Physical Activity After Weight Loss Surgery*

Choose the topic:

• Before the surgery
• The first few days after the surgery
• The first few weeks at home
• Benefits of exercising

Weight loss surgery is a surgical procedure designed to help a person lose excess body weight. The primary idea of the procedure is to physically reduce calorie intake by altering the structure of the gastrointestinal tract by performing gastric bypass or sleeve gastrectomy. There is no doubt about the importance of the surgical part of the procedure; however, the patient’s commitment is equally important in adopting a physically active lifestyle along with healthy eating habits which are critical for the long-term success and better health after the surgery.

Before the surgery

The best thing a weight-loss surgery candidate can do is to start an exercise program (e.g. start walking) prior to the surgery. This step will help you reduce weight, improve your heart condition and therefore minimize the risk of surgery complications. It  also helps you build a regime you can resume after the recovery.

However, it is very important to control the level of activities and not exert your body resources. Do not forget about the upcoming intervention. Exercising before the surgery helps you to prepare for the weight loss surgery both physically and mentally.

The first few days after the surgery at the clinic

Recovery after weight loss surgery depends on the type of surgery. It can be performed using a laparoscope which is a minimally invasive approach,or as an open surgery using a scalpel and opening up the abdominal cavity. After the laparoscopic surgery you will feel less pain and will be able to return to your daily activities sooner. The recovery following open surgery will take more time, so it is even more important to start early rehabilitation. The type of the procedure also determines the amount of physical activity after the procedure, ranging from a couple of days for a laparoscopic procedure to a couple of weeks afteran open surgery.

Your physical activity during the stay at a hospital after the procedure must be very cautious. On the first day after the surgery you are encouraged to do breathing exercises, change positions in bed, sit up, or even carefully stand up and take a walk. At first you may not feel well enough to move, but it is very important to try your best and do as much as possible, until you can walk around as your strength improves. Such activities help promote blood circulation and prevent blood clots from forming. Exercising also shortens the recovery time for weight loss surgery patients and reduces the risk of other postsurgical complications. However, not being cautious enough might lead to the rupture of the sutures, herniation and bleeding. The time at the clinic is crucial concerning the recovery from the intervention, so it is very important to be careful in promoting and controlling the increase of your physical activity.

The first few weeks at home

During the first few weeks after the surgery you will lose weight rapidly because of the reduced calorie intake as you eat less food. Due to this, your body will naturally seek for energy from your muscles. This means that with weight loss you will also lose muscle mass which leads to organ and body function impairment. Physical activity increases your muscle mass, so your body will gradually shift from using the muscle depotand start using the fat storage instead. Therefore, exercise is necessary to preserve the lean body mass and reduce fat mass even after the surgery has already been done.

After returning home from the hospital, start slow and gradually increase your physical activity. Walk around the house, do some light household works, use of stairs is also encouraged. Walking is one of the best exercises for overweight people, as it loads the joints minimally, so the risk of joint pain and damageis low. You can start walking 10 min a day, rest when necessary and gradually increase the walking time and distance. Tracking your progress with a pedometer or an app on your smart phone can be motivating too. So the first couple of weeks should befocused on getting back into performing your normal daily activities.

From two to four weeks after the procedure, if your doctor says it is fine, you may start or continue your exercise program. Also start gradually, choose physical activities that you enjoy as you will be more likely to stick to them. This includes walking, swimming, dancing, bicycling, yoga, etc. Swimming is suitable for people with joint problems. You can start to swim when all wounds have completely healed, usually after 2-3 weeks. To lower the risk of developing a hernia, all strenuous activity should be avoided for three to six weeks following the surgery. This includes lifting anything heavier than 10kg, doing push or pull motions such as vacuuming, or housework with raised arm. Also you should avoid any contact sports at this time. To conclude, maintenance of the reached weight is done by sticking to the changed lifestyle.

The increase and recovery of physical and social activity is individual. Usually after the gastric bypass surgery or sleeve gastrectomy you will not be able to go to work for some time depending on the type of work. Generally,it is two weeks for an office job and up to 4-6 weeks for a more physically demanding workplace. If you are not taking any medication that alters your driving ability, you should be able to drive in two weeks after the surgery.

It is important to note that you may resume sexual activity when you feel physically and emotionally stable. For young parents it is important to remember that lifting and playing with their kids might be a more strenuous activity than expected. It may cause some unintended adverse effects if done incautiously duringthe first weeks after the surgery. Even though physical activity individually determines social integration, it should be encouraged as it helps to adapt to the changes after the procedure.

Long term benefits of exercising

Exercising is one of the most important components of a person’s overall wellness. Physical activity helps maintain and develop muscle strength and tone, endurance, it promotes joint stability and enhances bone strength. Additionally, exercise lowers your arterial pressure and reduces the risk of developing heart disease, diabetes; the risk of some types of cancer is reduced, too. A lot of somatoformic disturbances, depression and cognitive impairment are all improved withthe increase of physical activity. Also, it is reported that people experience mental improvement, elevated mood, boosted self-confidence, well-being and reduced stress with the help of it. To sum up, exercising is not only necessary for the successful maintenance of your reduced body weight, but is equally important for your overall health and well-being.