Bariatric surgery, weight loss and the role of physical activity: a systematic review


  • Manuel Moya
  • Artur Hernández
  • Jose Manuel Sarabia
  • Miguel Ángel Sánchez-Martos
  • Jose Luis Hernández-Davó
  • Raúl López-Grueso
  • Adolfo Aracil
  • Diego Pastor
  • Jaime Fernández-Fernández


Obesity has become one of the major health problems of today’s society, being considered as an epidemic. For people with morbid obesity (Body Mass Index (BMI) ≥ 40 kg·m-2) who don’t lose weight using conventional weight reduction methods we must resort to bariatric surgery. There is controversy in the relationship between physical activity and weight loss after bariatric intervention. Therefore, the aim of this paper is to review and describe the different research existing about this topic. A literature review of Medline and Scopus databases was performed. From a total of 128 articles and after the exclusion criteria 24 full papers were read, out of which, 21 were observational research and 3 were experimental research. We found that physical activity positively correlated with weight loss; however, although there are no significant differences in the short term (six months), differences begin to be seen in the medium to long term (+ 9 months).


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Ainsworth, B. E., Haskell, W. L., Whitt, M. C., Irwin, M. L., Swartz, A. M., Strath, S. J., O'Brien, W. L., Bassett, D. R. Jr., Schmitz, K. H., Emplaincourt, P. O., Jacobs, D. R. Jr., & Leon, A. S. (2000). Compendium of Physical Activities: an update of activity codes and MET intensities. Medicine & Science in Sports & Exercise, 32(9; Suppl/1):S498-504.

Angrisani, L., Cutolo, P. P., Formisano, G., Nosso, G., & Vitolo, G. (2013). Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 10-year results of a prospective, randomized trial. Surgery for Obesity and Related Diseases, 9(3), 405-413.

Avenell, A., Broom, J., Brown, T., Poobalan, A., Aucott, L., Stearns, S. C., Smith, W. C., Jung, R. T., Campbell, M. K., & Grant, A. M. (2004). Systematic review of the long-term effects and economic consequences of treatments for obesity and implications for health improvement. Health Technology Assessment, 8 (21), pp.1-182.

Baillot, A., Mampuya, W., Comeau, E., Méziat-Burdin, A., & Langlois, M. (2013). Feasibility and impacts of supervised exercise training in subjects with obesity awaiting bariatric surgery: a pilot study. Obesity surgery, 23(7), 882-891.

Boddu, R., Snyder, B. E., Wilson, E. B., & Wilson, T. D. (2012). Optimising weight loss outcomes in bariatric surgery patients: the role of physical activity. Royal College of Surgeons in Ireland Student Medical Journal, (5), 24-27.

Bond, D. S., Evans, R. K., Wolfe, L. G., Meador, J. G., Sugerman, H. J., Kellum, J. M., & Demaria, E. J. (2004). Impact of self-reported physical activity participation on proportion of excess weight loss and BMI among gastric bypass surgery patients. The American Surgeon, 70(9), 811-814.

Bond, D. S., Jakicic, J. M., Unick, J. L., Vithiananthan, S., Pohl, D., Roye, G. D., Ryder, B. A., Sax, H. C., & Wing, R. R. (2010). Pre‐to Postoperative Physical Activity Changes in Bariatric Surgery Patients: Self Report vs. Objective Measures. Obesity, 18(12), 2395-2397.

Bond, D. S., Jakicic, J. M., Vithiananthan, S., Thomas, J. G., Leahey, T. M., Sax, H. C., Pohl, D., Ryder, B. A., & Wing, R. R. (2010). Objective quantification of physical activity in bariatric surgery candidates and normal-weight controls. Surgery for Obesity and Related Diseases, 6(1), 72-78.

Bond, D. S., Phelan, S., Wolfe, L. G., Evans, R. K., Meador, J. G., Kellum, J. M., Maher, J. W., & Wing, R. R. (2009). Becoming Physically Active After Bariatric Surgery is Associated With Improved Weight Loss and Health‐related Quality of Life. Obesity, 17(1), 78-83.

Brolin, R. E. (2002). Bariatric surgery and long-term control of morbid obesity. Jama, 288(22), 2793-2796.

Bueter, M., Thalheimer, A., Lager, C., Schowalter, M., Illert, B., & Fein, M. (2007). Who benefits from gastric banding? Obesity surgery, 17(12), 1608-1613.

Carrasco, F., Papapietro, K., Csendes, A., Salazar, G., Echenique, C., Lisboa, C., Díaz, E., & Rojas, J. (2007). Changes in resting energy expenditure and body composition after weight loss following Roux-en-Y gastric bypass. Obesity surgery, 17(5), 608-616.

