Physical therapists can facilitate exercise programs to improve outcomes and keep patients healthy.
Obesity is a very common problem in the United States, where more than a third of all adults (78.6 million) are obese, with a Body Mass Index (BMI) of 30 or higher. Those with a BMI of 40 or higher are considered severely obese.
Bariatric surgeries are used to treat severe obesity. A range of procedures, which vary considerably in risk and effectiveness, restrict the amount of food that can be consumed, typically resulting in significant weight loss. The surgeries also may improve other obesity-related conditions, including type 2 diabetes, heart disease, stroke, obstructive sleep apnea, and certain types of cancer.
Experts believe that physical activity can help people lose weight and experience other positive outcomes after bariatric surgery. However, because most bariatric patients are relatively inactive prior to surgery, they may have difficulty embracing exercise post-surgery.
Patients considering or recovering from bariatric surgery are more likely to keep the weight off and ultimately enjoy better outcomes when appropriate exercise is incorporated into their treatment plan. This can be challenging for some, but with physical therapy, success is achievable.
Pre-and Post-Surgical Recommendations
To help patients achieve maximum weight loss and other benefits following bariatric surgery, research indicates that patients need reassurance and support before and after surgery, the type of support that can be obtained through physical therapy.
The American Society for Metabolic and Bariatric Surgery (ASMBS) recommends aerobic conditioning and light resistance training of 20 minutes per day, three or four days a week, before bariatric surgery to improve cardiorespiratory fitness, reduce the risk of surgical complications, speed healing, and enhance the potential for recovery. The American Heart Association (AHA) makes similar recommendations.
After surgery, the ASMBS, the Obesity Society, and the American Association of Clinical Endocrinologists all agree that postoperative bariatric patients who lead a healthy lifestyle have a better chance of achieving optimal body weight and improving body composition. This includes a minimum of 30 minutes of exercise per day. To maintain a healthy body weight, increased physical activity is necessary.
Physical Therapy and Bariatric Surgery
Bariatric surgery patients stand to gain noticeable benefits from physical activity under the guidance of a physical therapist. Therapies that can be extremely beneficial include anti-gravity treadmills, balance training, exercises to improve strength and flexibility, and aerobics according to fitness level. Exercise not only helps patients control and manage weight, but it also prevents and manages a variety of chronic medical conditions and improves coronary risk factors.
After bariatric surgery, your physical therapy training regimen should focus on:
- Cardio-aerobic exercise to strengthen the heart and lungs, increase bone density, boost mental sharpness, and produce endorphins to help combat anxiety and depression
- Strength training to maintain lean muscle mass, keep bones strong, and tone and build muscles so patients can remain active
- Flexibility, including walking and stretching exercises to help avoid injury
A post-bariatric surgery exercise program will typically begin slowly as recovery progresses, and gradually evolve over the next six to eight weeks toward the patient’s fitness goals. As the body continues to heal and strengthen, post-bariatric patients will need to increase activity accordingly to help keep the weight off and reclaim their health.