The Role of Exercise Post Bariatric Surgery

Embarking on a journey towards significant weight loss through bariatric surgery is a life-altering decision, but it’s just the beginning of a transformative path. While surgery can kickstart the process, maintaining long-term benefits requires dedication and strategic lifestyle changes. In this blog post, we delve into the importance of post-bariatric strength training and how it can maximise the benefits of your weight loss journey.

 

The Power of Bariatric Surgery

Bariatric surgery offers a profound opportunity for individuals to achieve substantial weight loss and alleviate the burden of obesity-related health conditions. Research indicates that post-surgery, clients typically experience an impressive ~32% reduction in total body weight, leading to significant improvements in mobility, quality of life, and overall well-being. However, the journey doesn’t end with surgery; it’s essential to implement sustainable lifestyle interventions to maintain these positive health outcomes in the long term.

 

Understanding the Role of Strength Training

While cardiovascular exercise plays a crucial role in overall fitness, strength training holds particular importance post-bariatric surgery. It helps to preserve lean muscle mass, boost metabolism, and improve overall body composition. Research suggests that even just a few sessions per week of moderate-intensity strength training can lead to significant health improvements. However, not all exercises are created equal; focusing on fitness, strength, and flexibility is key to a well-rounded routine.

 

Real-Life Insights

Let’s consider the story of a 50-year-old woman who underwent gastric sleeve surgery and experienced a remarkable 31% reduction in total body weight over 14 months. While her progress seemed positive initially, a closer look revealed a concerning loss of skeletal muscle mass. This highlights the importance of incorporating structured strength training into the post-operative routine to preserve muscle mass and prevent metabolic slowdown.

She achieved these results by:

• Having less calories than she usually does
• Focusing on eating a high protein intake
• Walking 4-5 times per week for 45 min.

Graph 1. Displays the pre-operative weight in January 2023 (~93kg) and post operative weight in March 2024 (~65kg), a 31% weight reduction.

 

 

Graph 2.  ~5kg loss in skeletal muscle mass from Jan 2023 to March 2024

Graph 3. Total Skeletal Muscle Mass relative to BMI risk category

 

This lady fortunately had a bioimpedance scan at the clinic pre-op and 14 months post-op. The great thing about the bioimpedance scan is that it differentiates what the weight in our body is. We get a snapshot of what is muscle and what is fat mass. This particular lady had lost 5kg of muscle mass, which is about 18% of the total weight that she had lost so far.

As seen in Graph 3 losing 5kg of muscle mass has now placed her at critically low levels of muscle mass, which means her metabolism is lower than ideal and would also place her at risk of rebounding in future years. We clearly need to make some changes to her weekly routine.

She had been prescribed a strength program but changed jobs and lost her structure and as a result hadn’t been completing it. We can confidently make the assumption that is she had regularly completed the strength program over the 14 months we would have seen that muscle mass loss reduce or even potentially even swing to a positive number.

The reason why this is an issue is because now her muscle mass has dropped down to a critical level. We can turn this around and she is motivated to do so, but possibly we could have avoided it by simply completing 2-3 moderate strength sessions (home or gym based) each week. Please note there are specific exercises, sets and reps that are more likely to assist with holding muscle mass and bone mass and this is why we advise you to consult an Exercise Physiologist.

It is important to define what the weight number of the set of standard scales actually is. It is predominately a combination of fat mass, bone mass, muscle mass, organs and fluid.

What is the ultimate health Goal?

• Reduce fat mass to healthy levels (we need essential fat).
• Have as much skeletal muscle mass as possible as muscle is important for body function i.e. doing active daily living tasks and also because muscle mass is hungry and wants to eat energy (food), more muscle mass equals a higher metabolism.
• Maintain or improve bone density (we don’t want fractures if you fall over).
• Not have your mental health focusing on a vague number a set of scales gives you, rather focusing on enjoying and doing activities that promote muscle mass development and also burn up fat mass, complimented by making healthy food choices most of the time.

 

The Importance of Resistance Training

Resistance training, in particular, plays a critical role in maintaining muscle mass and promoting overall health post-surgery. It helps to increase fat mass loss, improve metabolism, reduce the risk of chronic diseases, and enhance mental well-being. By engaging in regular resistance training, individuals can safeguard their long-term weight loss success and enjoy a higher quality of life.

On average people who have bariatric surgery lose 8kg of muscle mass during surgery, which may cause some serious long-term consequences if not managed or addressed properly through expert advice. Skeletal muscle mass plays a crucial role in the human body, providing support, protection, movement, storage, red blood cells, and endocrine functions. Maintaining adequate skeletal muscle mass is essential for overall well-being, functionality, support, and health.

Research has suggested that individuals who engage in regular structured exercise have a 28% increase in fat mass loss and an 8% increase in lean muscle mass gained, compared with those who don’t engage in physical activity.

Engagement in regular exercise programs, specifically resistance training has been shown to:

• Maintain weight loss
• Improve metabolism. Strength training has an anabolic effect.
• Reduce the risk of heart diseases and cancers.
• Improve quality of life and overall mental health.
• Promotes joint stability and integrity.
• Maintain function, strength and endurance of activities of daily living.
• Promote protein synthesis.

Incorporating strength training into your post-bariatric surgery journey is crucial for maximising the benefits and ensuring long-term success. By preserving muscle mass, boosting metabolism, and improving overall health, you can enjoy lasting improvements in mobility, vitality, and well-being. At Perth Weight Loss Surgery, we’re here to support you every step of the way on your transformative journey to a healthier, happier you.