥ 30 kg/m2

I: Exercise training

C: Regular care (no specific exercise training)

O: Improvement of anthropometric variables, physical fitness and cardiovascular risk factors

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Types of exercise programs

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Exercise before surgery

Significant improvement of anthropometric variables (Baillot et al. 2013, Funderburk et al. 2010, Marcon et al. 2011)

Significant improvement of cardiovascular risk factors and inflammation:

- Blood pressure (Funderburk et al. 2010, Marcon et al. 2011)

- Glucose, insulin and blood lipid profile (Marcon et al. 2011, Hickey et al. 1999)

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Exercise before surgery (2)Significant improvement of physical fitness and functional capacity:

-The six-minute walk test distance increased (Funderburk et al. 2010, Marcon et al. 2011, Baillot et al. 2013)

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Exercise after surgerySignificant improvement of anthropometric variables (Castello-Simoes et al. 2013, Stegen et al. 2011, Berggren et al. 2008, Shah et al. 2011)

No significant changes in cardiovascular risk and inflammation

Significant increase in fatty-acid oxidation (Berggren et al. 2008)

Prevention of a decrease in muscle strength by an exercise program (Stegen et al. 2011)

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Challenges in clinical practice

- Supervision (by whom?)

- Timing around surgery

- What do we have to do

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Conclusion- Exercise is good for everyone

- Even for a (future) bariatric patient population

- In current literature Wide range of exercise programs and peri-operative timing

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Thank you for your attention

Exercise Is Good For Everyone!

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