A Model of Exercise Referral Scheme Before and After Bariatric Surgery for People With Obesity

Background: Obesity, as defined by the WHO, has reached pandemic levels globally, affecting about one-third of the world’s population. This multifactorial condition results from an imbalance between caloric intake and expenditure, exacerbated by genetic, epigenetic, social, and environmental factors. While bariatric surgery is the most effective long-term treatment for severe obesity, post-surgery weight regain remains a significant issue due to lack of professional support and accessible exercise facilities.

Purpose: The B-FIT project aims to develop a new referral and intervention model to improve physical activity (PA) and reduce sedentary behaviour (SB) among individuals undergoing bariatric surgery. This model seeks to prevent post-surgical weight regain and promote long-term healthy habits through supervised interventions and behaviour change techniques.

Methods: A randomized controlled trial will be conducted with a long-term follow-up (10 years) to evaluate the impact of PA and reduced SB (accelerometery) on weight control (body mass index and waist circumference), metabolic outcomes (HbA1c), and quality of life (SF-12) before and after bariatric surgery. Participants in the intervention group will be referred from the Hospital Sant Joan de Déu to the University of Vic-Central University of Catalonia for tailored exercise programs and behaviour modification support, starting 8 months pre-surgery and continuing 12 months post-surgery. The control group will follow the current hospital care protocol, which includes nutrition and PA advice without supervision pre- and post-surgery.

Discussion: Preliminary findings indicate that incorporating structured PA programs is crucial for sustaining weight loss and improving overall health post-surgery. Challenges such as accessibility to exercise facilities and professional support highlight the need for integrated care models like B-FIT.

Practical implications: The B-FIT model could serve as a blueprint for other healthcare institutions aiming to integrate PA programs into their obesity treatment protocols, potentially reducing healthcare costs associated with obesity-related comorbidities.