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Thorhauge KAL, Hansen JB, Jensen J, Nalepa IF, Burcharth J. Feasibility of app-based home monitoring after abdominal surgery: A systematic review. Am J Surg 2024:115764. [PMID: 38830790 DOI: 10.1016/j.amjsurg.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/03/2024] [Accepted: 05/15/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Abdominal surgery presents great challenges postoperatively. Considering financial healthcare constraints, the use of mobile applications has received increased interest. This systematic review was conducted to assess and report the feasibility of app-based home monitoring after abdominal surgery. METHODS MEDLINE, EMBASE, and The Cochrane Library were searched on the October 17, 2023. This systematic review was conducted in accordance with the PRISMA guidelines. RESULTS Thirty-six articles were included, 17 of these originating from USA or Canada. The response rate varied between 11.9 % and 100 %. Bariatric, upper gastrointestinal, and colorectal surgery reported the highest response rates. All included studies had a degree of bias. CONCLUSION This study found varying response rates. The data indicated that the response rates were high within bariatric surgery, with additional factors potentially affecting this. The degree of bias was generally high, and the quality of the included studies limits the conclusions.
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Affiliation(s)
- Klara Amalie Linde Thorhauge
- Department of Gastrointestinal and Hepatic Diseases, Copenhagen University Hospital - Herlev and Gentofte, Denmark; Emergency Surgery Research Group Copenhagen (EMERGE Cph), Copenhagen University Hospital - Herlev and Gentofte, Denmark.
| | - Jannick Brander Hansen
- Department of Gastrointestinal and Hepatic Diseases, Copenhagen University Hospital - Herlev and Gentofte, Denmark; Emergency Surgery Research Group Copenhagen (EMERGE Cph), Copenhagen University Hospital - Herlev and Gentofte, Denmark.
| | - Julie Jensen
- Department of Gastrointestinal and Hepatic Diseases, Copenhagen University Hospital - Herlev and Gentofte, Denmark; Emergency Surgery Research Group Copenhagen (EMERGE Cph), Copenhagen University Hospital - Herlev and Gentofte, Denmark.
| | - Isabella Flor Nalepa
- Faculty of Science, University of Copenhagen, Nørre Campus, Universitetsparken, 2100 København Ø, Denmark.
| | - Jakob Burcharth
- Department of Gastrointestinal and Hepatic Diseases, Copenhagen University Hospital - Herlev and Gentofte, Denmark; Emergency Surgery Research Group Copenhagen (EMERGE Cph), Copenhagen University Hospital - Herlev and Gentofte, Denmark.
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Sundgot-Borgen C, Bond DS, Rø Ø, Sniehotta F, Kristinsson J, Kvalem IL. Associations of adherence to physical activity and dietary recommendations with weight recurrence 1-5 years after metabolic and bariatric surgery. Surg Obes Relat Dis 2024; 20:383-390. [PMID: 38160134 DOI: 10.1016/j.soard.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/07/2023] [Accepted: 11/12/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Little is known about longer-term adherence to recommended physical activity (PA) and dietary behaviors after metabolic and bariatric surgery (MBS) and whether adherence is associated with weight recurrence. OBJECTIVES To explore (1) changes in and associations between adherence to PA and general dietary recommendations after MBS and (2) whether PA and dietary behaviors interact to predict weight recurrence. SETTING University hospital; public practice. METHODS Participants completed ActiGraph PA monitoring, dietary questionnaire, and weighing 1 and 5 years after surgery. Parametric and non-parametric tests evaluated changes in and associations between adherence to PA and dietary recommendations. Multiple linear regression explored associations of adherence and weight recurrence 5 years post-surgery. RESULTS A total of 73 participants (66% loss to follow-up, 80.8% females) were included. From 1 to 5 years after surgery, adherence to PA recommendations did not change (23.5% versus 20.5%, P = .824), whereas adherence to dietary recommendations decreased (P = <.001). Adherence to PA recommendations is positively associated with eating fruits and vegetables and limiting intake of sugar and fat at 1 year (P < .05) and negatively associated with choosing meat with less fat at 5 years (P = .018). Adherence to PA and dietary behaviors did not independently contribute or interact to predict weight recurrence. CONCLUSIONS Adherence to recommendations was poor. Dietary adherence decreased from 1 to 5 years post-surgery, whereas PA adherence remained stable. PA adherence was positively associated with adherence to some dietary recommendations at 1 year but not at 5 years. Neither behavioral adherences were associated with weight recurrence. Additional research is needed to understand how to improve adherence and its relationship with other health outcomes after MBS.
