Addressing non-obesity related barriers may improve bariatric surgery effectiveness

1. In a qualitative, interview-based study of 19 bariatric surgery candidates, many perceived barriers to physical activities were not obesity related such as lack of motivation, environment, and restricted resources.

Evidence Rating Level: 2 (Good)           

Study Rundown: Previous studies in the bariatric surgery population have demonstrated that the majority of candidates are aware of the importance of engaging in regular physical activity in order to acquire maximal benefits from bariatric surgery. Despite this, many continue to lead a sedentary lifestyle that consists of minimal physical exercise post-surgery. Although the barriers to physical activity have been well-studied in the over-weight and obese population, there is a paucity of data related to specific challenges faced by the bariatric population.

In this study, the authors conducted semi-structured, one-on-one interviews with 19 bariatric surgery candidates and explored the perceived barriers and facilitators to physical activities in patients scheduled to undergo bariatric surgery. At the conclusion of the study, the majority of patients agreed that physical activity was an important component of a healthy lifestyle, but reported significant physical barriers as well as feelings of helplessness from previous failed weight-loss attempts. Furthermore, many of the perceived barriers were not obesity related, but related to social factors, time management skills, and access to financial resources. The results of this study support the hypothesis that a significant number of barriers to physical activity in the bariatric population may be independent of weight-loss and advocate for the implementation of additional social supports for these patients post-surgery. An important strength of this study is its prospective study design. However, its limitations include a small sample size and recruitment of patients from a single private institution, which may limit the generalizability of this study.

Click to read the study in Obes Surg

Relevant Reading: Patterns of physical activity and sedentary behavior after bariatric surgery: an observational study

In-Depth [prospective cohort]: This is a qualitative, semi-structured, one-on-one interview study involving 19 obese adults from a private bariatric clinic who were scheduled to undergo bariatric surgery in a single institution in Australia. There were a total of 4 males and 15 females, with a mean (standard deviation) age of 41.6 (12.1) years, weight of 119.2 (20.5) kg, and BMI of 41.6 (6.7) kg/m2. Inductive thematic analysis was used to analyze the data. The authors found that although most bariatric surgery patients were aware of the importance of regular physical exercise in weight management, many of them were faced with barriers that were both obesity and non-obesity related. The obesity-related barriers included bodily pain, physical strain, self-presentational issues, as well as feelings of hopelessness due to previous failed weight-loss attempts. The most significant non-obesity related barriers were lack of motivation, environment, and restricted resources. Many bariatric surgery candidates also identified non-obesity related facilitators, including social factors, better time management, and access to financial resources, to be important determinants of regular physical exercise.

Image: CC/Flickr/US Navy
