To be or not to be active - a matter of attitudes and social support? Women's perceptions of physical activity five years after Roux-en-Y Gastric Bypass surgery

Exploring Social Support Dynamics After Bariatric Surgery: Insights From Patients and Providers

INTRODUCTION

Weight loss after bariatric surgery is impacted by several factors, and social support is one of them. Our objective was to characterize patient and provider perceptions about social support after bariatric surgery.

METHODS

We reported a secondary analysis of qualitative data acquired from semi-structured interviews conducted from January-November 2020 with bariatric surgery patients and providers. Participants included primary care providers, health psychologists, registered dietitians, bariatric surgeons, and patients with at least 1 y of follow-up after their bariatric procedure. Interview guides were designed using a hybrid of Andersen's Behavioral Model of Health Services and Torain's Framework for Surgical Disparities. Using directed content analysis, study team members generated codes, which were categorized into themes about social support pertaining to dietary habits, physical activity, and follow-up care.

RESULTS

Forty-five participants were interviewed, including 24 patients (83% female; 79% White; mean age 50.6 ± 10.7 y) and 21 providers (six primary care providers, four health psychologists, five registered dieticians, and six bariatric surgeons). We identified four themes relating to social support affecting weight loss after surgery: (1) family involvement in helping patients adjust to the bariatric diet, (2) engagement in activities with partners/friends, (3) help with transportation to appointments, and (4) life stressors experienced by patients within their social relationships.

CONCLUSIONS

Continued assessment of interpersonal factors after bariatric surgery is essential for weight loss maintenance. Providers can contribute by reinforcing the facilitators of social support and making referrals that may help patients overcome barriers to social support for sustained weight loss after surgery.

Levels of Physical Activity, Enjoyment, Self-Efficacy for Exercise, and Social Support Before and After Metabolic and Bariatric Surgery: a Longitudinal Prospective Observational Study

INTRODUCTION

Physical activity (PA) after metabolic and bariatric surgery (MBS) can influence weight loss, health status, and quality of life. Known mediators to participate in PA are enjoyment, self-efficacy, and social support. Little is known about PA behavior in MBS individuals. The aim of this study was to explore levels of PA and the PA mediators enjoyment, self-efficacy, and social support before and after MBS and to investigate changes over time.

METHODS

Adults scheduled to undergo MBS were recruited from a Swedish university hospital. Accelerometer-measured and self-reported PA, body weight, and PA mediators were collected at baseline and at 12 to 18 months post-surgery.

RESULTS

Among 90 individuals included, 50 completed the follow-up assessment and had valid accelerometer data. Sedentary time (minutes/day) was unchanged, but sedentary time as percentage of wear time decreased significantly from 67.2% to 64.5% (p<0.05). Time spent in light PA and total PA increased significantly from 259.3 to 288.7 min/day (p < 0.05) and from 270.5 to 303.5 min/day (p < 0.01), respectively. Step counts increased significantly from 6013 to 7460 steps/day (p < 0.01). There was a significant increase in self-reported PA, enjoyment, self-efficacy for exercise, and positive social support from family. The increase in PA mediators did not lead to a significant change in time spent in moderate to vigorous PA.

CONCLUSION

The increase in PA-mediators was not associated with an increase in moderate to vigorous PA, but the strengthened PA mediators suggest potential for an increase in moderate to vigorous PA in patients undergoing MBS.

Exploring the physical activity of Iranian migrant women in the United Kingdom: a qualitative study

PURPOSE

This article explores the role migration has on the physical activity of Iranian migrant women living in the United Kingdom.

METHOD

This qualitative study includes 22 first-generation Iranian migrant women, aged 24-64, residing in London. Data was collected through in-depth, semi-structured, individual interviews and was analyzed thematically.

RESULTS

The findings show that for those women from traditional backgrounds, migration corresponds with liberation from social and cultural pressures experienced in Iran and greater motivation to adopt a physically active lifestyle. However, for Iranian women who had arrived in the UK more recently and had a higher social standing in Iran, migration was associated with the loss of their careers, sources of income, and social networks. These issues were compounded by a lack of cohesion in Iranian migrant communities and poor access to local physical activity resources. This resulted in diminishing motivation and the subsequent de-prioritisation of the women's physical activity, even though they had regularly engaged in physical activity in Iran.