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Affiliation(s)
- Christine Sundgot-Borgen
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
| | - Dale S Bond
- Departments of Surgery and Research, Hartford Hospital, Hartford, Connecticut
| | - Øyvind Rø
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Falko Sniehotta
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom; Department of Public Health, Preventive and Social Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jon Kristinsson
- Center for Morbid Obesity and Bariatric Surgery, Oslo University Hospital, Oslo, Norway
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Bond DS, Smith KE, Schumacher LM, Vithiananthan S, Jones DB, Papasavas P, Webster J, Thomas JG. Associations of daily weight management-focused social support with weight loss, activity behaviors, and eating regulation in the context of metabolic and bariatric surgery. Obes Sci Pract 2024; 10:e717. [PMID: 38263993 PMCID: PMC10804323 DOI: 10.1002/osp4.717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/03/2023] [Accepted: 10/12/2023] [Indexed: 01/25/2024] Open
Abstract
Objective Greater perceived social support (PSS) is associated with more favorable changes in weight loss, activity behaviors, and eating regulation after metabolic and bariatric surgery (MBS). However, studies have relied on generic, retrospective PSS measures, and stability of PSS levels and relations with weight loss and weight-related behaviors over time is unknown. Using smartphone-based Ecological Momentary Assessment, this study evaluated pre-to 1-year post-MBS changes in daily weight management-focused PSS and associations with weight loss, device-measured activity behaviors, and eating regulation before and during the initial year after MBS. Method Adult MBS patients (n = 71) received (1) an accelerometer to measure daily moderate-to-vigorous intensity physical activity (MVPA) and sedentary time (ST) minutes/day, and (2) a smartphone to complete morning weight-focused PSS ratings and eating regulation (dietary restraint/disinhibition) ratings at four semi-random times daily for 10 days at pre- and 3, 6, and 12-month postoperative. Generalized linear mixed models analyzed the associations of PSS with total weight loss (%TWL) and activity/eating outcomes. Results Participants on average reported relatively stable moderate-to-high PSS (3.98 on one to five scale) across assessments. Perceived social support was not related to %TWL, MVPA, or ST. Participants with higher PSS reported lower disinhibition and higher restraint than those with lower PSS (ps < 0.05); however, participants reported higher restraint on days that PSS was lower than their usual levels (p = 0.009). Conclusions MBS patients on average had stable PSS levels across time. Higher PSS levels were associated with greater resistance to overeating cues (disinhibition) and cognitive control to restrict food intake (restraint) over time. Additionally, participants reported higher restraint when PSS levels were lower than usual. Overall, weight-focused PSS appeared to hold greater importance in relation to regulating eating behavior than engaging in activity behaviors or weight loss among MBS patients during the initial postoperative year. Clinical Trial Registration NCT02777177.
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Affiliation(s)
- Dale S. Bond
- Department of SurgeryHartford HospitalHartfordConnecticutUSA
- Department of ResearchHartford HospitalHartfordConnecticutUSA
| | - Kathryn E. Smith
- Department of Psychiatry and Behavioral SciencesUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Leah M. Schumacher
- Department of Social and Behavioral SciencesCollege of Public HealthTemple UniversityPhiladelphiaPennsylvaniaUSA
- Center for Obesity Research and EducationCollege of Public HealthTemple UniversityPhiladelphiaPennsylvaniaUSA
| | | | - Daniel B. Jones
- Department of SurgeryRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | | | - Jennifer Webster
- Department of Psychiatry and Human BehaviorWeight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Brown Alpert Medical SchoolProvidenceRhode IslandUSA
| | - J. Graham Thomas
- Department of Psychiatry and Human BehaviorWeight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Brown Alpert Medical SchoolProvidenceRhode IslandUSA
