Essential Exercise After Bariatric Surgery: Tips for a Strong Recovery

It's well known that exercise, whether or not you've had weight loss surgery, leads to a change in body composition. But did you know there are even more beneficial effects of exercise? In the majority of reports on exercising in the bariatric population, a positive effect on anthropometrics, cardiovascular risk factors, and physical fitness was described. Today we will discuss the parameters of a beneficial exercise program, how long it should last, common questions patients ask when starting a new routine, and when to get started for optimal and lasting results.

Obesity is a major contributor to a wide variety of diseases, including diabetes, hypertension, dyslipidemia, and obstructive sleep apnea syndrome. The only treatment with a longstanding effect is bariatric surgery, and there is extensive knowledge that exercise helps one gain better physical fitness and quality of life.

You were probably told by your bariatric surgeon to start exercising in some capacity before your surgery to help you get ready and establish a good habit of exercise that you will need post-op for long-term success. The American Society for Metabolic and Bariatric Surgery (ASMBS) recommends mild exercise (including aerobic conditioning and light resistance training) 20 min/day 3 - 4 days/week prior to surgery to improve cardiorespiratory fitness, reduce the risk of surgical complications, facilitate healing, and enhance postoperative recovery. Following these guidelines will improve your cardiovascular health and fitness and reduce the risk of surgical complications by healing and enhancing postoperative recovery. Establishing exercise habits prior to surgery will make it much less challenging to get back into it once your surgery has been completed and you've been cleared to start exercising again.

How long should I wait before going to the gym post-op?

After weight loss surgery, you will need to be extremely careful to not overdo it when it comes to exercise, and do not perform any exercises that could potentially damage your incision, as this will cause more harm than good. A general guideline is to wait at least 1-2 weeks before exercising. Also, you did just have surgery, and you'll be sore. You have to allow your body time to heal and adapt. For the first 6-8 weeks after surgery, stick to walking to allow your body to recover and heal properly. This will also give you time to get used to your new, changing body.

1-month post-op

During the first 4 weeks after surgery, your focus should be on flexibility exercises, deep breathing, and getting back to performing your normal activities of daily life. Gradually incorporate low-intensity aerobic exercises. Try walking for 10-minute stretches until you've worked your way up to 30 minutes, 5 days a week. If walking for longer durations at one time is too difficult, you can break it up into 2-3 sessions throughout the day, reaching your goal of 30 minutes total most days of the week.

2-3 months post-op

By now, your body has adapted to walking. Now, you can start to add variety, and you may choose to go to the gym. There, you can try different types of cardio machines like the stationary bike or the elliptical. Aqua aerobics is also a great idea; it's especially wonderful for working the entire body while keeping the added stress and pressure off your knees and joints. You'll want to avoid abdominal exercises for 8-12 weeks after surgery to allow your incision(s) to heal completely. This also helps alleviate abdominal hernias near or around the incision.

4-6 months post-op

Now, you can start to incorporate light strength training and resistance training in your weekly routine. Start with lighter weights and lower volumes, and increase as your tolerance and strength improves. Rapid weight loss can affect your balance and coordination, making it more challenging to do certain exercises, such as yoga, Pilates, and Zumba. Please use caution, and avoid specific exercises during this period. It's not worth risking an injury.

6-12 months post-op

By this point, you should be feeling great and be able to perform both strength training and cardiovascular exercises on a regular basis without issue. Nevertheless, you'll want to be mindful and make sure you aren't pushing yourself harder than your body can handle. Listen to your body, and be sure to rest accordingly.

1 year and beyond

Congratulations! You made it through the first year, and you're feeling great. You've lost a significant amount of weight and gained a whole new outlook on life. At this point, you should be able to start increasing the intensity and frequency of your workouts. Adding abdominal/core exercises should be beneficial at this point. Exercising after weight loss surgery will not only improve your quality of life; it will also help you reach and maintain your weight loss goals quicker and more efficiently.

Before starting any kind of exercise program, please obtain clearance from your surgeon or health care provider. They are best suited to know when it will be ideal for you to begin. Start with lower intensity exercises, and gradually work your way up as your body adjusts to the rapid weight loss and your new lifestyle. Make sure you're doing some kind of physical activity every day. This will play a huge role in your long-term success. Even if it takes you a little longer than others to get into a routine/the habit of exercising on a regular basis, you are on your own journey. Keep your eyes forward, always seek to improve, and never give up!

References:

• Pouwels S, Wit M, Teijink JA, Nienhuijs SW. Aspects of Exercise before or after Bariatric Surgery: A Systematic Review. Obesity Facts. 2015;8(2):132-146.
• Jeffrey I. Mechanick et al. / Surgery for Obesity and Related Diseases 16 (2020) 175 - 247.
• King WC, Bond DS. The importance of preoperative and postoperative physical activity counseling in bariatric surgery. Exerc Sport Sci Rev. 2013;41(1):26-35.

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