“Play an active part in the treatment of your condition”
Prior to meeting with the Exercise Therapist, the patient will normally have seen their physician and undergone a full family history and physical exam as well as some diagnostic tests such as fasting blood sugar, lipid profile (total cholesterol, LDL and HDL cholesterol, triglycerides), and thyroid hormone levels (TSH, free T4). Other tests may also be conducted in some cases such as nonalcoholic fatty liver, renal function, and testosterone levels as well as testing for deficiencies in certain vitamins and minerals. If patient exhibits signs of cardiac abnormalities such as palpitations or has a cardiac condition or high blood pressure then an ECG may be required as well.
Clinical exercise testing will be conducted in order to collect baseline information on the patient and assess their functional capacity as well as help in establishing the exercise prescription.
It is one thing having weight loss surgery and it is quite another being as ready as you can be physically for that surgery. Studies have shown that preparing by engaging in exercise before bariatric surgery helps you recover quicker and improves overall success in the future (1). The road to a more physically active life begins before surgery and must become part of a regular routine or habit.
(1) The exercise therapist’s role is to put you on the right track and help guide you in the right direction so that you engage in the much needed exercise safely and effectively.
Before surgery, your exercise therapist will help you:
(1) Toussi, R., Fujioka, K., Coleman, K.J. Pre- and post-surgery behavioral compliance, patient health, and post-bariatric surgical weight loss. Obesity, May 2009; 17:(5): 996-1002
Now that you’ve been through it, it’s time to look forward and take charge of your health by making sure you continue to engage in what will, in part, preserve and enhance your health, physical activity. The evidence is quite clear. Patients that engage in physical activity after bariatric surgery lose more weight and keep it off longer (2) and have do better outcomes overall.
The exercise therapist will continue to show you which types of exercises will help you most and what you can do to continue to challenge yourself as get more fit. She or he will also help you identify what is preventing you from engaging in the physical activity you need and what you can do to overcome these. They will follow-up with you to help you stay on track!
After your surgery, your exercise therapist will help you:
(2) Egberts, K., Brown, WA., Brennan, L., et al. Does exercise improve weight loss after bariatric surgery?A systematic review. Obesity Surgery, 2012:335-341
After performing a clinical exercise test, the exercise therapist is specifically trained to deliver evidence-based guidelines for exercise to chronic patients including obese patients. She or he will show you what exercise is best for you according to your health and fitness level and your medical condition.
The exercise therapist will also address issues of behavior change as well as lifestyle issues that may affect your health and medical condition such as stress level and sleep.
Working with other health professionals in a comprehensive, patient-centered approach, the exercise therapist will work with you on a one-on-one basis show you how exercise will be part of the medicine you need and in what doses you need to take medicines.
Note that in the National Weight Control Registry (NWCR), over 90% of the successful subjects combined exercise therapy with diet therapy (3).
(3) Klem, M.L, Wing, R.R., McGuire, M.T., Seagle, , H.M., Hill, J.O. A descriptive study of individuals successful at long term maintenance of substantial weight loss.American Journal of Clinical Nutrition, 1997; 66:239-246
Decline of about 10mmHg in systolic and diastolic BP in patients with hypertension (equivalent to most BP medications)
Decline of up to 50% in fasting glucose for newly diagnosed patients
(4) Haslam, D., Satter, N., Lean, M. ABC of Obesity. Obesity – time to wake up. British Medical Journal (BMJ), 2006; 333:640-642