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Bond DS, Heinberg LJ, Crosby RD, Laam L, Mitchell JE, Schumacher LM, Gunstad J, Steffen KJ. Associations Between Changes in Activity and Dietary Behaviors after Metabolic and Bariatric Surgery. Obes Surg 2023; 33:3062-3068. [PMID: 37312009 DOI: 10.1007/s11695-023-06682-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 06/01/2023] [Accepted: 06/08/2023] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Patients who undergo metabolic and bariatric surgery (MBS) are advised to make healthy activity and dietary changes. While previous research has examined post-surgical changes in activity and dietary behaviors separately, no study has assessed whether changes in these behaviors are beneficially associated with each other. We evaluated whether post-surgical improvements in activity behaviors related to favorable changes in dietary behaviors overall and by surgery type (Roux-en-Y gastric bypass [RYGB], sleeve gastrectomy [SG]). METHODS At pre-surgery and 6- and 12-months post-surgery, participants (N = 97; 67 RYGB/30 SG) wore an accelerometer for 7 days and completed 24-h dietary assessments on 3 days. General linear models assessed associations between pre- to post-surgical changes in activity (moderate-to-vigorous physical intensity activity [MVPA], sedentary time [ST]) and dietary (total energy intake [EI; kcal/day], dietary quality [healthy eating index/HEI scores]) behaviors, with surgery type as a moderator. RESULTS Participants on average: demonstrated small, non-significant post-surgical changes in MVPA and ST minutes/day (ps > .05); and reported significant post-surgical decreases in EI (p < .001), but no changes in HEI scores (ps > .25). Greater 12-month post-surgical increases in MVPA were significantly associated with greater decreases in EI, but only for RYGB participants (p < .001). DISCUSSION Participants reported large decreases in EI, but made minimal changes in other behaviors after MBS. Results suggest greater increases in MVPA could assist with achieving greater decreases in EI, although this benefit appears to be limited to RYGB patients. Additional research is needed to confirm these findings and determine whether activity-dietary behavior associations differ beyond the immediate post-surgical year.
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Affiliation(s)
- Dale S Bond
- Departments of Surgery and Research, Hartford Hospital/HealthCare, 80 Seymour Street, Harford, CT, 06102, USA.
| | - Leslie J Heinberg
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
| | - Ross D Crosby
- Sanford Center for Biobehavioral Research, Fargo, ND, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Leslie Laam
- Sanford Center for Biobehavioral Research, Fargo, ND, USA
| | - James E Mitchell
- Sanford Center for Biobehavioral Research, Fargo, ND, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Leah M Schumacher
- Department of Kinesiology, College of Public Health, Temple University, Philadelphia, PA, USA
| | - John Gunstad
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Kristine J Steffen
- Sanford Center for Biobehavioral Research, Fargo, ND, USA
- Department of Pharmaceutical Sciences, North Dakota State University, Fargo, ND, USA
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Emerson JA, Schumacher LM, Bond DS, Thomas JG, Lillis J. Physical activity changes during an automated online weight loss program. J Behav Med 2023; 46:680-688. [PMID: 36602619 DOI: 10.1007/s10865-022-00383-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 11/06/2022] [Indexed: 01/06/2023]
Abstract
Evidence-based online behavioral weight loss (BWL) treatment targets a combination of diet, physical activity, and behavioral skills training. While weight loss outcomes are well documented, little is known about changes in physical activity. This study examined changes in objectively measured physical activity across the energy expenditure spectrum during a fully automated, online BWL program. Adults with overweight or obesity (n = 63) completed a 12-week, online BWL program. Participants wore an accelerometer for 7 days and body weight was measured in-clinic at pre- and post-treatment. At post-treatment, mean daily moderate-to-vigorous physical activity increased by about 4 min (SE = 1.59, p = 0.01). There were no statistically significant changes in light physical activity or time spent sedentary (p's > 0.05). Despite only minimal changes in moderate-to-vigorous physical activity overall, larger increases correlated with greater weight loss (r = - 0.28, p = 0.02), which averaged 6.1% of baseline weight at post-treatment. Though achieving important weight loss outcomes, online programs may fail to produce clinically relevant improvements in physical activity, which can put weight loss maintenance at risk.
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Affiliation(s)
- Jessica A Emerson
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903, USA
| | - Leah M Schumacher
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 222 Richmond St., Providence, RI, 02903, USA
| | - Dale S Bond
- Hartford Hospital/Hartford HealthCare, 80 Seymour Street, Hartford, CT, 06106, USA
| | - J Graham Thomas
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903, USA.
