Why exercise is essential after bariatric surgery

Bariatric surgery is more than just surgery. It's a lifestyle change that includes a lifelong commitment to eating healthy with your dietitian's guidance and incorporating regular exercise into your routine.

After bariatric surgery, patients who regularly exercise for 60 minutes six days a week lose weight more quickly and dramatically improve their capacity for exercise.

Take advantage of peak weight-loss period

The time to establish your exercise habits is before you have the surgery. Then solidify that routine during the first year after surgery, which is when people typically find it easiest to lose weight.

After bariatric surgery, your body may try to hold onto its fat stores until its other energy sources are depleted. This can lead to the loss of muscle mass after surgery. To minimize or prevent the body from using muscle mass for energy, it's crucial to work your muscles regularly.

Some of the benefits of cardio, strength and endurance training are:

• Improved heart condition, balance, stability and mood
• Increased energy, lean muscle mass and bone density
• Reduced body fat, risk of injury and stress

Amp up, change your exercise routine

When people lose weight, their energy expenditure — the number of calories the body burns — is reduced both at rest and during exercise. This means that when you lose weight, but continue the same exercise routine, you burn fewer calories than before you lost weight.

In addition, regular exercise increases your capacity and ability to work harder. As you become better conditioned, your workout will feel easier than when you first began. This is an indication that it's time to increase the exercise intensity.

You want to aim for a level of cardiorespiratory exercise that's somewhat difficult for you. One test of intensity is if you can talk in breathy sentences as you exercise. If you can't speak, scale back until you can.

Consider changing your exercise routine by trying something new. If you feel comfortable with your treadmill workout, try switching to another piece of equipment, such as an elliptical or cycle. Or take a class such as low-impact aerobics, spinning, water fitness or aerobic dance.

These tweaks to your routine can challenge your body in new ways and help maintain your interest in exercising. Workout variety also plays a significant role five to six months after bariatric surgery, when many patients experience a weight-loss plateau. Changing your exercise routine can minimize or even eliminate a plateau.

Increase exercise intensity, time, frequency

As your fitness improves, you'll be able to increase the intensity, time or frequency of your exercise routine. One way to do that is through high-intensity interval training (HIIT). As with any new form of exercise, check with your healthcare team to make sure HIIT is a good fit for you.

A HIIT workout alternates between short intense bursts of exercise and active recovery, which is like a "breather" with less intense exercise. Research shows that HIIT workouts are more effective for heart health, fat loss and strength gain than traditional cardio and strength training. HIIT can be incorporated into nearly any exercise from running to water fitness.

Pay attention to strength training

As you plan your routine, focus on muscle-strengthening exercises at least three days a week, which will also improve your bone density and metabolism. Muscle burns calories even at rest, so if you increase your muscle mass, you will burn more calories throughout the day.

You can build muscle strength using weight machines, resistance bands, free weights and your own body weight.

A new lifestyle, not a chore

You've undergone bariatric surgery not only to lose weight but also to improve your health. Reaching your goals requires changing your lifestyle, and exercise is essential to that success. Becoming a regular exerciser can be empowering, fun and open doors to meeting new people and broadening your interests.

To keep exercise from becoming a chore, find what you like to do, but switch it up to add variety and challenge your body in different ways. Cardio and strength training are both key to a successful exercise and weight-loss routine.

Next steps:

• Find bariatric surgery resources.
• Explore the option of a personal or athletic trainer.
• Watch a video on heart health and wearable fitness devices:
  

Melinda Hahm is a clinical exercise physiologist in Bariatric Surgery and a cardiac rehab tech in Cardiology in Eau Claire, Wisconsin.