Castello, V., Simões, R. P., Bassi, D., Catai, A. M., Arena, R., & Borghi-Silva, A. (2011). Impact of aerobic exercise training on heart rate variability and functional capacity in obese women after gastric bypass surgery. Obesity surgery, 21(11), 1739-1749.

Colleen, M., & Edwards, C. (1999). Success habits of long-term gastric bypass patients. Obesity surgery, 9(1), 80-82.

Colles, S. L., Dixon, J. B., & O’Brien, P. E. (2008). Hunger control and regular physical activity facilitate weight loss after laparoscopic adjustable gastric banding. Obesity surgery, 18(7), 833-840.

Cook, D. J., Mulrow, C. D., & Haynes, R. B. (1997). Systematic reviews: synthesis of best evidence for clinical decisions. Annals of internal medicine, 126(5), 376-380.

Dixon, J. B., O’Brien, P. E., Playfair, J., Chapman, L., Schachter, L. M., Skinner, S., Proietto, J., Bailey, M., & Anderson, M. (2008). Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. Jama, 299(3), 316-323.

Fontaine, K. R., Redden, D. T., Wang, C., Westfall, A. O., & Allison, D. B. (2003). Years of life lost due to obesity. Jama, 289(2), 187-193.

Forbush, S., Nof, L., Echternach, J., Hill, C., & Rainey, J. (2011). Influence of activity levels and energy intake on percent excess weight loss after Roux-en-Y gastric bypass. Obesity surgery, 21(11), 1731-1738.

Freire, R. H., Borges, M. C., Alvarez-Leite, J. I., & Correia, M. I. T. D. (2012). Food quality, physical activity, and nutritional follow-up as determinant of weight regain after Roux-en-Y gastric bypass. Nutrition, 28(1), 53-58.

Giraldo, V. A., Serna, L. A., Mustiola, C. K., López, G. L., Donado, G. J., & Toro, E. J. (2012). [Factors related with weight loss in a cohort of obese patients after gastric bypass.]. Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral, 28(3), 623-630.

Hainer, V., Toplak, H., & Mitrakou, A. (2008). Treatment Modalities of Obesity What fits whom? Diabetes care, 31(Supplement 2), S269-S277.

Herman, K. M., Carver, T. E., Christou, N. V., & Andersen, R. E. (2014). Keeping the Weight Off: Physical Activity, Sitting Time, and Weight Loss Maintenance in Bariatric Surgery Patients 2 to 16 Years Postsurgery. Obesity surgery, 24(7), 1064-1072.

Hernandez-Estefania, R., Gonzalez-Lamuno, D., Garcia-Ribes, M., Garcia-Fuentes, M., Cagigas, J., Ingelmo, A., & Escalante, C. (2000). Variables affecting BMI evolution at 2 and 5 years after vertical banded gastroplasty. Obesity surgery, 10(2), 160-166.

Jakicic, J. M., Clark, K., Coleman, E., Donnelly, J. E., Foreyt, J., Melanson, E., Volek, J., & Volpe, S. L. (2001). American College of Sports Medicine position stand. Appropriate intervention strategies for weight loss and prevention of weight regain for adults. Medicine and Science in Sports and Exercices, 33(12), 2145-2156.

Josbeno, D. A., Kalarchian, M., Sparto, P. J., Otto, A. D., & Jakicic, J. M. (2011). Physical activity and physical function in individuals post-bariatric surgery. Obesity surgery, 21(8), 1243-1249.

King, W. C., Belle, S. H., Eid, G. M., Dakin, G. F., Inabnet, W. B., Mitchell, J. E., Patterson, E. J., Courcoulas, A. P., Flum, D. R., Chapman, W. H., & Wolfe, B. M. (2008). Physical activity levels of patients undergoing bariatric surgery in the Longitudinal Assessment of Bariatric Surgery study. Surgery for Obesity and Related Diseases, 4(6), 721-728.

Kruseman, M., Leimgruber, A., Zumbach, F., & Golay, A. (2010). Dietary, weight, and psychological changes among patients with obesity, 8 years after gastric bypass. Journal of the American Dietetic Association, 110(4), 527-534.

Kwok, C. S., Pradhan, A., Khan, M. A., Anderson, S. G., Keavney, B. D., Myint, P. K., Mamas, M. A., & Loke, Y. K. (2014). Bariatric surgery and its impact on cardiovascular disease and mortality: A systematic review and meta-analysis. International journal of cardiology, 173(1), 20-28.