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 222 Richmond St., Providence, RI, 02903, USA.
| | - Jason Lillis
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 222 Richmond St., Providence, RI, 02903, USA
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Nuijten MAH, Eijsvogels TMH, Sanders B, Vriese LM, Monpellier VM, Hazebroek EJ, Janssen IMC, Hopman MTE. Changes in Fat-Free Mass, Protein Intake and Habitual Physical Activity Following Roux-en-Y Gastric Bypass Surgery: A Prospective Study. Obes Surg 2023; 33:2148-2157. [PMID: 37249699 PMCID: PMC10228447 DOI: 10.1007/s11695-023-06650-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/05/2023] [Accepted: 05/12/2023] [Indexed: 05/31/2023]
Abstract
PURPOSE Large inter-individual variations in post-bariatric fat-free mass loss (FFML) are observed, which might relate to differences in protein intake and physical activity across patients. We performed repetitive assessments of protein intake and physical activity before and after banded Roux-en-Y gastric bypass surgery, and examined its relations to FFML during 6 months of follow-up. MATERIALS AND METHODS FFML (bio-impedance analyses), protein intake (24-h dietary recalls) and moderate-to-vigorous physical activity (MVPA; activPAL) were assessed in 28 patients (4 males, age 42 ± 12 years) before surgery and at 1-, 3- and 6-months post-surgery. Changes in protein intake and MVPA were evaluated with mixed model analysis, whereas associations with FFML were assessed by univariate regression analysis. RESULTS Six-month FFML was -7.3 ± 3.6 kg. Protein intake decreased from 80 ± 29 g/day (pre-surgery) to 45 ± 26 g/day (1 month post-surgery (P < 0.001)) and did not improve thereafter (51 ± 21 g/day; P > 0.05). Seven participants (25%) consumed ≥ 60 g protein/day at 6 months post-surgery. Participants performed 7394 ± 2420 steps/day in 54 ± 20 min/day of MVPA, which did not change from pre- to post-surgery (P > 0.05). A higher step count (B = -0.002; 95%CI = [-0.004 - 0.000]; P = 0.048) and higher level of MVPA (B = -0.29; 95%CI = [-0.54 - -0.03]; P = 0.018) were related to a lower FFML. CONCLUSION A lower post-surgery FFML was attributable to higher MVPA levels but not protein intake. This may be due to the low total protein intake and the observation that only a minority of patients achieved a protein intake ≥ 60 g/day. Future studies should focus on interventions to increase post-bariatric protein intake and MVPA levels.
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Affiliation(s)
- Malou A H Nuijten
- Department of Medical BioSciences (Route 928), Radboud University Medical Center, P.O. Box 1901, 6500 HB, Nijmegen, The Netherlands
- Nederlandse Obesitas Kliniek, Huis Ter Heide, The Netherlands
| | - Thijs M H Eijsvogels
- Department of Medical BioSciences (Route 928), Radboud University Medical Center, P.O. Box 1901, 6500 HB, Nijmegen, The Netherlands
| | - Boy Sanders
- Nederlandse Obesitas Kliniek, Huis Ter Heide, The Netherlands
| | - Laura M Vriese
- Department of Medical BioSciences (Route 928), Radboud University Medical Center, P.O. Box 1901, 6500 HB, Nijmegen, The Netherlands
| | | | - Eric J Hazebroek
- Department of Surgery, Rijnstate Hospital/Vitalys Clinics, Arnhem, The Netherlands
| | | | - Maria T E Hopman
- Department of Medical BioSciences (Route 928), Radboud University Medical Center, P.O. Box 1901, 6500 HB, Nijmegen, The Netherlands.
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Smith KE, Varnado A, Thomas JG, Vithiananthan S, Jones DB, Papasavas P, Bond DS. Characterizing the Course of Loss of Control Eating and Prognostic Factors Following Bariatric Surgery: an Exploratory Analysis. Obes Surg 2023; 33:1170-1177. [PMID: 36808385 PMCID: PMC10079698 DOI: 10.1007/s11695-023-06497-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 02/21/2023]
Abstract
PURPOSE Postoperative loss of control eating (LOCE) has detrimental associations with weight outcomes and mental health following bariatric surgery. However, little is known regarding LOCE course following surgery and preoperative factors that predict remittance, continuance, or development of LOCE. The present study aimed to characterize LOCE course in the year following surgery by identifying four groups: individuals with (1) postoperative de novo LOCE, (2) maintained LOCE (endorsed at pre- and post-surgery), (3) remitted LOCE (endorsed only at pre-surgery), and (4) those who never endorsed LOCE. Exploratory analyses examined group differences in baseline demographic and psychosocial factors. MATERIALS AND METHODS A total of 61 adult bariatric surgery patients completed questionnaires and ecological momentary assessment at pre-surgery and 3-, 6-, and 12-month postoperative follow-ups. RESULTS Results showed that 13 (21.3%) never endorsed LOCE prior to or after surgery, 12 (19.7%) developed LOCE after surgery, 7 (11.5%) evidenced remittance from LOCE after surgery, and 29 (47.5%) maintained LOCE prior to and after surgery. Relative to those who never endorsed LOCE, all groups who evidenced LOCE before and/or after surgery reported greater disinhibition; those who developed LOCE reported less planned eating; and those with maintained LOCE reported less satiety sensitivity and greater hedonic hunger. CONCLUSION These findings highlight the importance of postoperative LOCE and need for longer-term follow-up studies. Results also suggest a need to examine the longer-term impact of satiety sensitivity and hedonic eating on LOCE maintenance, and the extent to which meal planning may buffer risk for de novo LOCE following surgery.
