Impact of Aerobic and Body Weight Resistance Training Program in Post-bariatric Surgery Rehabilitation: A Double-blind Randomised Controlled Trial

Introduction: Obesity is linked to a wide range of comorbidities affecting multiple systems of the body, including the cardiovascular and metabolic systems and is therefore considered a major public health concern. Bariatric surgery has increasingly executed intervention for weight loss and for alleviating obesityrelated co-morbidities. Additionally, mild aerobic and body weight resistance training are essential components of physical therapy for postoperative recovery and for optimising clinical outcomes in post-bariatric surgery patients. Aim: To assess the effectiveness of body weight resistance training and aerobic exercise regimen in post-bariatric surgery patients. Materials and Methods: A double-blind, Randomised Controlled Trial (RCT) was conducted at Bariatric Surgery Centre, Hope Obesity and Super Speciality Hospital, Ahmedabad, Gujarat, India, for a duration of one year (March 2022 to March 2023) to allow for recruitment, intervention and follow-up. A total of 132 post-bariatric surgery patients were enrolled for the study considering the dropout rate. However, 88 patients undergoing bariatric surgery were included and categorised into two groups (control and experimental) of 44 patients each. The control group received counseling on lifestyle modification, elimination of sedentary behaviour and enhancing physical activity and brisk walking. The experimental group, in addition to receiving the same counseling, participated in a structured body weight resistance and aerobic exercise protocol for three months. Outcome measures evaluated consisted of aerobic capacity and body composition. Statistical analysis involved the F-test and post-hoc Dunn’s test for comparison across different intervals, while the Mann-Whitney U test was performed for analysis of parameters between groups. A p-value ≤0.05 was considered statistically significant. Results: Both groups showed significant improvements in Body Mass Index (BMI), Body Fat Percentage (BFP), Waist Circumference (WC) and aerobic capacity (VO2peak). BMI decreased from 38.13±7.64 kg/m2 to 30.7±6.35 kg/m2 in the control group and from 37.86±5.17 kg/m2 to 29.91±4.13 kg/m2 in the experimental group. BFP declined from 40.38±2.71% to 35.42±4.66% in the control group and from 40.43±2.75% to 34.29±4.76% in the experimental group. WC reduced from 48.61±4.16 cm to 41.43±3.62 cm in the control group and from 47.75±4.43 cm to 34.84±4.88 cm in the experimental group. VO2peak increased from 10.39±2.78 mL/kg/min to 12.08±2.66 mL/kg/min in the control group and from 10.41±2.39 mL/kg/min to 13.11±2.38 mL/kg/min in the experimental group (p-value <0.05). Compared to the control group, the experimental group demonstrated significantly greater improvements in BFP, WC (p-value <0.001) and VO2peak (p-value=0.011). BMI reductions were comparable between groups, with no statistically significant difference (p-value=0.396). The structured exercise intervention was well-tolerated, with high adherence rates and no reported adverse events. Conclusion: This study evaluated the effectiveness of a structured exercise regimen combining aerobic and body weight resistance training in post-bariatric surgery patients. The results demonstrated that while both the control and experimental groups achieved significant improvements in BMI, BFP, WC and VO2peak, the experimental group showed significantly greater improvements in VO2peak, BFP and WC. BMI reduction was comparable in both groups. These findings suggest that incorporating structured exercise training in postbariatric rehabilitation enhances key physiological outcomes beyond those achieved through lifestyle counseling alone, supporting the integration of exercise interventions into routine postoperative care for bariatric patients.