Perceived Barriers and Facilitators to Physical Activity in Patients Undergoing Bariatric Surgery: A Systematic Review of Qualitative Studies

People with obesity encounter barriers that shape adherence to lifestyle interventions. This systematic review examined barriers and facilitators to physical activity from the perspective of patients undergoing bariatric surgery. A literature search across 4 databases identified studies published through July 31, 2025; 16 met inclusion criteria. 4 overarching thematic units emerged: internal psychological, internal physical, external social, and external environmental factors. Internal physical barriers were the most frequently reported (14 studies), with pain and functional limitations being the most common. Among facilitators, internal psychological factors predominated and were cited in 11 studies. Behavioral strategies and positive associations with physical activity were the most frequent. Overall, the findings highlight physical and psychosocial determinants influencing engagement in physical activity among this population and support multilevel interventions to enhance participation.