Larsen, J. K., Geenen, R., van Ramshorst, B., Brand, N., Hox, J. J., Stroebe, W., & van Doornen, L. J. (2006). Binge eating and exercise behavior after surgery for severe obesity: a structural equation model. International Journal of Eating Disorders, 39(5), 369-375.

Latner, J. D., Wetzler, S., Goodman, E. R., & Glinski, J. (2004). Gastric Bypass in a Low‐Income, Inner‐City Population: Eating Disturbances and Weight Loss. Obesity research, 12(6), 956-961.

Livhits, M., Mercado, C., Yermilov, I., Parikh, J. A., Dutson, E., Mehran, A., Ko, C. Y., & Gibbons, M. M. (2010). Behavioral factors associated with successful weight loss after gastric bypass. The American Surgeon, 76(10), 1139-1142.

Livhits, M., Mercado, C., Yermilov, I., Parikh, J. A., Dutson, E., Mehran, A., Ko, C. Y., & Gibbons, M. M. (2011). Patient behaviors associated with weight regain after laparoscopic gastric bypass. Obesity research & clinical practice, 5(3), e258-e265.

Madan, A. K., Beech, B., & Tichansky, D. (2008). Body esteem improves after bariatric surgery. Surgical innovation.

Mathus‐Vliegen, E., & De Wit, L. (2007). Health‐related quality of life after gastric banding. British journal of surgery, 94(4), 457-465.

Mazure Lehnhoff, R., Salgado Mijail, G., Valencia, A., Villarreal, P., Cobo, B., & Peran, S. (2007). Ejercicio físico y cirugía bariátrica. Nutrición Hospitalaria, 22(n04).

Mechanick, J. I., Kushner, R. F., Sugerman, H. J., Gonzalez-Campoy, J. M., Collazo-Clavell, M. L., Guven, S., Spitz, A. F., Apovian, C. M., Livingston, E. H., Brolin, R., Sarwer, D. B., Anderson, W. A., & Dixon, J. (2008). American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Surgery for Obesity and Related Diseases, 4(5), S109-S184.

Metcalf, B., Rabkin, R. A., Rabkin, J. M., Metcalf, L. J., & Lehman-Becker, L. B. (2005). Weight loss composition: the effects of exercise following obesity surgery as measured by bioelectrical impedance analysis. Obesity surgery, 15(2), 183-186.

Mitchell, J. E., Lancaster, K. L., Burgard, M. A., Howell, L. M., Krahn, D. D., Crosby, R. D., Wonderlich, S. A., & Gosnell, B. A. (2001). Long-term follow-up of patients' status after gastric bypass. Obesity surgery, 11(4), 464-468.

Mulrow, C., & Oxman, A. E. (1997). Cochrane Collaboration Handbook. Oxford: Cochrane Librar.

Mundi, M. S., Lorentz, P. A., Swain, J., Grothe, K., & Collazo-Clavell, M. (2013). Moderate physical activity as predictor of weight loss after bariatric surgery. Obesity surgery, 23(10), 1645-1649.

Nijamkin, M. P., Campa, A., Sosa, J., Baum, M., Himburg, S., & Johnson, P. (2012). Comprehensive nutrition and lifestyle education improves weight loss and physical activity in Hispanic Americans following gastric bypass surgery: a randomized controlled trial. Journal of the Academy of Nutrition and Dietetics, 112(3), 382-390.

O'Brien, P. E., MacDonald, L., Anderson, M., Brennan, L., & Brown, W. A. (2013). Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Annals of surgery, 257(1), 87-94.

Poirier, P., & Després, J.-P. (2001). Exercise in weight management of obesity. Cardiology clinics, 19(3), 459-470.

Pontiroli, A. E., Fossati, A., Vedani, P., Fiorilli, M., Folli, F., Paganelli, M., Marchi, M., & Maffei, C. (2007). Post-surgery adherence to scheduled visits and compliance, more than personality disorders, predict outcome of bariatric restrictive surgery in morbidly obese patients. Obesity surgery, 17(11), 1492-1497.

Ricci, C., Gaeta, M., Rausa, E., Macchitella, Y., & Bonavina, L. (2014). Early impact of bariatric surgery on type II diabetes, hypertension, and hyperlipidemia: a systematic review, meta-analysis and meta-regression on 6,587 patients. Obesity surgery, 24(4), 522-528.

Rosenberger, P. H., Henderson, K. E., White, M. A., Masheb, R. M., & Grilo, C. M. (2011). Physical activity in gastric bypass patients: associations with weight loss and psychosocial functioning at 12-month follow-up. Obesity surgery, 21(10), 1564-1569.