CONCLUSION

Despite migration leading to improving physical activity for some Iranian women, for others, migration leads to marginality in Britain. Local authorities and Iranian community organizations need to adopt innovative strategies to reach out to recent Iranian migrant women.

A Qualitative Investigation on the Roles of Social Support on Physical Activity Behaviour among the Rural-Dwelling Older Women in Malaysia

Despite many health benefits of physical activities, both physically and mentally, the majority of the older women in the rural areas of Malaysia are showing a low prevalence of physical activities. Understanding the roles of social support to improve physical activities is imperative to promote active and healthy ageing among the rural-dwelling older women in Malaysia. Hence, this qualitative study adopted an inductive design using 17 in-depth interviews to understand the role of social support on physical activity behaviour among the rural community-dwelling older woman in Kuala Pilah District, Negeri Sembilan, Malaysia from December 2019 to January 2020. Three categories of themes were identified in this study. Firstly, adaptive social support in terms of informational, companionship and emotional supports reported enhancing physical activity levels among older women. Secondly, the absence of help and assistance from the social network asserts independence and triggers the older women to perform the activities by themselves, thus engage in physically active lifestyles. Thirdly, lacking social support demotivate older women to be engaged in physical activities. In particular, loss of companionship support, poor acceptance or appraisal support, logistic issues to attend exercise programmes and neighbourhood safety and security issues were among the main barriers of physical activities reported by the older women. The main findings of this study shed some light on the exigency of strengthening social support from the social network to engage the older women in physical activities. The roles of social media, effective patient-doctor communication and interventions targeting the spouses and family members must be strengthened to create a supportive atmosphere to enhance physical activity levels among older women.

Barriers to Physical Exercise and Associated Factors in the Pre- and Postoperative Periods of Bariatric Surgery

BACKGROUND

To compare the barriers to exercise and its associated factors among patients in the pre- and postoperative periods of bariatric surgery.

METHODS

Cross-sectional study with patients who were split into preoperative (n = 81) and postoperative (n = 209) groups. It was collected sociodemographic characteristics, and the Exercise Benefits Barriers Scale was adopted in order to identify the barriers related to exercise practice. Chi-square, Mann-Whitney, and Poisson regression were applied for comparisons and associations.

RESULTS

The postoperative group had a lower score on the barrier scale, except for the lack of time subdimension. In the preoperative, the subjects were considered physically active (p = 0.03), and those over 42 years old (p < 0.001) had the lowest score in lack of time subdimension. Those with a body mass index (BMI) higher than 36.89 kg/cm² had a higher overall score on the scale (p < 0.001), also in the lack of time (p = 0.003) and physical effort subdimensions (p < 0.001). Those with higher education scored more in the lack of time (p = 0.014) and family discouragement subdimensions (p = 0.034). In the postoperative, the participants considered active had the lowest score on the general scale, as well as in all subdimensions (p < 0.001), and the ones with higher education presented better scores in physical effort subdimension (p = 0.041).

CONCLUSIONS

The preoperative group had a higher score of barriers to practice exercises related to physical effort, environment, and family discouragement, when compared to the postoperative. The factors associated were physical inactivity, BMI over 36.89 kg/cm², age 42 years old or under, and higher education.

Bariatric Surgery: Consequences on Functional Capacities in Patients With Obesity

INTRODUCTION

Bariatric surgery leads to loss of fat and fat-free mass (FFM). To preserve FFM it is recommended that weight loss interventions are accompanied by physical activity. However, it remains unknown if functional capacities spontaneously improve after a substantial weight loss. Study's aim was to assess the effect of bariatric surgery on strength, functional capacities and quality of life of participants with a body mass index (BMI) ≥ 35 kg/m².

METHOD

Anthropometric parameters (weight, BMI, waist circumference), physical functions (quadriceps strength, walking capacity, spatio-temporal gait parameters, dynamic balance, lower limb power) and quality of life were assessed before and at three months after the bariatric surgery in 33 individuals who did not follow any physical activity program.

RESULTS

The anthropometric parameters, quality of life and three functional abilities (walking capacity, normal gait speed and lower limb power) improved significantly three months post-surgery. In contrast, fast gait speed, absolute strength, normalized strength, and dynamic balance did not improve.

DISCUSSION

A massive weight loss should be accompanied by an exercise program aiming to maintain FFM and to enhance muscle strength and balance. Such a program might also enhance functional capacities and help to sustain the weight loss over time.