TOPLINE:

An initially large improvement in fitness levels experienced by patients with severe obesity who either had gastric bypass surgery or no intervention over an 11.5-year period ebbed over time but remained higher than fitness levels in nonsurgical patients for more than a decade.

METHODOLOGY:

• Several short-term studies have shown that bariatric surgery improves patients’ fitness levels, but little is known about how long these benefits last.
• Researchers analyzed data of patients with severe obesity who either underwent Roux-en-Y gastric bypass surgery (n = 82; mean age, 43.7 years; 84% women; mean BMI, 45.7) or did not undergo surgery (n = 88; mean age, 46.1 years; 84% women; mean BMI, 42) to examine the long-term effect of metabolic and bariatric surgery on fitness.
• Fitness was evaluated using submaximal treadmill tests at baseline before surgery and 11.5 years later, and a subset of patients (n = 97) also completed maximal treadmill tests at 2 and 6 years post-baseline. Weight and BMI were recorded at each visit.

TAKEAWAY:

• The surgery group experienced marked reductions in unadjusted BMI, weight, and body fat of 11.9%, 36.5%, 4.2%, respectively, from baseline to 11.5 years (P < .0001), whereas the nonsurgery group showed no significant changes in these measures.
• At 11.5 years, submaximal treadmill test duration was an average of 66.4 seconds longer in the nonsurgery group after adjusting for sex, weight, and baseline treadmill time than in the nonsurgery group (adjusted mean treadmill time, 630.7 seconds vs 564.3 seconds; P < .01).
• Mean duration of the maximal treadmill test in the surgery group rose from 658 seconds at baseline to 882.8 seconds at 2 years but dropped to 841.7 seconds at 6 years. In the nonsurgery group, it increased from 617.2 seconds at baseline to 632.6 seconds at 2 years and to 696 seconds at 6 years.
• Participants who sustained weight loss after surgery performed markedly better on submaximal treadmill tests than those with significant weight regain (675 seconds vs 584.1 seconds).

IN PRACTICE:

"Given the role of both bariatric surgery and high fitness in reducing morbidity and mortality, patients and physicians should couple the initial fitness improvements from surgery with an opportunity for structured exercise interventions to establish a foundation for long-term habits of physical activity and exercise, minimizing weight recurrence, retaining muscle and cardiovascular fitness, and ensuring long-term health benefits," the authors wrote.

SOURCE:

The study, led by Taggert J. Barton, Brigham Young University, Provo, Utah, was published online in Obesity.

LIMITATIONS: 

The study population was relatively homogeneous, consisting primarily of White participants. Because participants willingly completed multiple treadmill tests, they probably represented a healthier subset of the parent study population. Using weight-bearing exercise testing as the sole fitness indicator limited the ability to detect changes independent of weight loss.

DISCLOSURES:

This study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases and National Center for Research Resources. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.