Rubio, M. A., Martínez, C., Vidal, O., Larrad, A., Salas-Salvadó, J., Pujol, J., Díez, I., & Moreno, B. (2004). Documento de consenso sobre cirugía bariátrica. Revista Española de Obesidad, 4, 223-249.

Ruiz-Tovar, J., Zubiaga, L., Llavero, C., Diez, M., Arroyo, A., & Calpena, R. (2014). Serum Cholesterol by Morbidly Obese Patients after Laparoscopic Sleeve Gastrectomy and Additional Physical Activity. Obesity surgery, 24(3), 385-389.

Schauer, P. R., Ikramuddin, S., Gourash, W., Ramanathan, R., & Luketich, J. (2000). Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Annals of surgery, 232(4), 515.

Seabra, A. C., Seabra, A. F., Brito, J., Krustrup, P., Hansen, P. R., Mota, J., Rebelo, A., Rêgo, C., & Malina, R. M. (2014). Effects of a 5-month football program on perceived psychological status and body composition of overweight boys. Scandinavian Journal of Medicine & Science in Sport, 24(S1), 10–16.

Shada, A. L., Hallowell, P. T., Schirmer, B. D., & Smith, P. W. (2013). Aerobic exercise is associated with improved weight loss after laparoscopic adjustable gastric banding. Obesity surgery, 23(5), 608-612.

Shah, M., Simha, V., & Garg, A. (2006). Long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. The Journal of Clinical Endocrinology & Metabolism, 91(11), 4223-4231.

Shah, M., Snell, P. G., Rao, S., Adams‐Huet, B., Quittner, C., Livingston, E. H., & Garg, A. (2011). High‐Volume Exercise Program in Obese Bariatric Surgery Patients: A Randomized, Controlled Trial. Obesity, 19(9), 1826-1834.

Shetty, P., & Schmidhuber, J. (2006). Introductory lecture the epidemiology and determinants of obesity in developed and developing countries. International journal for vitamin and nutrition research, 76(4), 157-162.

Silver, H. J., Torquati, A., Jensen, G. L., & Richards, W. O. (2006). Weight, dietary and physical activity behaviors two years after gastric bypass. Obesity surgery, 16(7), 859-864.

Sjöström, L., Lindroos, A.-K., Peltonen, M., Torgerson, J., Bouchard, C., Carlsson, B., Dahlgre, S., Larsson, B., Narbro, K., Sjöström, C. D., Sullivan, M., & Wedel, H., (2004). Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. New England Journal of Medicine, 351(26), 2683-2693.

Stegen, S., Derave, W., Calders, P., Van Laethem, C., & Pattyn, P. (2011). Physical fitness in morbidly obese patients: effect of gastric bypass surgery and exercise training. Obesity surgery, 21(1), 61-70.

Thivel, D., Chaput, J. P., Adamo, K. B., & Goldfield, G. S. (2014). Is energy intake altered by a 10-week aerobic exercise intervention in obese adolescents?. Physiology & Behavior, 135, 130–134.

Thomas, H., & Agrawal, S. (2012). Systematic review of obesity surgery mortality risk score—preoperative risk stratification in bariatric surgery. Obesity surgery, 22(7), 1135-1140.

Tompkins, J., Bosch, P. R., Chenowith, R., Tiede, J. L., & Swain, J. M. (2008). Changes in functional walking distance and health-related quality of life after gastric bypass surgery. Physical therapy, 88(8), 928-935.

Trapp, E., Chisholm, D., Freund, J., & Boutcher, S. (2008). The effects of high-intensity intermittent exercise training on fat loss and fasting insulin levels of young women. International journal of obesity, 32(4), 684-691.

Welch, G., Wesolowski, C., Piepul, B., Kuhn, J., Romanelli, J., & Garb, J. (2008). Physical activity predicts weight loss following gastric bypass surgery: findings from a support group survey. Obesity surgery, 18(5), 517-524.

Welch, G., Wesolowski, C., Zagarins, S., Kuhn, J., Romanelli, J., Garb, J., & Allen, N. (2011). Evaluation of clinical outcomes for gastric bypass surgery: results from a comprehensive follow-up study. Obesity surgery, 21(1), 18-28.

Wolfe, B. L., & Terry, M. L. (2006). Expectations and outcomes with gastric bypass surgery. Obesity surgery, 16(12), 1622-1629.

World Health Organization. (2014a). 10 facts on obesity. Retrieved 15.04.2014, 2014.

World Health Organization. (2014b). Obesity and overweight. Retrieved 15.04.14, 2014.






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