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Affiliation(s)
- Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, 90033, USA.
| | - Aimee Varnado
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, 90033, USA
| | - J Graham Thomas
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, RI, 02903, USA
| | | | - Daniel B Jones
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Pavlos Papasavas
- Department of Surgery, Hartford Hospital/HealthCare, Hartford, CT, 06106, USA
| | - Dale S Bond
- Department of Surgery, Hartford Hospital/HealthCare, Hartford, CT, 06106, USA
- Department of Research, Hartford Hospital/HealthCare, Hartford, CT, 06106, USA
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Sundgot-Borgen C, Bond DS, Sniehotta FF, Kvalem IL, Hansen BH, Bergh I, Rø Ø, Mala T. Associations of changes in physical activity and sedentary time with weight recurrence after bariatric surgery: a 5-year prospective study. Int J Obes (Lond) 2023; 47:463-470. [PMID: 36828898 PMCID: PMC9951836 DOI: 10.1038/s41366-023-01284-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Increasing physical activity and limiting sedentary time may minimize weight recurrence after bariatric surgery. However, few studies have evaluated potential associations of objectively-measured physical activity and sedentary time with post-surgical weight recurrence over time. AIMS To evaluate associations of change in physical activity and sedentary time with weight recurrence after bariatric surgery. METHODS Participants from the Oslo Bariatric Surgery Study, a prospective cohort study, wore an ActiGraph monitor for seven days at 1- and 5 years after surgery to assess daily physical activity and sedentary time. Participants' weight was measured at in-person clinic visits. Chi-square Test and Paired-samples T-test evaluated group differences and change over time, while Pearson's Correlation, multiple logistic and linear regression investigated associations between variables. RESULTS Five years after surgery 79 participants (70.5% response rate, 81% female) (mean (sd) age: 54.0 (±9.3), BMI: 32.1 (±4.7)) had valid monitor data. Participants increased their sedentary time (71.4 minutes/day (95% CI: 54.2-88.6, p = <0.001)) and reduced daily steps (-1411.1 (95% CI: 737.8-208.4), p = <0.001), light physical activity (-54.1 min/day (95% CI: 40.9-67.2, p = <0.001)), and total physical activity (-48.2 (95% CI: 34.6-63.3), p = <0.001) from 1- to 5 years after surgery. No change was found for moderate-to-vigorous intensity physical activity. No associations were found between changes in steps, physical activity or sedentary time and weight recurrence. CONCLUSION Participants increased sedentary time and decreased light- and total physical activity between 1- and 5 years post-surgery. Overall, changes in physical activity and sedentary time were not associated with weight recurrence. Interventions to help patients increase physical activity and limit sedentary time after bariatric surgery are needed.
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Affiliation(s)
- C. Sundgot-Borgen
- grid.55325.340000 0004 0389 8485Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - D. S. Bond
- grid.277313.30000 0001 0626 2712Department of Surgery and Research, Hartford Hospital, Hartford, CT USA
| | - F. F. Sniehotta
- grid.1006.70000 0001 0462 7212Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK ,grid.7700.00000 0001 2190 4373Department of Public Health, Preventive and Social Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - I. L. Kvalem
- grid.5510.10000 0004 1936 8921Department of Psychology, University of Oslo, Oslo, Norway
| | - B. H. Hansen
- grid.23048.3d0000 0004 0417 6230Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | | | - Ø. Rø
- grid.55325.340000 0004 0389 8485Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - T. Mala
- grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, University of Oslo, Oslo, Norway ,grid.55325.340000 0004 0389 8485Center for Morbid Obesity and Bariatric Surgery, Oslo University Hospital, Oslo, Norway
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