Metabolic efficiency and cardiorespiratory adaptations to endurance and resistance exercise programs in post-bariatric surgery patients with sub-optimal weight loss

Abstract

Obesity is a significant and highly prevalent disease with several musculoskeletal, cardiovascular, endocrine and psychological negative consequences and is associated with an increased mortality risk. Bariatric surgery is the mainstay treatment option for patients with severe obesity. Despite its well-recognized benefits, bariatric surgery is associated with substantial decreases in lean mass, namely skeletal muscle mass, which can negatively affect physical function, metabolism, and cardiovascular health. Exercise training effectively tackles some of these limitations of bariatric surgery and increases the long-term sustainability of many bariatric surgery benefits. Nevertheless, it is still not clear what should be the most adequate exercise prescription for post-bariatric surgery patients. To address this purpose, we performed a single-center, open-label, randomized clinical trial comparing two exercise interventions -endurance (EEG) vs resistance (REG) training- for a period of 16 weeks. Analyzing the cardiorespiratory fitness (CRF) and energy metabolism efficiency in adult patients of both genders with obesity that underwent bariatric surgery in the preceding 18 to 24 months and experienced sub-optimal weight loss. Our results indicate that EEG had significantly higher relative to body weight (RelBW) peak V̇O2, maximal heart rate and speed attained during the cardiopulmonary exercise test (CPET), as well as in heart rate and pulse oxygen response at sub-maximal intensities. These findings suggest that, even for this specific population, endurance exercise is not only more effective at increasing cardiorespiratory fitness but also more effective at improving some parameters related to metabolic efficiency, when compared to resistance exercise.